vinca alkaloid

vincristine

med under vinca alkaloid

vincristine

therapeutic use

• Treats the following types of cancer

Acute leukemias $ Lymphomas

Wilms’ tumor and neuroblastoma (children)

Breast and lung cancer

Soft tissue sarcomas

adverse effect

• Peripheral neuropathy

• Tissue damage if IV infiltration and extravasation occur

• Alopecia (occurs in about 20% of clients taking vincristine)

• Severe constipation and upper colon impaction; possible intestinal ileus (mostly in children)

interventions

• Check deep tendon reflexes periodically, especially Achilles reflex.

• Monitor for decreased strength or movement of hands and feet.

• Decrease dosage if peripheral neuropathy occurs.

• Monitor IV site carefully for infiltration.

• Stop IV immediately if infiltration occurs.

• Antidote: apply heat and local subcutaneous injection of hyaluronidase to help disperse the extravasated medication.

• Monitor client for alopecia.

• Monitor carefully for constipation; monitor bowel sounds and palpate abdomen frequently.

• Administer stool softeners and laxatives, as needed

administration

• Available for IV administration.

• Calculate dosage by client’s weight and decrease if liver impairment occurs.

• Avoid contact of medication with eyes—can cause corneal damage; flush both eyes immediately with large amounts of water if injury occurs.

• Administer IV dose directly into tubing, and infuse IV fluid over at least 1 min.

client instructions

• Report paresthesias and decreased sensation or strength of hands or feet.

• Immediately report pain, swelling or discoloration of IV site.

• Inform client that alopecia can occur.

• Report constipation, hard stools, or a decrease in bowel movements to provider.

contraindications

• Pregnancy risk category D, lactation

• Intestinal ileus

• Liver radiation

• Charcot-Marie-Tooth syndrome

precautions

• Low leukocyte count

• Neuromuscular or neurologic disorders

• Hypertension

• Liver or gallbladder disease

interactions

• Mitomycin, an anticancer antibiotic, may cause shortness of breath and bronchospasm.

• May decrease antibody response to live-virus vaccines