chemo pharm test 3njk

s/s peripheral nerve injury

NUMB/TINGLING TOXICITY SIGN

HIGH GROWTH FACTOR

PROLIFERATING RAPIDLY, CHEMO WORKS WELL ON THIS

What activities by nursing can increase the patient's risk for bleeding

SQ INJECTION, BP CUFF, PLATELET COUNT LESS 150,000 S/S BLEEDING, HEMOTOMA, BLOODY URINE/STOOL, BRIGHT RED BLEEDING, LOOK FOR PETECHIA

Opreleiken moa

STIMULATES BONE MARROW FOR THROMBOCYTE

What do colony stimulating factors do

STOP INFECTION, NEUTROPENIA, FEVER

Filgrastim is what

granulocyte colony stimulating factor

Colony stimulating factors

granulocyte colony stimulating factor (filgrastim), long-acting granulocyte colony stimulating factor (pegfilgrastim), granulocyte macrophage colony stimulating factor (sargramostim)

What cancers respond to chemo better

high growth, leukemia/testicular

How long does it take Neutrophils to recover

in a week.

daunorubicin

injury to heart (lv),

cisplatin

injury to kidney

vincristine

injury to peripheral nerves

Strategies for Achieving Maximum Benefits from Chemotherapy

intermittent chemo, combination chemo

If severe thrombocytopenia, can be treated with

platelet infusion. oprelvekin (Neumega) can be administered.

Cancers found in men

prostate, lung, colorectal and urinary bladder cancers.

Persistent proliferation

un-restrained growth and division

how does sisplatine limititation determined

DOSE LIMITED DUE TO CR LEVEL

Neutropenia level

< 500 mm3

Drug resistance

ADAPT

What do you do if there is a fever during chemo

BLOOD Cultures. IV antibiotics against gram negative bacteria

How is rbc anemia treated

Can be treated with a packed red blood cell transfusion, epoetin alpha

Heterogeneity of tumor cells

DIFFERENCE IN CELLS AND MUTATES SO HARD TO TREAT

Why do we not give a lot of blood transfusion

Develop antibiodies, transfusion reaction, iron toxicity

Optimizing Dosing Schedules in Combination Therapy

Each drug should be effective by itself, should have a different mechanism of action, have minimally overlapping toxicities

Opreleiken AE

FLUID RETENTION, HYPER Kalemia, allergic reaction, crackles, edema, anemia, dysrhythmias due to hyperK.

When is a fever in chemo

Fever 100 OR GREATER.

Solid tumors respond poorly to cytotoxic drugs

LACK OF VASCULAR SUPPLY TO SOLID TUMORS

how do you prevent injury to heart and daunorobuicin

LISTEN TO HEART SOUNDS, SUBJECTIVE SOB WITH EXERTION, POOR CO SIGN

DOSE LIMITING TOXICITY

VERY BAD SIDE EFFECT

Absence of true early detection

VISUALLY EVIDENT THERE ARE A BILLION CELLS, RADIOGRAPHICALLY

Which drugs would the patients have an increased risk for bleeding

WARFARIN, ANTIPLATELET, ANTI COAG

nadir period

WILL GO REALLY LOWest blood cell.

Characteristics of Neoplastic Cells

persistent proliferation, invasive growth, formation of metastases, immortality

Neoplastic cells

abnormal cell growth

Toxicity to normal cells

anticancer drugs like cytotoxic drugs lack selective toxicity- TOXIC TO NORMAL CELLS

Cancers commonly seen in women

breast, lung, colorectal and uterine cancers

What is given for fevers, gram negative and chemo

ceftazidime (Fortaz)

Invasive growth

cells can penetrate adjunct tissues

What drug used most often but can hurt normal tissue fast

cytotoxic

Drug therapy is in 4 main classes

cytotoxic, hormones, biological response modifier, targeted drugs

Immortality

endless division

What bacteria is responsipble for Hospital Acquired Infection

gram negative

anticancer drugs affect the red blood cells more or less often and why

less as the erythrocyte life span is 120 days providing time to recover before the levels of erythrocytes fall too low.

When is your highest risk for infections

nadir period

Bone Marrow Suppression

neutrophils, thrombocytes, platelets, rbc

Intermittent Chemotherapy benefit

normal cells have time to repopulate NORMAL CELLS TO REPOPULATE FASTER THAN CANCER CELL, AVOID ae

Anemia

reduced circulating red blood cells (RBC)

Neutropenia

reduction in circulating neutrophil BABY WBC-

Thrombocytopenia

reduction in circulating platelets- causes an increased risk BLEEDING

Formation of metastases

secondary tumors that appear away from the site of origin

Regional Drug Delivery

special techniques such as intrathecal- bypasses the blood-brain barrier; intra-arterial- used to treat solid tumors/renal cancers

Combination Chemotherapy benefits of drug combinations

suppression of drug resistance, increased cancer cell kills, reduced injury to normal cells

Three treatment modalities for cancer

surgery, radiation, drug therapy

When do you use filgrastim

to make new WBC

Chemo and Sepsis med

tobramycin or amikacinHIGH RISK FOR DRUG RESIST.

Obstacles to Successful Chemotherapy

toxicity to normal cells, absence of true early detection, sold tumors ,heterogentity, drug resistant, cures req 100% kill, limit access to brain