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  • [::..archive..::]
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    :: Sunday, August 03, 2003 ::

    antimetabolite medications

    A. Description

    1. halt the synthesis of cell protein
    2. replace normal proteins required for DNA synthesis
    3. cell cycle phase specific and affect the S phase

    B. side effects

    1. anorexia, nausea and vomiting
    2. diarrhea
    3. alopecia
    4. stomatitis
    5. depression of bone marrow
    6. cytarabine HCL (cytosar U) may cause alopecia, stomatitis, hyperuricemia, and hepatotoxicity
    7. florouracil (adrucil) may cause alopecia, stomatitis, diarrhea, phototoxicity reactions, and cerebellar dysfunction.
    8. mercaptopurine (purinethol) may cause hyperuricemia, and hepatotoxicity
    9. methotrexate (folex) may cause alopecia, stomatitis, hyperuricemia, photosensitivity, hepatotoxicity, hematological, GI, and skin toxicity.

    C. Implementation

    1. monitor vital signs and temperature for signs of infection.
    2. monitor the CBC, WBC, uric acid, and platelet count
    3. the medication is withheld if the WBC count is less than 4,000 cells/ul or the platelet count is less than 75,000 cells/ul and the physician is notified.
    4. monitor renal funciton studies.
    5. monitor for cerebellar dysfunction
    6. monitor for photosensitivity
    7. antiemetics are administered 30 to 60 minutes before the antineoplastic medication as prescribed.
    8. monitor the IV site for extravasation.
    9. encourage fluid intake of 2 to 3 liters per day
    10. encourage good oral hygiene
    11. instruct the client how to avoid infections and bleeding.
    12. when teh client is receiving flororuracil (adrucil), monitor for signs of cerebellar dysfunciton such as dizziness, weakness, and ataxia, and for stomatitis, and diarrhea, which may necessitate medication discontinuation.
    13. when the client is receiving folex in large doses, leucovorin (folinic acid or citrovorum factor) may be prescribed to prevent fatal toxicity ( known as leucovorin rescue)
    14. when the client is receiving adrucil or folex, instruct the client to use sunscreen and wear protective clothing to prevent photosensitivity reactions.

    :: Sindhu's Medical News @ 3:26 AM [+]

    ...
    antimetabolite medications

    folic acid antagonist
    methotrexate (folex)

    pyrimidine analogs
    cytarabine HCL (ara-C)
    floxuridine (FUDR)
    procarbazine (maturane)

    purine analogs
    mercaptopurine (purinethol)
    thioguanine

    miscellaneous ribonucleotide reductase inhibitors
    hydroxurea (hydrea)
    trimetrexate glucoronate (neutrexin)

    antimicrotuble
    pentostatin (nipent)



    :: Sindhu's Medical News @ 3:09 AM [+]

    ...
    antineoplastic medications continued

    Alkalating medications



    nitrogen mustards

    Chlorambucil (leukeran)
    cyclophosphamide (cytoxan)
    Estramustine phosphate sodium (emcyt)
    ifosfamide (Ifex)
    methchlorethamine HCL (mustargen)
    melphalan (alkeran)

    nitrosoureas

    busulfan (myleran)
    Carmustine (BCNU)
    chlorozotozin (DCNU)
    lomustine (CCNU)
    semustine (Methyl CCNU)
    streptozocin (Zanosar)


    alkalalting like medications

    altretamine (Hexalen)
    carboplatin (paraplatin)
    cisplatin (platinol)
    thiotepa
    dacarbazine (DTIC)

    description

    affects the synthesis of DNA by causing cross linking of DNA to inhibit cell reproduction
    cell cycle phase nonspecific medication.


    side effects

    1. Anorexia, nausea, and vomiting
    2. Stomatitis
    3. Skin rash
    4. Pain During IV administration
    5. busulfan (myleran) may cause hyperuricemia
    6. Chlorambucil (leukeran) and mechlorethamine HCL (mustargen) may cause gonadal suppression and hyperuricemia
    7. Cisplatin (platinol) may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia and nephrotoxicity.
    8. Cyclophosphamide (cytoxan) may cause alopecia, gonadal suppression, hemorrhagic cystitis, and hematuria.

    C. implementation

    1. monitor vital signs and the temperature for signs of infection.
    2. monitor CBC, WBC, platelet, uric acid and electrolyte counts
    3. the medication is withheld if the platelet count is less than 75,000 and notify the physician.
    4. pulmonary function tests are monitored
    5. chest radiographs and renal and liver function studies are monitored.
    6. the client is hydrated with IV and/or fluids before teh antineoplastic medication is administered as prescribed.
    7. an antiemetic is prescribed 30 to 60 minutes before the antineoplastic medication
    8. as prescribed, IV site pain is reduced by altering IV rates, diluting the medication, or warming the injection site to distend vein and increase blood flow.
    9. monitor IV site for irritation and phlebitis
    10. when the client is receiving cisplatin (platinol), monitor the client for dizziness, tinnitus, hearing loss, incoordination, and numbness and tingling of extremities.
    11. monitor for signs of hemorrhagic cystitis, such as hematuria or dysuria, during cyclophosphamide (cytoxan) or ifosfamide (ifex) therapy, and encourage the client to drink atleast 2 to 3 literes per day.
    12. instruct the client that cyclophosphamide (cytoxan) when prescribed orally, is administered without food.
    13. instruct the client to follow a diet low in purines to alkalize urine and lower uric acid blood levels.
    14. instruct the clients how to avoid infection
    15. instruct the client to report signs of infection or bleeding.
    16. instruct the client about good oral hygiene and the use of a soft toothbrush.

    antitumor antibiotic medications

    antitumor antibiotic medications

    bleomycin sulfate (blenoxane)
    dactinomycin (actinomycin D)
    Daunorubicin (cerubidine)
    doxorubicin (adriamycin)
    idarubicin (idamycin)
    mitomycin (mutamycin)
    plicamycin (mithracin)
    mitoxantrone (novantrone)

    description

    interferes with DNA and Ribonucleic acid synthesis
    cell cycle phase non specific medications



    side effects

    1. nausea and vomiting
    2. fever
    3. bone marrow depression
    4. skin rash
    5. alopecia (baldness)
    6. stomatitis
    7. gonadal suppression
    8. hyperuricemia
    9. vesication (blistering of tissue at IV site)
    10. plicamycin (mithracin) affects bleeding time.
    11. Daunorubicin (cerubidine) may cause congestive heart failure and dysrhythmias
    12. doxorubicin (adriamycin) and idarubicin (idamycin) may cause cardio toxicity,, cardiomyopathy, electrocardiogram changes (EKG)
    13. pulmonary toxciity can occur with bleomycin sulfate (blenoxane)

    C. implementation

    1. monitor vital signs and temperature for signs of infection.
    2. monitor CBC, WBC , platelets, uric acid, bleeding time and electrolyte counts
    3. the medications are withheld if the platelets are less than 75, 000 cells or the WBC ccount is less than 4,000 cells/ul and the physician is notified.
    4. pulmonary function tests are monitored.
    5. The ECG is monitored for changes
    6. monitor lung sound for rales.
    7. monitor for signs of CHF; including dyspnea, crackles, peripheral edema, and weight gain.
    8. chest radiographs and renal and liver function studies are monitored.
    9. the cilent is hydrated with IV and or oral fluids before the antineoplastic medication
    10. an antiemetic is administered 30 to 60 minutes before the antineoplastic medication
    11. as prescribed, IV Site pain is reduced by altering IV rates, diluting the medication, and warming the injection site to distend the vein and increase blood flow.
    12. monitor Iv site for irritation, phlebitis, and vesication.
    13. monitor for myocardial toxicity, dyspnea, dysrhythmias, hypotension, and weight gain when doxorubicin (adriamycin) or idarubicin (idamycin) is administered.
    14. monitor the pulmonary status when bleomycin (blenoxane) is administered.
    15. aspirin, anticoagulants, and thrombolytic agents are avoided when plicamycin (mithracin) is administered.



    :: Sindhu's Medical News @ 2:58 AM [+]

    ...

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