Transcript File
Drugs Used for Cancer Treatment
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Cancer and the Use of
Antineoplastic Agents
Treatment requires combination of surgery,
radiation, chemotherapy, and immunotherapy
Recent developments enhance role of
antineoplastic agents in therapy
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Cancer Cases and Deaths
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Phases of Cell Growth
Mitosis: phase of cellular proliferation in
which cells divide into two equal daughters
Cells are either in the non-proliferative stage
(G0), or in the first gap phase (G1)
Phase G1: pre-synthetic phase in which the
cell manufactures needed enzymes to
prepare for DNA synthesis
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Phases of Cell Growth (cont.)
Phase G2: post-synthetic phase in which
the cell prepares for mitosis by producing
RNA and specialized proteins
Mitosis divides the cell into two G1
daughter cells
G1 cells may advance again to S phase or
pass into a non-proliferative stage (G0)
S phase: stage of active synthesis of two
sets of DNA
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Phases of Cell Growth (cont.)
http://www.youtube.com/watch?v=Q6ucKWIIFmg
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Cell Cycle and Effects of Drugs
Cell cycle–specific
Drug is selectively toxic when the cell is in a specific
phase of growth—schedule dependent
Effective against malignancies that proliferate
rapidly
Cell cycle–nonspecific
Active throughout the cell cycle
More effective against slowly proliferating
neoplastic tissue
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Drug Therapy for Cancer
Goals for chemotherapy : administering a dose large
enough to be lethal to cancer cells but small enough to
be tolerable for normal cells
Control of the disease (arresting of tumor)
Goal for palliation: alleviation of symptoms if cancer is
beyond control
Goal for prophylaxis: prophylactic measures if patient is
a known risk for developing cancer
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Nursing Assessments
History of risk factors
Dietary habits
Preexisting health problems
Adaptation to diagnosis
Psychomotor functions
Safety
Symptoms of pharmacologic adverse effects
Physical and sexual assessment
Pain
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Nursing Interventions
Care plan is based on assessment data and individual
needs of patient:
Monitor VS
Examine lab tests
Monitor for development of emergencies
Monitor hydration and electrolyte status
Report early signs of infection
Nausea and vomiting are common
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Nursing Interventions (cont.)
Pre-administer antiemetic; report poor control,
Monitor for changes in bowel movements
Meticulous oral hygiene for stomatitis
Report bleeding
Give pain medications at intervals to maintain
maximum pain control
Nutritional needs
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Nursing Interventions (cont.)
Encourage patient/family to discuss concerns with
support group
Allow patient to make choices on her/his care
Sexual needs: discuss birth control during
chemotherapy and/or sperm storage
Vascular access devices
Skin care to prevent skin breakdown
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Patient Education
Neutropenia: discuss hand washing; avoiding infected
individuals; no fresh flowers, vegetables, pets, items
with free-standing water, those receiving
immunizations
Pain: report pain that is new or not controlled, take
medications at prescribed intervals to obtain
maximum relief
Anemia: space activities and rest
Thrombocytopenia: monitor for bleeding episodes;
avoid sharps, ASA, anticoagulants
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Drug Class: Alkylating Agents
Actions: Highly reactive chemical compounds that
bond with DNA molecules, preventing separation of
the double-coiled DNA molecules which are necessary
for cellular division
Uses: Treatment of chronic lymphocytic leukemia,
ovarian cancer, brain tumors, multiple myeloma,
Hodgkin’s disease, Non-Hodgkin’s lymphoma,
Serious adverse effects: Bone marrow depression,
nephrotoxicity
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Drug Class: Antimetabolites
Actions: Inhibit key enzymes in the biosynthetic
pathways of DNA and RNA synthesis
Uses: Treatment of breast cancer; colon cancer; hairy
cell leukemia, lymphomas, acute lymphocytic
leukemia, myelodysplastic syndromes
Serious adverse effects: Bone marrow depression,
petechiae, hepatotoxicity, dermatitis, stomatitis
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Drug Class: Natural Products
Actions: Cell cycle–specific agents block formation of
the mitotic spindle during mitosis, inhibiting cell division
Uses: Treatment of Hodgkin's disease; non-Hodgkin’s
lymphoma; acute lymphocytic leukemia; Kaposi’s
sarcoma; ovarian, breast, testicular cancers
Serious adverse effects: Bone marrow depression,
peripheral neuropathy, hepatotoxicity
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Drug Class:
Antineoplastic Antibiotics
Actions: Bind to DNA, inhibiting DNA or RNA synthesis
Uses: Hodgkin’s disease, non-Hodgkin’s lymphoma;
squamous cell, head and neck, testicular cancers;
Wilms’ tumor; rhabdomyosarcoma; Ewing’s and
osteogenic sarcoma; acute lymphocytic leukemia;
acute myeloid leukemia
Serious adverse effects: Bone marrow depression,
hepatotoxicity, stomatitis, cardio toxicity
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Drug Class: Hormones
Actions: Reduce edema secondary to radiation therapy
and act as palliative therapy; temporarily suppress
fever, diaphoresis, and pain
Uses: Estrogens and androgens used in malignancies of
sexual organs
Serious adverse effects: Gynecomastia, hot flashes,
diarrhea, pelvic pain, edema, hepatitis, thrombosis,
hyperglycemia
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Drug Therapy for Cancer
Targeted anticancer agents
Act on pathways that provide growth and survival
advantages for cancer cells
Not associated with toxicities common with
cytotoxic chemotherapy
Chemoprotective agents
Reduce toxicity of chemotherapeutic agents to
normal cells
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Drug Therapy for Cancer (cont.)
Bone marrow stimulants: trigger recovery of bone
marrow cells
Davepoetin and epoetin stimulate bone marrow to
produce RBCs to treat anemia
Filgrastim, pegfilgrastim stimulate production of
neutrophilic white blood cells
Oprelvekin stimulates platelet production
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Audience Response Question-1
By which method does cell cycle–specific treatment
therapy work?
A.
B.
C.
D.
Treating cancer cells at their vulnerable cell
reproductive stage
Affecting a cancer cell throughout its entire life cycle
Inhibiting slowly growing cancer cells
Targeting key pathways that provide growth to
cancer cells
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Audience Response Question-2
Which bone marrow stimulant increases the
production of white blood cells?
A.
B.
C.
D.
Filgrastim (Neupogen)
Epoetin alpha (Epogen)
Darbepoetin (Aranesp)
Oprelvekin (Neumega)
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Audience Response Question 3
A patient has developed thrombocytopenia following
a round of chemotherapy. The nurse should instruct
the patient to:
A.
B.
C.
D.
use an electric razor to shave.
wash his hands frequently.
plan his activities to allow rest time.
report temperature elevations.
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Audience Response Question 4
A patient has been taking an alkylating agent for
chemotherapy to treat ovarian cancer. The care plan
mentions observing for nephrotoxicity during
treatment. The nurse should monitor for
development of:
A.
B.
C.
D.
jaundiced skin and sclera.
decreased urine output.
increased liver enzymes.
frequent bleeding episodes.
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Audience Response Question 5
Which type of cancer is the leading cause of cancerrelated death in women?
A.
B.
C.
D.
Breast
Colon
Lung
Ovary
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