Nurs 2514 – Drugs
Methotrexate* Correct Answer-Antimetabolite (Antifolate), S-phase
USE oncology, non-hodgkins, head and neck sarcomas,
choriocarcinoma
MOA inhibition of folic acid synthesis, disrupts synthesis of DNA
precursors, induces programmed cell death
ROUTE po/Im/iv/it
ONSET/PEAK 4-7d/7-14d
ELIMINATION urine
S/E interstitial pneumonitis, renal failure, myelosuppression,
thrombocytopenia, anemia, hemorrhage, septicemia, hepatic toxicity
INTERACTIONS
MONITOR CBC, neurological, hepatic, renal, lung status, infection,
bleeding, anemia, pts with diabetes, hydration, status
EDUCATION avoid infection, increase fluid intake, maintain oral
hygiene, photosensitivity, signs of bms, alopecia
DOSE LIMITING: bone marrow suppression, mucositis
Cyclophosphamide (Cytoxan)* Correct Answer-Alkylating agent
(cytotoxic antineoplastic), phase non-specific
USE broad spectrum of neoplastic diseases, prodrug
MOA Kills rapidly growing cells by interrupting DNA/RNA synthesis
by cross-linkage, strand breaking
ROUTE PO IV
,SE Can cause bone marrow suppression, N/V, acute hemorrhagic
cystitis, alopecia, bladder injury, bleeding
PATIENT Ed. with food.
DOSE LIMITING: bone marrow suppression
Prednisone/Prednisolone* Correct Answer-Used in combination with
chemotherapy for blood cancers. Also used in autoimmune disease.
Paclitaxel* Correct Answer-mitotic inhibitor, microtubule inhibitor, G2-
M-phase
USE first line ovarian-, non-small cell lung cancer, adjuvent to breast
cancer treatment
ROUTE IV
MOA promotes formation of stable microtubule bundles inhibiting
mitosis
SE severe hypersensitivity, alopecia
DOSE LIMITING bone marrow suppression, peripheral neuropathy
Vincristine (oncovin)* Correct Answer-vinca alkaloid, M-phase specific
USE bone marrow sparing, combination therapy, broad
ROUTE IV
MOA blocks microtubule assembly
Peripheral neuropathy (foot drop, numbness and tingling, hoarseness,
jaw pain)
constipation (adynamic ileus due to neurotoxicity)
,DOSE LIMITING peripheral neuropathy
Bleomycin* Correct Answer-Cytotoxic antibiotic, G2-phase
ROUTE iv, im, sq, IP
MOA: breaks DNA strands, prevents repair
USE: Testicular cancer, Hodgkin lymphoma
S/E: *Pulmonary fibrosis*, skin hyper pigmentation, mucositis.
*Minimal myelosuppression*
DOSE LIMITING pneumonitis, pulmonary fibrosis
Doxorubicin (adriamycin)* Correct Answer-Antineoplastic:
anthracycline drug (cell
cycle−nonspecific), phase non-specific
USE broad
ROUTE IV
MOA intercalates between base pairs to disrupt DNA and inhibits
topoisomerase II.
DOSE LIMITING: *cardiotoxicity,* myelosuppression
Tamoxifen (Soltamox)* Correct Answer-selective estrogen receptor
modulator
ROUTE PO
MOA blockade of estrogen receptors, prodrug
USE ER-positive breastcancer
, SE *endometrial cancer*, thrombosis
Fulvestrant (not testable) Correct Answer-estrogen receptor antagonist
MOA blockade of estrogen receptor
ROUTE IM
USE ER-positive breast cancer
KINETICS peak at 7 days, therapeutic for a month
SE GI-disturbances, hot flashes, headache, pharyngitis, bone/back pain
Epoetin alfa (Epogen)* Correct Answer-BMR, CSF, erythropoietic
growth factor
USE anemia from anti-neoplastic therapy in pts with non-myeloid
malignancies
MOA stim. erythroid progenitor stem cells
ROUTE Iv sq
ONSET/Peak 7-10d/6-8wk
SE seizures, pure red cell aplasia, Death, hypertension, cardiovascular
events.
CONSIDERATION pts with hx heart disease, heparin
MONITOR CV cns i&o iron hgb
EDUCATION dizziness, home procedure, bp, rash-> d/c
Neupogen (filgrastim)* Correct Answer-granulocyte Colony Stimulating
Factor; Hematopoietic agent BRM
