oncology meds

  • Vincristine

    • Uses/Indications

      • prevents cell division + blocks mitosis

    • side effects

      • peripheral neuropathy (numbness tingling esp in feet)

      • hypersensitivity esp if plant allergy

    • Nursing administration/Considerations

      • assess breath sounds for bronchospasm (may indicate allergic reaction)

      • monitor deep tendon reflexes, neurologic status, LOC

      • assess for neuropathy (weakness, numbness, tingling, foot drop, ataxia)

      • teach pt to inform the nurse of any chest pain or SOB (hypersensitivity reaction)

    • Lab monitoring

  • Bleomycin

    • Uses/Indications

      • head + neck, testicular, ovarian cancers

    • side effects

      • adverse: pulmonitis in 10% of pts, pulmonary fibrosis

      • problems w/ heart: cardiac toxicity, dysrhythmias, cardiomyopathy, heart failure (may have delayed onset)

      • bone marrow suppression

      • extravasations of vesicants cause severe tissue damage.

      • alopecia

    • Nursing administration/Considerations

      • extravasation = stop chemo ASAP, use cool compress

      • use central line bc smaller veins = higher risk of extravasation

      • hair loss 7-10 days after starting, max 2 months

    • Lab monitoring

      • monitor EKG

      • monitor for myelosuppression (CBC with diff)

  • Tamoxifen

    • Uses/Indications

      • competes w/ estrogen for receptors on target tissues

      • adult patients w/ estrogen receptor-positive metastatic breast cancer

      • adjuvant treatment of adult patients w/ early stage estrogen receptor positive breast cancer

      • prevent development of breast cancer in adult women at high risk (prophylaxis)

    • side effects

      • BLACK BOX: increased risk of uterine cancer + thromboembolic disease (stroke, PE, DVT)

      • hot flashes, fluid retention, vaginal discharge

    • Nursing administration/Considerations

      • contraindicated in pts going thru anticoagulant therapy, history of thromboembolic disease, pregnancy

      • give w/ food/fluid to decrease GI irritation

      • do not crush or chew

      • avoid antacids 1-2 after

      • monitor fluid status

      • assess breath sounds

      • teach pt

        • may develop cross-gender secondary sexual characteristic (voice deeper, faster body hair growth)

        • monitor for bleeding, get yearly PAP bc risk of uterine cancer

        • report chest pain or SOB

    • Lab monitoring

      • monitor for hypercalcemia