Adriamycin

Bleomycin

Mitomycin

Novantrone

Alterns DNA and RNA 

"mycin" except Novatrone  

 Cell cycle NON specific

SE: Cardiac - Pulmonary Fibrosis - Bleeding precautions

Extravasation - ICE antidote - Dimethyl sulphoxide

Give anitemtic and antacids prior

Alters DNA 

Cell Cycle specific 

SE: Renal Toxicity & Photosensitivity

Leucovorin tx methotrexate toxicity and potentiates effects of 5FU

Methotrexate

5FU

Altima

Cytosar

Xelada

Cytoxin 

Cisplatin

Carboplatin

Oxaliplatin

Ifex

Thioplex

DTIC

Alters DNA & RNA 

"platin" "ex" and cytoxan

Cell cycle non specific

Hemmorrhagic cyctitis main concern tx w/ mensa

Antitumor medication

"Red Devil" - Makes veins red

NI: Fluid & antiemetic prior - bleeding precautions

      Decrease cardiac toxicity w/Zinecard

SE: Cardiac, liver, blood discrasias

Extravasation: Ice - Hydrocortisone or Na+ Bicarb

 - antidote for extravasation = Dimethyl sulphoxide

Antitumor Medication

SE: Pulmonary Fibrosis, Liver

NI: Give antacid and antiemetic prior

Extravasation - Ice - Antidote - Dimethyl sulphoxide

Antitumor Medication

NI: Oral Antacid before- give before dinner or at HS

      IV: Give AM

SE - Liver, Resp, Kidney Failure

Extravasation: Ice - Antidote  - Dimethyl sulphoxide

Antitumor med

SE; Heart, Liver, Blood, Seizures

Antimetabolite

SE: Renal & Hepatic toxicity, PCP, Methotrexate induced lung disease,

NI: Leucovorin tx methotrexate toxicity

Antimetabolite

Cell cycle specific

SE: Photosensitivity - GI hemorrhage - Blood discrasias

NI: Leucovorin potentiates effects

Antimetabolite

Cell cycle specific

No info in drug book

Antimetabolite

Alkylating Agent

Cell cycle NON specific

SE: Nephrotoxicity, seizures, respiratory fibrosis, anaphylaxis

NI: Hidrate w/ NS 8-12 hrs prior - Give all medsPO or IV (avoid IM)

Antimetabolite

Cell cycle specific

PO route only

SE: Intestinal obstruciton - Blood discrasias

Alkylating Agent

Cell cycle NON specific

SE: Hemmorhagic cycstitis (tx w/ Mesna)

      Cardiactoxicity - Hepatotoxicity - Respiratory fibrosis - Hema

NI: Give in AM - Use small needle (21-25g) to prevent phelbitis

Alkylating Agent

Cell cycle NON specific

SE: Hemmorrhagic cycstitis (tx w/ Mensa)

      Nephro & heptotoxicity, sizures, hema

NI: Diulte w/ sterile water before IV admin - Increase fluids

Alkylitic Agent

Cell cycle NON specific

SE: Neuro, Hema, Anaphylaxis

NI: Dont give w/in 1 mo of chemo (increases bone marrow suppression)

       Give over 5 - 6 hrs

       Administer Lasix after infused

Alkylating Agent

Cell cycle NON specific

SE: Respiratory fibrosis, Anaphylaxis, angioedema, Hema

NI: Assess for Jaundice (dark urine)

      Increase fluids - hydrate 8-12 hrs prior

      Lasix or Mannitol after infusion

      Allopurinol to maintain uric acid levels

Etoposide

Navelbine

Vinblatine

Vincristine

Alkylating Agent

Cell cycle NON specific

SE: Anaphylaxis

Alkylating Agent

Cell cycle on specific

No info in drug book

Vinca Alkaloid

cell cycle specific

SE: Hypotension, metalic food taste, hema

Vinca Alkaloid

Cell cycle specific

SE: Respiratory, seizures, hema

Extravation: Warm compress

Vinca Alkaloid

Cell Cycle specific

SE: paryltiic ileus, hepatotoxicity, seizures, hema

Extravasation: Warm compress

Navelbine

Vinca Alkaloid

Cell cycle specific

SE: Hepatotoxicity, Seizures, hema

NI: Monitor BP - Antacid before oral

Extravasation:Warm compress

Alters RNA 

most end in "ine"  except Etoposide,

Cell Cycle specific

Extravasation: Warm compress

Lupon - Prostate

Tamoxifen - Breast

Megace - Prostate and Breast

Decadron - Syntehsizes cell to be more affected by chemo agents

Hormone chemo agent - prostate and breast

APPETITE STIMULANT - MAY CAUSE DIZZINESS, FATIGUE, LETHARGY

Hormone chemo agent - synthesizes cells to be more affected by chemo

Also and Adjuvant that potentiates the effect of certain chemo rx

Chemo agent 

"tecan" 

Irinotecan

Topotecan

Topisomerase is an enzyme that promotes cell devision - these drugs inhibit that

Enzyme that promotes cell division in the body

Zinecard

Tx Adriamycin cardiac toxicity

Define Adjunct Therapy

Drugs that enhance the primary therapy

Combination therapy

Cytoxan

Oncovin

Adriamycin

Prednisone

Benadryl - reduce risk for anaphylaxis

Decadron - potentiate effects of some chemo

NSAIDS

ANTIDEPRESSANTS

ANTIEMETICS - POTENTIATES EFFECTS OF ANALGESICS

Chemo agent that can cause blistering or ulcers on veins or skin

Antitumor meds (adriomycin, bleomycin, mitomycin)

Vinca Alkaloids - ("ine" drugs & Etoposide)

Stimulate the production of certain blood cells

RBC's - D & E alpha drugs

Neutrophils - Neupogen, Neulasta

Platelet - Neumega

Macrophages - Leukine

Colony stimulating factor

Increases platelet production

SE: Anaphylaxis risk

SQ ROUTE

Darbopoetin Alfa

Colony stimulating factr

Increases RBC's

Longer half life than the other

Colony Stimulating Factor

Increases RBC production

SE: HTN

Colony stimulating factor

Increases Neutrophils

SE: Splenic rupture

SQ ROUTE

Colony stimulating factor

increases Neutrophils

SE: Spleanic rupture

Colony stimulating factor

Increases macrophage production

Biological Modifiers

Substances that stimulate the bodys natural substances that fight infections and diseases

Cytokines

Monoclonal Antibodies (MAB's)

Immunomodulators (vaccines)

Retinoids (Vit A)

Nursing Considerations for Biological Modifiers

Allergy to eggs, iodine, IgG, and neomycin

Baseline: VS, Mental status, LOC, Blood counts, signs of infection

Dilute w/ NS except Leukine w/ sterile water

Swril dont shake

Give at HS to reduce CNS effects

S/E Flulike - diarrhea (stop med) Myalgia

graisetron (Kytril)

antiemetic

antiemetic

Antiemetic

GI stimulant

Antiemtic

Tranquilizer

Antiemetic

Dopamine receptor antagonist

Bilogical Response Markers

Interferons - Viral - Alters celluar metabolism of ALL cells

Interleukins - Stimulate production of Immune cells from Thymus

Colony Stimulating Factors - Stimulate WBC, RBC, Platelet

Tumor Necrosis Factors

S/E Fluelike s/s

"mab" 

Biological Response Modifiers

Bind w/ antigens on tumor (antigens unlike normal body antigens)

trastuzumab (Herceptin)

cetuximab  (Erbitux)

rutuzimab (Rutuxin)

bevacizumab (Avastin)

S/E Fluelike

Rigors - TX W/ DEMEROL

Bilogical response modifier

Vaccines

Biological response modifiers

Retinol/Vit A - stimlates cellular differentiation

APPETITE STIMULANT

MAY CAUSE DIZZINESS, FATIGUE, LETHARGY

Extravasation protocol

Stop the drug

Leave angiocath in

Administer Antidote

D/C angiocath

Apply Ice or heat (depending on drug)

Call doc

Document/monitor

C ough

H/a

A norexia, alopesia

R ash - fever

M uscle - bone pain

E dema

D iarrhea/nausea/vomiting - discrasias of blood