Questions and Answers
What is the primary characteristic of Cell Cycle-Nonspecific (CCNS) antineoplastic drugs?
Which phase of the cell cycle is characterized by the cell copying its DNA?
What is the term for the adverse effects that prevent an antineoplastic drug from being given in higher dosages?
What is the term for a group of symptoms that cannot be directly attributed to the spread of a cancerous tumor?
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What is a common adverse effect of chemotherapy drugs?
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What is the benefit of using a combination of chemotherapy drugs?
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What type of cells are most affected by chemotherapy drugs?
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What is an example of a Cell Cycle-Specific (CCS) drug?
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At which phase of the cell cycle do mitotic inhibitors work?
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What is a common indication for the use of mitotic inhibitors?
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What is a common adverse effect of mitotic inhibitors?
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Why is it important to assess baseline blood counts before administering antineoplastic drugs?
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What is a nursing implication for patients with neutropenia or leukopenia?
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What is a measure to reduce the effects of stomatitis?
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Why is it important to monitor for therapeutic responses to antineoplastic therapies?
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What is a consideration for women of childbearing age during antineoplastic therapy?
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What is the term for the suppression of bone marrow function, resulting in a reduced number of red blood cells, white blood cells, and platelets?
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What is the lowest level of WBCs in the blood after chemotherapy or radiation treatment?
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What is the term for the unintended leakage of a chemotherapy drug into the surrounding tissues outside of the IV line?
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What type of therapy uses drugs that recognize a specific molecule involved in the growth of cancer cells, while mostly sparing healthy cells?
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What is the class of drugs that work by antagonizing the actions of key cellular metabolites?
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Which drug is used to treat severe cases of psoriasis and rheumatoid arthritis?
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What is the term for the potential of a drug to cause nausea and vomiting?
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What is the class of drugs that includes vinblastine, vincristine, and vinorelbine?
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What is the term for the hair loss caused by chemotherapy?
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What is the mechanism of action of alkylating drugs?
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Which taxane is derived from the bark of the Western (Pacific) yew tree?
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What type of tumors can cisplatin be used to treat?
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What is a common adverse effect of alkylating drugs?
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What is the purpose of hormonal therapy in cancer treatment?
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What is a contraindication for tamoxifen?
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What is an important nursing implication during chemotherapy?
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What is a potential complication associated with bone marrow suppression?
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What is the purpose of cytoprotective drugs?
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What is an oncologic emergency that may require close monitoring?
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What is a common use of methotrexate aside from cancer treatment?
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Study Notes
Cell Cycle-Nonspecific (CCNS) vs Cell Cycle-Specific (CCS) Drugs
- CCNS drugs: cytotoxic during any cell-cycle stage, miscellaneous CCS drugs, hormonal agents, and radioactive antineoplastics
- CCS drugs: cytotoxic during a specific cell-cycle phase, used to treat a variety of solid or circulating tumors
Cell Cycle Phases
- G0: resting phase
- G1: first gap phase (cell increases in size)
- S: synthesis phase (cell copies its DNA)
- G2: second gap phase (cell prepares to divide)
- M: mitosis phase (cell reproduction, cell divides)
Chemotherapy
- Drugs have a narrow therapeutic index
- Combination of drugs is usually more effective than single-drug therapy
- Drug resistance is possible
- Nearly all drugs cause adverse effects, which can be dose-limiting
- Harmful to all rapidly growing cells, including:
- Hair follicles
- Gastrointestinal (GI) tract cells
- Bone marrow cells
Chemotherapy Terms
- Dose-limiting adverse effects: adverse effects that prevent an antineoplastic drug from being given in higher dosages, often restricting the effectiveness of the drug
- Alopecia: hair loss
- Emetic potential: the potential of a drug to cause nausea and vomiting
- Myelosuppression: suppression of bone marrow function, which can result in a decreased number of red blood cells, white blood cells, and platelets
- Nadir: the lowest level of WBCs in the blood after chemotherapy or radiation treatment
Targeted Therapy
- Uses drugs that recognize a specific molecule involved in the growth of cancer cells, while mostly sparing healthy cells
- Examples: monoclonal antibodies and tyrosine kinase inhibitors (TKIs)
Antimetabolites
- Cell cycle-specific analogues that work by antagonizing the actions of key cellular metabolites
- Inhibit cellular growth by interfering with the synthesis or actions of compounds critical to cellular reproduction
- Examples:
- Folate (folic acid) antagonists (e.g., methotrexate, pemetrexed, pralatrexate)
- Purine antagonists (e.g., fludarabine, mercaptopurine, thioguanine)
- Pyrimidine antagonists (e.g., fluorouracil, cytarabine, capecitabine)
- Indications: used to treat various types of cancer, including acute and chronic lymphocytic leukemias, colon, rectal, breast, stomach, lung, and pancreatic cancers
- Adverse effects: hair loss, nausea and vomiting, myelosuppression, neurologic, cardiovascular, pulmonary, hepatobiliary, GI, genitourinary, dermatologic, ocular, otic, and metabolic toxicity
Mitotic Inhibitors
- Natural products obtained from the periwinkle plant (e.g., vinblastine, vincristine, vinorelbine)
- Mechanism of action: work in various phases of the cell cycle, delaying cell division
- Indications: used to treat a variety of solid tumors and some hematologic malignancies, including testicular, small cell lung, breast, ovarian, and non-small cell lung cancers
- Adverse effects: hair loss, nausea and vomiting, myelosuppression, liver, kidney, lung toxicities, convulsions, and extravasation
Alkylating Drugs
- Cell cycle-nonspecific (CCNS) antineoplastic drugs
- Examples: cisplatin, cyclophosphamide, mechlorethamine
- Mechanism of action: work by preventing cancer cells from reproducing, altering the chemical structure of the cells' DNA
- Indications: used to treat various types of cancer, including recurrent ovarian cancer, brain tumors, lymphomas, leukemias, breast cancer, and bladder cancer
- Adverse effects: dose-limiting adverse effects, nausea and vomiting, myelosuppression, alopecia, nephrotoxicity, peripheral neuropathy, ototoxicity, and extravasation
Hormonal Drugs
- Used to treat a variety of neoplasms in men and women
- Hormonal therapy used to oppose effects of hormones, block the body's sex hormone receptors, and used as adjuvant and palliative therapy
- Examples: antiandrogens (e.g., bicalutamide, flutamide, nilutamide), antineoplastic hormone (e.g., estramustine)
Nursing Implications
- Assess baseline blood counts before administering antineoplastic drugs
- Follow specific administration guidelines for each antineoplastic drug
- Monitor for expected effects, including bone marrow suppression, nausea, vomiting, diarrhea, and stomatitis
- Monitor for complications, including anemia, thrombocytopenia, neutropenia, and oncologic emergencies
- Keep epinephrine, antihistamines, and anti-inflammatory drugs on hand for anaphylactic reactions
- Monitor closely for complications associated with bone marrow suppression
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Description
Distinguish between cell cycle-nonspecific (CCNS) and cell cycle-specific (CCS) antineoplastic drugs, including their characteristics and examples. This quiz covers the basics of pharmacology and cancer treatment.