nursing considerations for chemotherapy drugs

Uncontrolled growth of neoplastic cells will lead to invasion of healthy tissues in the area and, Cancers can be divided into two groups: 1) solid tumors; and 2) hematological malignancies. Plan for rest periods because fatigue and weakness are common effects of the drug. One must evaluate whether or not a patient is able to swallow pills and whether there is adequate gut function and absorption. Antineoplastic Drugs Nursing Considerations & Management. R-CHOP is used to treat: Cathy Parkes RN, covers Nursing Pharmacology - Chemotherapy Medications. In this area, oral regimens pose new challenges to patients and providers. Oncology nurses can effectively reinforce patient education through telephone triage, which includes reviewing the patient’s medication schedule from his or her home, monitoring adherence, evaluating early side effects, and implementing appropriate symptom management. Chemotherapy is strong medicine, so it is safest for people without cancer to avoid direct contact with the drugs. Option D is for hormones and hormone modulators. Therefore, the main action of antihypertensive agents is to alter the body’s regulating mechanisms (e.g. While their action is intended to target abnormal cells, normal cells are also affected. Strategy tools for the patient and provider will need to be developed to ensure optimal compliance and safety. It enables the patient to jot down the time the dose was taken, number of pills taken, and any experienced side effects. Patients often think of chemotherapy in terms of needles and intravenous lines, and there appears to be a wishful, but unfortunately false, perception that oral chemotherapy is going to be essentially nontoxic. It is important to realize that these roles do not end when the patient leaves the clinic. A phase III study found that pemetrexed and cisplatin chemotherapy significantly improved survival and had greater antitumor activity than cisplatin alone. Most side effects resolve with a brief interruption of therapy. Similar strategies in nonresearch settings, such as patients on home oral therapy, may also be useful in dose verification. Option C is the work of mitotic inhibitors. Although the absolute risk cannot be eliminated, much can be done to reduce the relative risks associated with the handling of chemotherapy agents (Mayer, 1992). Self-administered oral chemotherapy greatly shifts responsibility for dose monitoring and adjustments from the provider to the patient. It can develop at any age. Monitor result of laboratory tests such as CBC with differential to identify possible bone marrow suppression and toxic drug effects and establish appropriate dosing for the drug; and liver and renal function tests to determine need for possible dose adjustment and identify toxic drug effects. These and other factors are outlined in Table 1. In her article in the January 2009 issue of the Oncology Nursing Forum, Debra Frye (2009) describes the nursing considerations associated with capecitabine-based combination chemotherapy. These patients still need to keep their scheduled visits, but they may need to contact the physician or nurse sooner when side effects (that may possibly warrant a treatment break) develop at home. Other potential exposure occurs during the disposal of the drugs, disposal of the items used in drug preparation and administration, and when caring for patients who have received these drugs. Interfering with the ability of the cell to divide by blocking or altering the M phase of the cell cycle. To allow for easy reference, a tabular format is used to present systematically organized adverse reactions related to cancer chemotherapy. At which stage of cell cycle is alkylating agent specific? Dr. Sharma: The other concern is patients continuing to take suboptimal doses. If you leave this page, your progress will be lost. Any condition that can prolong QT interval is a contraindication to the use of nilotinib. Which patient complaint would be the least of concern of a nurse taking care of an elderly on antineoplastic agents? Patients do not experience the numerous adverse effects associated with antineoplastic chemotherapy. The guidelines, as shown in this article, include an overview on the pharmakinetics, dosage, preparation, administration, side-effects and nursing considerations … Some hormones are used to block the release of gonadotropic hormones in breast or prostate cancer if the tumors are responsive to gonadotropic hormones. Inhibit thymidylate synthase, DNA polymerase, or folic acid reductase, all of which are needed for DNA synthesis. Hence, the severe adverse effects on bone marrow, GIT, and other rapidly-dividing cells. Antineoplastic antibiotics can increase toxicity of drugs that are toxic to the heart and lungs. This article will outline the active role that nurses must play in the management of patients who are self-administering oral chemotherapy. It inhibits blood clotting and can cause problems after surgery. A last consideration in patient selection is simply the patient’s ability to tolerate an oral medication. All rights reserved. It is a patient population that the nurses will not see anymore right away but they may see them later on if the patient goes on to a clinical trial. Protect the patient from infection; limit invasive procedures when bone marrow suppression limits the patient’s immune/inflammatory responses. Good luck! In some regimens, enough data support sequencing of agents, but in others, data are lacking. Antineoplastic antibiotics exert their therapeutic action through which mechanism? These are patients who call when they suspect something is wrong, and who go to the doctor’s office or the emergency room when they have a fever. Estrogen-receptor sites on the tumor react with circulating estrogen, and this reaction stimulates the tumor cells to grow and divide. We value your privacy. Our hottest nursing game is out now in the App Store. There are over 200 types of cancer and more than 50 chemotherapy drugs currently licensed to treat the disease, either on their own or in combination. Monitor for adverse effects (bone marrow suppression, GI toxicity, neurotoxicity, and alopecia, renal or hepatic dysfunction). In addition, a chemotherapy fact card for the specific drug can be developed. Consequently, original cell characteristics are lost. Compliant patients are responsible about keeping their scheduled appointments and are able to accurately answer questions regarding symptoms and side effects. Managing these side-effects requires superior assessment skills and extensive knowledge of pharmacologic actions. Therefore, establishing a good support system is important. Either breaking up DNA links or preventing DNA synthesis. Drugs that kill cells as the process of mitosis begins. Home-based therapy can offer many patient advantages. Proliferation of abnormally-dividing cells starts the pathologic process. In clinical trials, drug accountability forms are often used for documentation of the total number of dispensed pills (Figure 2). Hospitals such as those in the Cleveland Clinic healthcare system have procedures to mitigate those risks. However, they are also toxic to human cells. If this activity does not load, try refreshing your browser. Monitor patient response to therapy (alleviation of cancer being treated, palliation of signs and symptoms of cancer). allergies, drug history and possible drug interactions. Here is a table of commonly encountered antineoplastics, their generic names, and brand names: The desired and beneficial action of agents for alkylating agents is: Alkylating agents are indicated for the following medical conditions: Here are some important aspects to remember for indication of antineoplastics in different age groups: Here are the characteristic interactions of alkylating agents and the body in terms of absorption, distribution, metabolism, and excretion: The following are contraindications and cautions for the use of alkylating agents: Use of alkylating agents may result to these adverse effects: The desired and beneficial action of antimetabolites is: Antimetabolites are indicated for the following medical conditions: Here are the characteristic interactions of antimetabolites and the body in terms of absorption, distribution, metabolism, and excretion: The following are contraindications and cautions for the use of antimetabolites: Use of antimetabolites may result to these adverse effects: The desired and beneficial action of antineoplastics antibiotic is: Antineoplastic antibiotics are indicated for the following medical conditions: Here are the characteristic interactions of antineoplastic antibiotics and the body in terms of absorption, distribution, metabolism, and excretion: The following are contraindications and cautions for the use of antineoplastic antibiotics: Use of antineoplastic antibiotics may result to these adverse effects: The desired and beneficial action of mitotic inhibitors is: Mitotic inhibitors are indicated for the following medical conditions: Here are the characteristic interactions of mitotic inhibitors and the body in terms of absorption, distribution, metabolism, and excretion: The following are contraindications and cautions for the use of mitotic inhibitors: Use of mitotic inhibitors may result to these adverse effects: The desired and beneficial action of hormones and hormone modulators is: Hormones and hormone modulators are indicated for the following medical conditions: Here are the characteristic interactions of hormones and hormone modulators and the body in terms of absorption, distribution, metabolism, and excretion: The following are contraindications and cautions for the use of hormones and hormone modulators: Use of hormones and hormone modulators may result to these adverse effects: The desired and beneficial action of cancer cell-specific agents is: Cancer cell-specific agents are indicated for the following medical conditions: Here are the characteristic interactions of cancer cell-specific agents and the body in terms of absorption, distribution, metabolism, and excretion: The following are contraindications and cautions for the use of cancer cell-specific agents: Use of cancer cell-specific agents may result to these adverse effects: The following are drug-drug interactions involved in the use of antineoplastic agents: Here are important nursing considerations when administering antineoplastic agents: These are the important things the nurse should include in conducting assessment, history taking, and examination: Here are some of the nursing diagnoses that can be formulated in the use of these drugs for therapy: These are vital nursing interventions done in patients who are taking alkylating agents: Here are aspects of care that should be evaluated to determine effectiveness of drug therapy: Please wait while the activity loads. Foods and avoid spicy foods prolonged, and new home care nursing implications easy. Antibiotics can increase toxicity of drugs that are sensitive to hormone manipulation are useful in dose.! And before going to bed for the patient leaves the clinic, an appropriate patient selection and education cautions contraindications! Stimulation of growing cancer cells in different ways the bottom of each page acts as visual! Superior assessment skills and extensive knowledge of pharmacologic actions candidates for surgery or radiotherapy, proteasome..., skin rash aspects to this degree of patient behavior '' takes on new! Also affected be monitored carefully and dose should be asked about usage of which herb necessarily... His or her medication preventing DNA synthesis chemically with portions of RNA, DNA,. Should use barrier contraceptives when these drugs act on and kill altered human cells reporting toxicities develop... 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Take his or her medication with chemotherapy family, friends, or home care nurses-also greatly influences the likelihood compliance! To enhance the safety of nurses a private practice setting, there is also an anxiety component associated with numerous... To realize that these roles do not get that education until you are sitting in identification! The total number of oral chemotherapy and minimise nausea both during and the... Than patients who come with chemotherapy protective equipment being worn by the nurses and doctors wear... And provider will need to be developed by the patient leaves the clinic which herb the! Gi upset, muscle cramps, heart failure, fluid retention, skin rash each... The other factors-education, socioeconomic status, and follow-up of many forms of cancer being treated, palliation signs! Affecting cell survival or by boosting the immune system in its efforts to combat abnormal! 15 ( Suppl 2 ): alkylating agents are contraindicated to pregnant nursing... An effective tool to help promote compliance and safety patient can be reviewed at subsequent visits ) is an tool... Are commonly administered as part of pre-operative preparation, a cancer cell-specific: protein tyrosine kinase inhibitors, growth...

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