Antineoplastic Medications Chapter 14 Antineoplastic Medications

Chapter 14 Lesson 14.1

Learning Objectives List the types of drugs used to treat neoplastic disease or cancer Identify the major adverse reactions associated with antineoplastic agents Develop a teaching plan for a patient taking an antineoplastic drug

Overview Neoplasms Metastasis Malignancy Chemotherapeutic agents How do chemotherapeutic drugs work to treat malignant diseases? Why are the cells in the GI tract, bone marrow, hair follicles, testes, and ovaries affected during cancer treatment? Why is it important for the nurse to monitor the patient closely during chemotherapy treatment?

Antineoplastic Medications Action and Uses Alkylating agents interfere with cell division Antibiotic preparations not used as antiinfectives Antimetabolites affect cell metabolism Action of male, female hormones on cancer unclear Mitotic inhibitors interfere with cell division Miscellaneous agents How do antibiotic preparations act in the cancer cell? Antimetabolites disrupt normal cell functions by interfering with various metabolic functions of the cells. When is this most effective? Why is it important for these drugs to undergo clinical trials before they are used in cancer treatment? When a drug is used to treat cancer as an “off-label” use, what does this mean? What is the rationale for use of an antiandrogen hormone in the treatment of prostate cancer? Table 14-1 has further information about these agents.

Antineoplastic Medications (cont.) Adverse Reactions Dose-dependent GI: nausea, vomiting, diarrhea and anorexia Bone marrow depression System-specific toxicity If a patient is experiencing bone marrow depression secondary to chemotherapeutics, what symptoms would be exhibited? What body systems are at high risk for chemotherapy toxicity? If the patient is experiencing peripheral neurotoxicity, what subjective finding is common? Adverse reactions may not occur for several days after treatment.

Antineoplastic Medications (cont.) Drug Interactions Drug-specific: consult manufacturer’s guidelines

Antineoplastic Medications (cont.) Nursing Implications and Patient Teaching Assessment Diagnosis Planning Implementation Evaluation What impact would cultural and spiritual beliefs have on the patient’s cancer treatment plan? How is the dosage of antineoplastic medications determined? Should a pregnant nurse administer antineoplastic drugs? What types of medications may be useful in treating the adverse effects of antineoplastic drugs? Why is it important for the nurse to inquire about herbal supplements the patient may be using?

Antineoplastic Medications (cont.) Nursing Implications and Patient Teaching (cont.) Patient and Family Teaching Chemotherapy/product education Adverse effects When to report symptoms to the healthcare provider Nutrition Signs of dehydration Hair loss Support groups What education will the LPN/LVN include for home storage of chemotherapy drugs? After surgery for cancer, the patient should be provided education on muscle strengthening and the use of a prosthesis if one has been prescribed. What resources can the nurse suggest for patients who are experiencing hair loss secondary to chemotherapy use? What are signs of dehydration? What symptoms and/or adverse effects will the nurse advise the patient/family to report to the healthcare provider?