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Nursing study guides, Study notes of Pharmacology

K D StudioPharmacology

Nursing pharmacology study guides

Typology: Study notes

2021/2022

Uploaded on 09/28/2022

smdixon22
smdixon22 🇺🇸

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Antineoplastic Agents, Pharmacology
Drug Assessment
erythropoietin (Epogen, Procrit) RBCs (stimulates production)
filgrastin (Neupogen)
pegfilgrastim (Neulasta)
WBCs (stimulates production)
ondansetron Nausea/Vomiting (decreases N/V);
administer 30-60 min prior
cyclophosphamide (Cytoxan) Hemorrhagic cystitis (assess for s/s of
cystitis—pain, frequency; hematuria)
Interventions: Void frequently,
Hydration (pre and post chemo)
cisplatin (Platinol)
Amifostine (Ethyol) cytoprotective agent
given with cisplatin: Hypotension
Renal toxicity (assess BUN/Creatinine,
UA)
Neurotoxicity (parasthesias, numbness
and tingling in ext., problems with snaps
and buttons, walking/clumsy)
Magnesium loss
Interventions: Hydration (pre-post
chemo), monitor I/O, DW, edema
Increase magnesium
Monitor BP prior and every 5 min
bleomycin (Blenoxane) Pulmonary toxicity (assess CXR,
Pulmonary Function Tests (PFT), Breath
sounds prior and during treatment)
doxorubicin (Adriamycin)----“RED DEVIL” Cardiac toxicity (assess Echocardiogram
prior, EKG, heart rate and rhythm)
vincristine (Onconvin) Severe neurotoxicity (Assess for motor
difficulty, Deep tendon reflexes (DTR))
vinblastine (Velban) Severe bone marrow depression
Monitor LFTs
paclitaxel (Taxol) Hair loss
Neurotoxicity
tamoxifen (Nolvadex) Anti-estrogen (symptoms of menopause)
pf2

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Antineoplastic Agents, Pharmacology

Drug Assessment

erythropoietin (Epogen, Procrit) RBCs (stimulates production) filgrastin (Neupogen) pegfilgrastim (Neulasta) WBCs (stimulates production) ondansetron Nausea/Vomiting (decreases N/V); administer 30-60 min prior cyclophosphamide (Cytoxan) Hemorrhagic cystitis (assess for s/s of cystitis—pain, frequency; hematuria) Interventions: Void frequently, Hydration (pre and post chemo) cisplatin (Platinol) Amifostine (Ethyol) cytoprotective agent given with cisplatin: Hypotension Renal toxicity (assess BUN/Creatinine, UA) Neurotoxicity (parasthesias, numbness and tingling in ext., problems with snaps and buttons, walking/clumsy) Magnesium loss Interventions : Hydration (pre-post chemo), monitor I/O, DW, edema Increase magnesium Monitor BP prior and every 5 min bleomycin (Blenoxane) Pulmonary toxicity (assess CXR, Pulmonary Function Tests (PFT), Breath sounds prior and during treatment) doxorubicin (Adriamycin)----“RED DEVIL” Cardiac toxicity (assess Echocardiogram prior, EKG, heart rate and rhythm) vincristine (Onconvin) Severe neurotoxicity (Assess for motor difficulty, Deep tendon reflexes (DTR)) vinblastine (Velban) Severe bone marrow depression Monitor LFTs paclitaxel (Taxol) Hair loss Neurotoxicity tamoxifen (Nolvadex) Anti-estrogen (symptoms of menopause)

Antineoplastic Agents, Pharmacology

Extravasation with Anti-neoplastics

Vesicants are agents that, if deposited into the subcutaneous tissue (extravasation), cause tissue necrosis and damage to underlying tendons, nerves, and blood vessels. The full extent of tissue damage may take several weeks to become apparent. Indications of extravasation include: MONITOR IV SITE Absence of blood return from IV catheter Resistance to flow of IV fluid Swelling, pain, and/or redness to IV site Some medications classified as vesicants: Vinca Alkaloids and Antitumor Antibiotics Daunorubicin, Doxorubicin (Adriamycin), Vincristine, Vinblastine, Nitrogen Mustard If extravasation is suspected, stop drug administration immediately and administer protocol according to institution’s policy through existing IV line. (Ex- aspiration of infiltrated drug and inject neutralizing solution such as Hyaluronidase.) Ways to minimize extravasation: Check for blood return prior to drug administration Good IV access or Implanted vascular access device Slow administration of chemotherapeutic agent Monitor IV access closely during administration Have client report any s/s of swelling, pain, redness or burning to IV site If you have to administer a combination of chemotherapeutic agents that consist of vesicants and non-vesicants (such as irritants), you need to administer the non-vesicants first. These are less likely to cause tissue destruction.