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Questions and Answers
What is the therapeutic class of vincristine?
What actions does vincristine perform?
Cell-cycle specific (M-phase); kills cancer cells by preventing their ability to complete mitosis.
What is a common use of vincristine?
What are some administration alerts for vincristine?
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What are some adverse effects of vincristine?
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Which of the following is a contraindication for vincristine?
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What laboratory tests are important when administering vincristine?
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What should patients report when receiving vincristine?
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Vincristine causes less myelosuppression than other agents.
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What is the black box warning associated with vincristine?
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What should be used for treating symptoms of gout when a patient is on vincristine?
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Which of the following requires certification to administer vincristine?
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Study Notes
Vincristine Overview
- Vincristine is an antineoplastic medication primarily used to treat various cancers.
- It is classified under the therapeutic class of antineoplastics, specifically vinca alkaloids.
Mechanism of Action
- Vincristine is cell-cycle specific, targeting the M-phase of cell division.
- It inhibits cancer cell mitosis, effectively killing malignant cells.
Clinical Uses
- Commonly used in combination therapy for:
- Hodgkin’s and non-Hodgkin’s lymphomas
- Leukemias
- Kaposi's sarcoma
- Wilms' tumor
- Bladder and breast carcinomas
Administration Alerts
- Caution against extravasation during IV administration.
- Prevent contact with eyes.
- Classified as pregnancy category D, indicating potential risks to the fetus.
Adverse Effects
- Notable nervous system toxicity:
- Symptoms include numbness, tingling, muscle weakness, and loss of reflexes.
- Other adverse effects include:
- Severe constipation, alopecia, agitation, insomnia, and mental status changes.
- Risk of cortical blindness, diplopia, bronchospasms, and gastrointestinal issues such as nausea, vomiting, and abdominal cramps.
- Blood-related complications: anemia, thrombocytopenia, leukopenia.
- Risk of phlebitis at the IV site and potential tissue necrosis from extravasation.
- Monitoring for SIADH and hyperuricemia is crucial.
Drug-Drug Interactions
- Significant interactions can occur with:
- Asparaginase (decreased metabolism)
- Mytomycin (risk of bronchospasms)
- Calcium channel blockers, digoxin, and methotrexate.
Contraindications
- Use is contraindicated in:
- Pregnancy and lactation
- Patients with hepatic impairment or obstructive jaundice
Monitoring and Interventions
- Continuous monitoring of lung sounds for pulmonary complications.
- Neurological assessments for signs of toxicity (numbness, weakness).
- Monitor urinary function and orthostatic hypotension.
- Assess for symptoms of gout and encourage hydration (2-3L/day).
Important Laboratory Tests
- Regular monitoring of:
- Complete Blood Count (CBC)
- Blood Urea Nitrogen (BUN)
- Creatinine levels
- Platelet counts
- Liver enzymes (ALT, AST)
- Uric Acid levels
Patient Education
- Instruct patients to report any site redness or signs of neurotoxicity (e.g., paresthesia).
- Advise monitoring for infection signs and episodes of bleeding.
- Recommend avoiding crowded places to reduce infection risk.
Special Considerations
- Vincristine has less myelosuppression compared to other chemotherapy agents.
Black Box Warning
- Potential for severe myelosuppression.
- Treatment of extravasation should utilize warm compresses; cold packs are harmful as they increase vinca alkaloid toxicity.
Additional Information
- Vincristine is often administered with other agents like methotrexate and asparaginase to enhance treatment efficacy.
- Administration via a central line is recommended due to its high vesicant nature.
- Peripheral neuropathy is a serious risk, especially with rapid administration; effects may be irreversible.
- Close monitoring of respiratory status and liver function is essential, as well as advising the use of effective contraception during treatment.
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Description
Test your knowledge on vincristine, an important antineoplastic medication used in cancer treatment. This quiz covers its therapeutic class, actions, and clinical uses, essential for healthcare professionals and students. Dive into the specifics of how vincristine acts against cancer cells and its applications in various cancers.
