Chemotherapy and Cancer Treatment Vocabulary Review

These flashcards cover essential terms and concepts related to combination chemotherapy, cancer treatment protocols, and patient management strategies.

Combination Chemotherapy

A treatment strategy using two or more chemotherapy drugs to enhance effectiveness against cancer cells and minimize drug resistance.

Nadir

The lowest point of blood cell counts (e.g., white blood cells, platelets) after chemotherapy, typically occurring 7-10 days post-treatment, increasing infection and bleeding risk.

Cyclophosphamide: Patient Teaching (General)

Patients should be taught about the importance of hydration to prevent hemorrhagic cystitis, monitoring for signs of infection or bleeding, and reporting any severe side effects promptly.

Cyclophosphamide: Patient Teaching (Side Effects)

Key side effects include nausea, vomiting, hair loss, bone marrow suppression, and hemorrhagic cystitis. Explain symptom management strategies.

Cyclophosphamide: Patient Teaching (Diet)

Encourage adequate fluid intake (2-3 L/day) to help prevent bladder toxicity. Advise on antiemetic use for nausea and maintaining nutrition.

Doxorubicin: Side Effects and Adverse Reactions

Common side effects include nausea, vomiting, alopecia, stomatitis, myelosuppression, and cardiotoxicity, including delayed congestive heart failure. Urine may turn reddish-orange.

Vincristine: Patient Teaching (General)

Emphasize reporting any numbness, tingling, or weakness in extremities due to the risk of neurotoxicity. Explain the importance of bowel regularit.

Vincristine: Patient Teaching (Taking Action)

Advise on strategies to manage constipation, such as increased fluid and fiber intake, or prescribed stool softeners, due to high risk of paralytic ileus.

Vincristine: Patient Teaching (Side Effects)

Key side effects involve neurotoxicity (neuropathy, paresthesias), constipation, and alopecia. Bone marrow suppression is less common with vincristine than other chemotherapies.

Sex Hormone Therapy (Use in Cancer)

Used to treat hormone-sensitive cancers (e.g., breast, prostate cancer) by blocking the production or action of hormones that promote tumor growth.

Sex Hormone Therapy (Mechanism of Action)

Works by either antagonizing hormone receptors (e.g., antiestrogens like Tamoxifen) or by inhibiting hormone synthesis (e.g., aromatase inhibitors) to deprive cancer cells of growth-stimulating hormones.

Targeted Therapy (Use in Cancer)

Targets specific molecules or pathways involved in cancer cell growth, progression, and spread, often with fewer side effects on healthy cells than traditional chemotherapy.

Targeted Therapy (Mechanism of Action)

Mechanisms include blocking growth factor signals (e.g., EGFR inhibitors), inhibiting angiogenesis (e.g., VEGF inhibitors), or inducing apoptosis in specific tumor cells.

mTOR Inhibitors: Nursing Interventions

Monitor for hyperglycemia, hyperlipidemia, stomatitis, and rash. Educate patients on managing these side effects and adhering to dosing schedules.

Proteasome Inhibitors: Nursing Interventions

Assess for peripheral neuropathy, thrombocytopenia, and gastrointestinal disturbances. Provide patient education on symptom recognition and management.

Monoclonal Antibodies (Targeted Therapy): Nursing Interventions

Monitor closely for infusion reactions (fever, chills, dyspnea, hypotension), especially during the first infusion. Manage adverse effects like skin rash and gastrointestinal toxicities.

Biologic Response Modifiers (BRMs) - Use

Substances that stimulate or restore the immune system's ability to fight cancer or its side effects, or make cancer cells more visible to the immune system.

Biologic Response Modifiers (BRMs) - Mechanism of Action

Work by enhancing host anti-tumor responses, modifying tumor biology to be less malignant, or acting directly as anti-tumor agents. Examples include interferons, interleukins, and colony-stimulating factors.

Filgrastim: Therapeutic Effects

Stimulates the production of granulocytes (a type of white blood cell) in the bone marrow, thus reducing the incidence and duration of neutropenia and febrile neutropenia in chemotherapy patients.

Filgrastim: Side Effects

Common side effects include bone pain, myalgia, fatigue, and headache. Less common but serious effects can include splenic rupture or acute respiratory distress syndrome.

Erythropoietin-Stimulating Agent (ESA) / BRM: Recognize Cues (Assessment)

Assess patient's baseline hemoglobin, iron stores, and blood pressure. Monitor for signs of cardiovascular events (e.g., hypertension, thrombosis). Regularly check hemoglobin levels as overtreatment can be risky.

Growth Hormone: Patient Teaching

Instruct patients and caregivers on proper subcutaneous injection technique, storage, and potential side effects. Emphasize regular follow-up for monitoring growth and hormone levels.

Growth Hormone: Side Effects

Can include hyperglycemia, carpal tunnel syndrome, peripheral edema, headache, and joint/muscle pain. In children, it can potentially accelerate epiphyseal closure if not monitored.

Repository Corticotropin: Patient Teaching

Educate on proper administration (IM or SC), importance of consistent dosing, and identifying signs of adrenal insufficiency or excess. Advise to not stop abruptly.

Hypothyroidism

A condition resulting from insufficient production of thyroid hormones, leading to slowed metabolism, fatigue, weight gain, cold intolerance, and bradycardia.

Levothyroxine Sodium: Therapeutic Effects

Replaces endogenous thyroid hormones, normalizing metabolic rate, improving energy levels, weight, and resolving symptoms of hypothyroidism.

Levothyroxine Sodium: Side Effects

Generally well-tolerated when dosed correctly. Side effects usually indicate hyperthyroidism due to overdosage: palpitations, tachycardia, tremors, insomnia, heat intolerance, weight loss.

Levothyroxine Sodium: Adverse Effects

Severe adverse effects of overtreatment include angina, myocardial infarction, and cardiac arrhythmias, especially in older adults or those with pre-existing cardiac disease.

Hyperthyroidism

A condition characterized by excessive production of thyroid hormones, leading to increased metabolism, tachycardia, weight loss, heat intolerance, anxiety, and exophthalmos.

Levothyroxine Sodium: Recognizing Cues (Assessment)

Assess for symptoms of both hypothyroidism (before treatment) and hyperthyroidism (during treatment if over-dosed), including vital signs, weight changes, energy levels, and cardiac status. Review TSH and T4 levels.

Levothyroxine Sodium: Take Action (Nursing Interventions)

Administer on an empty stomach, usually 30-60 minutes before breakfast. Do not administer with calcium, iron, or antacids. Monitor thyroid function tests and patient response closely.

Levothyroxine Sodium: Patient Teaching

Explain lifelong therapy, the importance of consistent timing (same time daily), interactions with other drugs/foods, and reporting symptoms of hypo- or hyperthyroidism.

Corticosteroids (Adrenal Hormones): Recognizing Cues

Assess for signs of adrenal insufficiency (fatigue, hypotension) or excess (Cushing's syndrome: moon face, buffalo hump, hyperglycemia, fluid retention, mood changes, delayed wound healing). Monitor glucose, electrolytes, and blood pressure.

Corticosteroids (Adrenal Hormones): Nursing Interventions

Administer with food to reduce GI upset. Advise gradual tapering of dose to prevent adrenal crisis. Monitor for infection, hyperglycemia, and fluid retention. Provide education on potential side effects and never abruptly stopping medication.

Administration of Insulin

Insulin is typically administered via subcutaneous injection using syringes, pens, or pumps. Rotate injection sites to prevent lipohypertrophy. Never inject into masses or scars.

Types of Insulin: Rapid-Acting

Onset: 10-30 min; Peak: 30-90 min; Duration: 3-5 hours. Examples: Lispro, Aspart. Used for mealtime coverage and correction.

Types of Insulin: Short-Acting (Regular)

Onset: 30 min-1 hr; Peak: 2-5 hrs; Duration: 5-8 hours. Example: Humulin R. Can be given IV and used for mealtime or sliding scale.

Types of Insulin: Intermediate-Acting (NPH)

Onset: 1.5-4 hrs; Peak: 4-12 hrs; Duration: 12-18 hours. Example: Humulin N. Administered once or twice daily.

Types of Insulin: Long-Acting

Onset: 1-4 hrs; No pronounced peak; Duration: 18-24+ hours. Examples: Glargine, Detemir. Provides basal coverage.

Types of Insulin: Premixed

Combinations of intermediate and short/rapid-acting insulins (e.g., 70/30 NPH/Regular). Administered before meals, typically twice daily.

Storage of Insulin

Unopened vials or pens should be refrigerated (not frozen). Once opened, insulin can be stored at room temperature for up to 28 days (check specific product instructions) and protected from direct sunlight or extreme heat.

Hypoglycemic Reactions

Occurs when blood glucose is too low (typically <70 mg/dL). Symptoms include shakiness, dizziness, sweating, hunger, tachycardia, confusion. Treated with fast-acting carbohydrates (e.g., juice, glucose tablets).

Diabetic Ketoacidosis (DKA)

A serious complication of diabetes, primarily type 1, due to severe insulin deficiency. Characterized by hyperglycemia, metabolic acidosis, and ketonemia. Symptoms include Kussmaul respirations, fruity breath, dehydration, and altered mental status. Requires emergency treatment.

Insulin Pumps

Small, computerized devices that deliver continuous subcutaneous insulin infusion (basal rate) and boluses for meals or correction. Offers precise control and flexibility but requires diligent monitoring and patient education.

Oral Antidiabetics: Take Action (Nursing Interventions)

Monitor blood glucose levels, renal and hepatic function. Educate on proper administration, dietary management, exercise, and recognizing signs of hypoglycemia or other side effects specific to the drug (e.g., GI upset for Metformin).

Metformin: Therapeutic Effects

Decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Leads to lower blood glucose levels.

Metformin: Side Effects

Common side effects include gastrointestinal disturbances (nausea, vomiting, diarrhea, abdominal discomfort). Lactic acidosis is a rare but serious adverse effect, especially in patients with renal impairment.

Ceftriaxone (Cephalosporin): Adverse Effects

Can cause gastrointestinal disturbances (diarrhea, nausea), allergic reactions (rash, pruritus), injection site pain, and rarely, C. difficile infection or hemolytic anemia. Avoid with calcium-containing IV solutions in neonates due to precipitation risk.

Ampicillin (Penicillin): Take Action (Nursing Interventions)

Administer on an empty stomach for optimal absorption. Monitor for allergic reactions (rash, anaphylaxis), GI upset (diarrhea), and secondary infections. Complete the full course of therapy.

Doxycycline (Tetracycline): Drug Interactions

Interacts with digoxin (increases levels), warfarin (potentiates anticoagulant effect), and oral contraceptives (decreases effectiveness). Avoid antacids, iron supplements, and dairy products within 2 hours of dose.

Doxycycline (Tetracycline): Side Effects

Common side effects include photosensitivity, gastrointestinal upset (nausea, vomiting, diarrhea), and esophageal irritation. Can cause tooth discoloration in children and inhibit bone growth in fetuses.

Gentamicin (Aminoglycoside): Take Action (Nursing Interventions)

Monitor peak and trough drug levels to optimize dosing and minimize toxicity. Assess renal function (BUN, creatinine) and hearing for ototoxicity. Ensure adequate hydration.

Levofloxacin (Fluoroquinolone): Nursing Interventions

Monitor for tendon pain/rupture (especially Achilles tendon), QT-interval prolongation, hyperglycemia/hypoglycemia, and C. difficile infection. Advise patients to avoid excessive sun exposure and ensure good hydration.

Sulfonamides: Patient Teaching (General)

Advise patient to complete the full course of treatment. Emphasize consuming plenty of fluids to prevent crystalluria. Report any severe rash, fever, or sore throat.

Sulfonamides: Patient Teaching (Self-Administration)

Take with a full glass of water. Avoid antacids. If a dose is missed, take it as soon as remembered unless it's close to the next dose.

Sulfonamides: Patient Teaching (Side Effects)

Inform about potential side effects like nausea, vomiting, photosensitivity (wear sunscreen), and allergic skin reactions (e.g., Stevens-Johnson syndrome).

Acyclovir (Antiviral): Take Action (Nursing Interventions)

Monitor renal function, especially with IV administration, ensuring adequate hydration to prevent renal toxicity. Advise patients that it treats symptoms but does not cure herpes viruses.

Tuberculosis (TB) Drug Combination Therapy

Treatment for active TB involves a multi-drug regimen (e.g., Isoniazid, Rifampin, Pyrazinamide, Ethambutol) for several months to prevent drug resistance and ensure eradication of the infection.

Isoniazid (INH): Therapeutic Effects/Uses

A primary antitubercular drug used for the treatment and prophylaxis of tuberculosis. It inhibits bacterial cell wall synthesis, specifically targeting Mycobacterium tuberculosis.

Pyridoxine (Vitamin B6): Take Action (Nursing Interventions)

Administer concurrently with Isoniazid (INH) to prevent peripheral neuropathy, a common side effect of INH. Educate patients on the importance of this co-administration.

Non-pharmacological Treatment and Prevention of Parasites

Includes practicing good hand hygiene, thoroughly cooking food, drinking purified water, avoiding walking barefoot in endemic areas, and using insect repellents and bed nets.

Chloroquine (Antimalarial): Dosage and Treatment Time

Dosage varies by indication (prophylaxis vs. acute treatment) and patient weight. Treatment courses can range from weekly doses for prophylaxis to a few days for acute attacks. Strict adherence is crucial for effectiveness.

Chloroquine (Antimalarial): Food Interactions

Can be taken with food to reduce gastrointestinal upset. Should not be taken with antacids or kaolin, as they can decrease absorption.

Chloroquine (Antimalarial): Adverse Reactions (Sensory Deficits)

Potential for retinopathy (irreversible vision changes), ototoxicity (hearing loss, tinnitus), and neuromuscular weakness. Regular ophthalmic examinations are crucial during long-term therapy.

Metronidazole (Antibacterial Peptide): Side Effects

Common side effects include metallic taste, nausea, vomiting, diarrhea, abdominal cramps, and dizziness. Peripheral neuropathy is possible with prolonged high doses.

Metronidazole (Antibacterial Peptide): Drug Interactions

Avoid alcohol consumption during therapy and for at least 3 days after stopping due to disulfiram-like reaction (nausea, vomiting, flushing, headache). Potentiates warfarin's anticoagulant effect.

Zidovudine (Antiretroviral): Side Effects

Can cause severe hematologic toxicity (anemia, neutropenia), myopathy, nausea, vomiting, headache, and fatigue. Lactic acidosis and severe hepatomegaly with steatosis are serious but rare adverse effects.

Atazanavir (Protease Inhibitor): Therapeutic Effects/Uses

Used in the treatment of HIV infection by inhibiting HIV protease, preventing assembly of new, infectious virions. It helps reduce viral load and increase CD4+ cell counts.

Nursing Care/Interventions with New Infection

Obtain cultures before initiating antibiotics. Monitor vital signs and signs of improving or worsening infection. Administer antibiotics on time. Educate patient on infection control and completing full course.

Nursing Care/Interventions for Cross-Resistance

Understand that resistance to one antibiotic in a class may confer resistance to others. Educate patients on appropriate antibiotic use to minimize resistance development across bacterial strains.

Cephalosporins: Nursing Interventions (New Infection)

Assess for allergies (especially penicillin allergy due to potential cross-reactivity). Administer as prescribed, monitor for side effects like GI upset or rash, and superinfections.

Nursing Care/Interventions with Continued Infection

Re-evaluate the treatment plan if infection persists or worsens. Obtain new cultures to check for resistance or different pathogens. Assess patient adherence to medication. Consider consultation with infectious disease specialists.

Therapeutic Drug Monitoring (TDM) with Antibiotic Therapy

Measures drug concentrations in the blood to optimize dosing, maximize therapeutic effects, and minimize toxicity. Particularly important for drugs with a narrow therapeutic index.

TDM: Vancomycin

Essential for vancomycin due to its narrow therapeutic window and risk of nephrotoxicity and ototoxicity. Trough levels are typically monitored to ensure adequate drug exposure while avoiding toxicity.