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Name three types of treatment for Cancers
- Cytotoxic Agents
- Biologic Agents
- Targeted Therapy
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This is an example of:
Extravasation
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Cisplatin (Planitol) should have what premed order?
IV fluids!!
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What is the mechanism of action for Alkylating agents?
- They break the DNA helix strand, thereby interfering with DNA replication
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Which Cytotoxic Agent has crystals that, if not flushed through the system, can cause hemorrhagic cystitis?
- Cytoxan
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Ifosfamide should ALWAYS BE GIVEN WITH:
Mesna...to prevent hemorrhagic cyctitis
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If treated with this Cytotoxic agent, the pt should be advised to avoid cold temps, esp hands and feet. They should not hold cold drinks.
- Oxaliplatin (Eloxatin)
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Pt's treated with Temozolomide (Temodar), should avoid what for several days after tx?
The sun
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These type of Cytotoxic Agents are used for liquid Ca's, such as Leukemia and Lymphomas
Antimetabolites
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When taking Capecitabine (Xeloda), what bloodwork should be closely monitored?
PT/INR....Capecitabine increases the effect of warfarin
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What is Adjuvant therapy?
Therapy intended to target minimal disease, or micromets, for pt's at high-risk for recurrence. Basically, clean-up after the main Ca is thought to be eradicated.
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What is Neoadjuvant therapy?
Therapy aimed at shrinking a tumor, prior to primary therapy. Goal is to improve the effectiveness of surgery.
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Define myeloablation
Obliteration of bone marrow in preparation for peripheral blood stem cell or bone marrow transplantation.
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Consistent treatment is essential if "cured" is the desired outcome because...
- Optimal cell kill is achieved by chemo at intervals that correspond to the cell cycle.
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While chemotherapy kills cells, Biotherapy works in several ways. List some
- 1. Enhances pt's own immune response
- 2. Alters milieu where Ca grows by modifying the actions of normal cells around it
- 3. Increase the Ca's vulnerability to pt's immune system
- 4. Alter the pathways by which normal cells transform into Ca cells
- 5. Prevent Mets
- 6. Enhance the repair of normal cells damaged by tx
- 7. Change Ca cells so they behave like normal cells
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Almost all chemo agents will make the pt sick...but this one REALLY makes them sick!
Cytarabine (cytosine arabisonide, ARA-C, Cytosar-U)
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This Cytotoxic agent must be used within 15 minutes of reconstitution
Decitabine (Dacogen)
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If taking this cytotoxic agent, inform pt of heightened photosensitivity
- Fluorouracil (5-FU)
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This cytotoxic agent must be infused over 30 min. Longer than 30 min can increase pulmonary toxicity.
Gemcitabine (Gemzar)
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Once this cytotoxic agent has been given, it must be followed by leucovorin and vigorous hydration!
Methotrexate
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After MTX (methotrexate), this vitamin in given because it stops the effects of MTX.
You want to give the MTX, get it in, then stop it...because it is so toxic.
Leucovorin
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Bleomycin has a lifetime dose limit due to:
Pulmonary toxicity
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Define Nadir
Following cytotoxic therpay, the time or level at which the lowest blood cell count is reached.
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When administering IV chemotherapy, ALWAYS DOCUMENT what?
Verification of blood return before, during and after IV therapy
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In the Immune System, name the 4 types of T Cells
- 1. Helper T Cells
- 2.Cytotoxic (Tc Cells)
- 3. T regulatory cells/supressor cells (Treg cells/ Ts cells)
- 4. Memory T cells (Tm cells)
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Name the 7 types of cells of the immune system
- 1. Antigen-presenting cells
- 2. T cells
- 3. NK cells
- 4. NKT cells
- 5. B lymphocytes
- 6. Antibodies
- 7. Cytokines
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