Cancer and Related Medications

Cyclophosphamide (Cytoxan) class

Alkylating agent

Cyclophosphamide (Cytoxan) indication

Leukemias, lymphomas, breast/ovarian cancer, multiple myeloma, lupus nephritis

Cyclophosphamide (Cytoxan) action

Cross-links DNA and inhibits replication

Cyclophosphamide (Cytoxan) side effect

Nausea, vomiting, diarrhea, alopecia, stomatitis, leukopenia.

Cyclophosphamide (Cytoxan) adverse effect

Hemorrhagic cystitis, myelosuppression, cardiotoxicity

Cyclophosphamide (Cytoxan) nursing consideration

Hydrate well, monitor CBC/renal function, assess for hematuria; mesna with high doses

Methotrexate (Trexall) class

Antimetabolite

Methotrexate (Trexall) indication

Leukemias, lymphomas, solid tumors, RA, psoriasis.

Methotrexate (Trexall) action

Inhibits folate metabolism and DNA synthesis

Methotrexate (Trexall) side effect

Nausea, stomatitis, fatigue.

Methotrexate (Trexall) adverse effect

Bone marrow suppression, hepatotoxicity.

Methotrexate (Trexall) consideration

Monitor CBC/liver/renal function; leucovorin rescue with high doses

Fluorouracil (5-FU, Adrucil) class

Antimetabolite

Fluorouracil (5-FU, Adrucil) indication

Breast, colorectal, gastric, pancreatic cancers.

Fluorouracil (5-FU, Adrucil) action

Inhibits thymidylate synthase, disrupting DNA/RNA synthesis.

Fluorouracil (5-FU, Adrucil) side effect

Nausea, diarrhea, stomatitis, alopecia.

Fluorouracil (5-FU, Adrucil) adverse effect

Myelosuppression, hand-foot syndrome, cardiotoxicity

Fluorouracil (5-FU, Adrucil) consideration

Monitor CBC and GI toxicity.

Doxorubicin (Adriamycin) class

Anthracycline antitumor antibiotic

Doxorubicin (Adriamycin) indication

Leukemias, lymphomas, breast and other solid tumors.

Doxorubicin (Adriamycin) action

Interferes with DNA/RNA synthesis

Doxorubicin (Adriamycin) side effect

Nausea, vomiting, alopecia.

Doxorubicin (Adriamycin) adverse effect

Cardiotoxicity, myelosuppression, vesicant injury

Doxorubicin (Adriamycin) consdeiration

Monitor cardiac function/CBC; assess IV site.

Vincristine (Oncovin) class

Vinca alkaloid

Vincristine (Oncovin) indication

Leukemias, lymphomas, solid tumors

Vincristine (Oncovin) action

Inhibits microtubule formation.

Vincristine (Oncovin) side effect

Constipation, jaw pain, alopecia.

Vincristine (Oncovin) adverse effect

Effects Peripheral neuropathy, paralytic ileus.

Vincristine (Oncovin) consideration

Never administer intrathecally; monitor neuro/bowel status.

Finasteride (Proscar, Propecia) class

5-alpha reductase inhibitor

Finasteride (Proscar, Propecia) indication

BPH; male pattern baldness.

Finasteride (Proscar, Propecia) action

Blocks testosterone conversion to DHT.

Finasteride (Proscar, Propecia) side effect

Decreased libido, erectile dysfunction.

Finasteride (Proscar, Propecia) adverse effect

Breast changes, angioedema, depression.

Finasteride (Proscar, Propecia) consideration

Pregnant women should not handle crushed tablets; monitor PSA and urinary symptoms.