chemotherapy pharm

what do anthracyclines end with

rubicin

what does doxorubicin do

disrupts DNA replication to stop cancer cell growth

se of doxorubicin

n/v, loss of appetite, fatigue, alopecia, bone marrow suppression, low blood cell counts, sleep/mood problems, red/orange urine, cardiotoxic

what to give to help with n/v

zofran

pt education for doxorubicin

inform what to expect, hairpieces/wigs, avoid crowds and infectious ppl

what to give to help treat bone marrow suppression

filgrastim

what to give to help with sleep/mood problems

zolpidem (hypnotic), trazodone (antidepressant)

RN interventions for doxorubicin

frequently check IV site (vesicant), monitor CBC, H&H, ECG, assess for bleeding

what is cyclophosphamide

alkylating agent, kills cancer cells by damaging DNA so it can’t grow/divide, suppresses immune system

complication of cyclophosphamide

hemorrhagic cystitis, bladder bleeding/irritation, oral mucositis

interventions for bladder irritation caused by cyclophosphamide

mesna (uroprotective agent), hydration

RN interventions for cyclophosphamide

monitor BUN/Cr, GFR, bone marrow suppression, hemorrhagic cystitis, reverse isolation

what to give to help with appetite

megestrol acetate

interventions for oral mucositis

soft toothbrush, saline rinses, avoid alcohol-based mouthwash, avoid spicy, acidic, rough, hot foods

contraindications of cylophosphamide

pregnancy/lactation (teratogenic), kidney disorder

what is cisplatin

platinum-based chemotherapy drug, enters cancer cell and stops it, common for lung cancer

se of cisplatin

n/v, nephrotoxicity, ototoxicity

RN interventions for cisplatin

IV hydration before and after, monitor I&O, BUN, Cr, GFR, give mannitol/diuretics to promote urine, avoid combining with furosemide (increase hearing loss)

contraindications of cisplatin

pregnancy/lactation (teratogenic), kidney disorders, hearing loss

what is vincristine

vinca alkaloid chemotherapy drug used for blood cancers

complications of vincristine

neurotoxicity (nerve damage)

contraindications of vincristine

pregnancy/lactation (teratogenic), liver disease

RN interventions for vincristine

assess IV site (vesicant), monitor LFTs, CBC

what is cetuximab

immunotherapy, inhibits epidermal growth factor receptor, increases immune response and decreases production of cancer

se of cetuximab

skin rash, SOB (stop treatment), PE, sun sensitivity

what to give for skin rash caused by cetuximab

diphenhydramine/corticosteroids

RN interventions for cetuximab

monitor RR, O2 sat, BP

what to do if SOB occurs caused by cetuximab

epinephrine, antihistamines, steroids