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
