Week 9 Words

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av8girl
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10814
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Week 9 Words
Updated:
2010-03-16 14:32:46
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Pharmacology Anticancer Biologic response modifiers
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Chapter 37-38-39
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  1. cyclophosphamide
    class: alkylating drug
    prototype
    • Cytoxan
    • Breast lung, ovarian cancer; Hodgkins disease; leukemias; lymphomas. An immunosuppressant agent.
    • MOA: inhibition of protein synthesis through inferference with DNA replication by alkylation of DNA.
    • Contra: hypersensitivety, sever bone marrow depression
    • Caution: Pregnancy, liver or kidney disease
    • SE: N&V diarrhea, weight loss, hematuia, alopecia, impotence, sterility, ovarian fibrosis, headache dizziness, dermatitis.
    • AR: Hemorragic cystitis, secondary neoplasm, bonemarrow depression.
    • Interactions: Decreases digoxin level. Increases drug action of barbituates, chloramphenicol half-life.
    • Toxicity if given with corticosteroids, phenytoin, or sulfamides.
    • Use cautiously with garlic, ginko, echinacea, ginseng, St. John's wort, Kava Kava, grape seed.
    • Suppresses positive reaction to uric acid, purified protein derivative, mumps, May cause false positive Candida pap smear.
  2. 5-fluorouracil
    Antimetabolite
    Prototype
    • 5-FU
    • Cancer of breast, cervix, colon, liver, ovary, pancreas, stomach, and rectum. Given in combination with levamisole after surgical resection in clients with Duke's stage C colon cancer.
    • MOA: prevention of thymidine symthetase production, thereby inhibiting DNA and RNA synthesis. Not phase specific.
    • Contra: Hypersensitivity, pregnancy, severe infection, myelo-suppression, marginal nutritional status. Reduce dose in clients with impaired hepatic or renal function or malnutrition.
    • SE: Stomatitis, N&V&D, alopecia, rash, photosensitivity, Diarrhea may be sever.
    • AR:bome marrow depression. Life threatening: thrombocytopenia, myelosuppression, hemorrhage, renal failure.
    • Interactions: bone marrow depressants increase chances of toxicity. Avoid live virus vaccines. May decrease albumin, increase excretion of 5-HIAA in urine. Use cautiously with genseng, St. John's Wort, gingko biloba. Topical pepermint oil and eucalyptus oil may increase absorption of topical 5-FU
  3. vincristin
    Class: Mitotic inhibitor/plant alkaloid
    prototype
    • Oncovin
    • Acute leukemia, hodgkin's desease, non-hodgkin's lymphoma, neuroblastoma, rhabdomyosacroma, Ewing's sarcoma, Wilms tumor, multiple myeloma, chronic leukemia, thyroid cancer, brain tumors.
    • MOA: affects cells in the M phase of the cell cycle and inhibits mitosis.
    • Contra: Fatal if given intrathecally. Don't give to patients receiving radiation therapy through ports into the liver. Hypersensitivity. Don't give to patients with charcot-Marie-Tooth syndrome.
    • Caution: Pregnancy, liver or kidney disease, neromuscular disease, infection.
    • SE: peripheral neuropathy, loss of deep tenon reflexes, phlebitis, constapation, cramps, nausea, vomiting, muscle weakness, reversible alopecia.
    • AR: sensory loss, hypotension, visual disterbances, ptosis, ileus, SIADH, hyponatremia, hyperuricemia, severe local reaction with extravasation, fever. Intestinal necrosis, seizures, coma, acute bronchospasm, bone marrow depression.
    • Interactions: Given 12-14 hrs prior to L-asparaginase to minimize toxixity. Increased risk of bronchospasams with mitomycin. decreases digoxin effects-monitor levels. mix only with normal saline or glucose in H2O - keep pH range at 3.5-5.5. May cause hyponatremia, hyperuricemia, anemia, leukopenia, thrombocytopenia.
  4. erythropoietin
    Biologic response modifier
    prototype
    • Procrit
    • To treat anemia secondary to CRF or AZT treatment of HIV infections. Use in clients with anemia secondary to cancer chemotherapy.
    • MOA: increased production of RBCs triggered by hypoxia or anemia.
    • Contra: Unccontrolled hypertension, hypersensitivity to mamalian cell-derivedproducts or human albumin.
    • Caution: pregnancy, lactation, porphyia;safety in children not known; increased mortality and/or tumor progression, serious cardiovascular and thromboembolic events if target hemoglobin of 12g/dl exceeded.
    • SE: sense of well-being, hypertension, arthralgias, nausea, edema, fatigue, injection site reaction, rash, diarrhea, SOB
    • AR: seizures, hyperkalemia, CVA, MI
    • Interactions: increase hematocrit, decrease plasma volume
  5. filgrastim
    Granulocyte colony-stimulating factor (G-CSF)
    prototype
    • Neupogen
    • To decrease incidence of infection in clients receiving myelosuppressive chemotherapeutic agents, including clients with AML undergoing induction or consolidation therapy, and clients undergoing bone marrow transplant; adjunct to chemotherapy for both solid tumor and hematologic malignancies; and for mobilization of progenitor stem cells used in autologous transplant; also for treatment of clients with severe, chronic neutropenia.
    • MOA: increases production of neutrophils and enhances their phagocytosis.
    • Contra: hypersensitivity to Escherichia coli-derived proteins. 24 hrs before or after cytotoxic chemotherapy.
    • Caution: pregnancy, lactation, safety in children is not known.
    • SE: N&V, skelatal pain, alopecia, diarrhea, fever, skin rash, anorexia, headache, cough, chest pain, sore throat, constipation
    • AR:Neutropenia, dyspnea, splenomegaly, psoriasis, hematuria. Thrombocytopenia, MI, adult respiratory distress syndrome in clients with sepsis, splenic rupture.
    • Interactions: increase in lactic acid, LDH, alkaline phoshatase transient increase in neutrophils.

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