chapter 40 agents used in the treatment of cancer
TRANSCRIPT
Chapter 40
Agents Used in the Treatment of Cancer
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 2
Cancer
Broad term A group of diseases characterized by
uncontrolled cellular growth Invasion into surrounding tissue
Metastasis Cancer spreads to other areas in the body
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 3
Etiology of Cancer
Remains a mystery Could be:
Environment Lifestyle Occupation Genetic and ethnic factors
Age- and sex-related differences
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 4
Cell Growth Cycle
Normal cells and cancer cells go through five distinct growth phase cycles
1. Go, resting phase
2. G1, first growth
3. S, DNA synthesis phase
4. G2, second growth phase
5. M, mitosis phase Cancer cells divide rapidly.
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 5
Treatment Considerations
Growth fraction The fraction of cells that are in active
phases Mitotic index
Percentage of cells undergoing mitosis Antineoplastics most effective when the
growth fraction and mitotic index are high
(continues)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 6
Treatment Considerations
Cancer stage when it is discovered Efficacy of the cancer treatment Development of drug resistance General health of the client
(continued)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 7
Antineoplastics
Divided into two groups1. Cell cycle nonspecific (CCNS)2. Cell cycle specific (CCS)
CCNS effective against slow-growing cancer cells
CCS effective against fast-growing cancer cells
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 8
Agents Used in the Treatment of Cancer
Alkylating agents Antimetabolites Mitotic inhibitors Antibiotics Hormones
(continues)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 9
Agents Used in the Treatment of Cancer
Radioactive drugs Biologic-response modifiers Miscellaneous agents Combination therapy Adjuvant agents
(continues)
(continued)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 10
Agents Used in the Treatment of Cancer
Alkylating agents: cell cycle nonspecific Antimetabolites: cell cycle specific in the
S phase Mitotic inhibitors: cell cycle specific in
the M phase
(continued)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 11
Antineoplastic Agents
Affect all cells, both healthy and sick Dose-limiting effects
Hair falls out Cells in the gastrointestinal tract die Nausea and vomiting occur; emetic
potential Myleosuppression
Nadir: lowest point for the bone marrow cells
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 12
Antineoplastics: Adverse/Side Effects
Common Fever, chills, headache, nausea, and
vomiting Serious
Bronchospasm, dyspnea, hypotension, and angioedema
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 13
Combination Therapy
Use of several antineoplastic agents at the same time
Proven effectiveness Rationale of using combination therapy
Have a more beneficial effect than when used alone
Each agent exhibits different actions and toxicities
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 14
Adjuvant Agents
Antiemetics Ondansetron HCl (Zofran)
Rescue agents Mesna Leucovorin
Blood-forming agents Epoetin alfa (Procrit)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 15
Nursing Implications
During administration of the antineoplastic:
Provide significant hydration to prevent nephrotoxicity
Provide periodic monitoring of heart and lung function
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
40 - 16
Legal and Ethical Principles
To avoid errors Standardized, preprinted order forms
Nurses Physicians Pharmacists