They replace these needed metabolites and thereby prevent normal cellular function. Although the absolute risk cannot be eliminated, much can be done to reduce the relative risks associated with the handling of chemotherapy agents (Mayer, 1992). Arrange for blood tests before, periodically during, and for at least 3 weeks after therapy to monitor bone marrow function to aid in determining the need for a change in dose or discontinuation of the drug. Proactive nursing follow-up is critical with home-based therapy. However, such patients require careful monitoring and oncology nurses will continue to play a significant role in the safe and effective management of these patients. A student nurse was asked to give an example of an antimetabolite. Compliance may be variable over time, with motivation and actual compliance potentially diminishing with the increasing duration of a patient’s illness. Strategy tools for the patient and provider will need to be developed to ensure optimal compliance and safety. baroreceptors, renin-angiotensin-aldosterone system, etc.) 1. This can be remedied by simply explaining to patients that. Plan for rest periods because fatigue and weakness are common effects of the drug. These are the agents of choice for slow-growing cancers. Continuing to take self-modulated dosing is another concern that is a little different than not appearing after taking 5 days of therapy. First and foremost, patients need to know the correct dose and administration schedule. Monitor patient compliance to drug therapy. These can affect not only how the patient follows his or her drug schedule, but also what he or she is willing to report or discuss regarding complications and side effects. Finally, patients often have a lack of appreciation for the potential seriousness of not reporting toxicities that develop. With oral chemotherapy, the patient-to some degree-is responsible for making dose adjustments in his or her own therapy; eg, the patient must decide whether to continue taking medication in the face of mild to moderate side effects. Each of the drugs in this combination is approved by the Food and Drug Administration (FDA) to treat cancer or conditions related to cancer. • Check urine for blood and specific gravity. JAdv Nurs 24:244-250, 1996. This medication guide provides information about the Prolia brand of denosumab. These limitations might include limited sight and limited manual dexterity in handling pills. All the chemotherapy drug information you need in the palm of your hand! These drugs act on and kill altered human cells. Patients are often reluctant to notify the nurse of side effects because they fear that their therapy may be interrupted or their dose will be lowered. Once you are finished, click the button below. Oncology nurses who are involved with patients taking oral chemotherapy must understand what factors affect compliance and how identification of these factors can aid in the development of educational strategies that will help assure patient compliance. Examination of drug containers during return visits can help ensure that patients have completed their therapy. An increasing number of oral chemotherapy agents are being developed and used in clinical practice. The guidelines, as shown in this article, include an overview on the pharmakinetics, dosage, preparation, administration, side-effects and nursing considerations … Other potential exposure occurs during the disposal of the drugs, disposal of the items used in drug preparation and administration, and when caring for patients who have received these drugs. Which patient complaint would be the least of concern of a nurse taking care of an elderly on antineoplastic agents? Treatment of breast cancer in postmenopausal women or in other women without ovarian function. Use has been somewhat limited because neoplastic cells rapidly develop resistance to these agents. Please visit using a browser with javascript enabled. Treatment of slow-growing cancers, like lymphomas, leukemias, myelomas, some ovarian, testicular, and breast cancers, and pancreatic cancers. All of the following statements are not true about antineoplastic agents, except: These drugs assume the role of the innate defenses of humans in destroying rapidly-dividing cells. Prompts, such as a spouse, alarm clock, watch, or even hand-held computer such as a Palm Pilot, may be used to remind patients to take their medication. Evaluate patient understanding on drug therapy by asking patient to name the drug, its indication, and adverse effects to watch for. Use in Cancer. • Assess platelet count. Alkylating agents are a type of chemotherapy medication to treat cancer. Nurses have always played a key role in the education and symptom management of patients undergoing chemotherapy. Which drug has been approved for use in treating CML? • Obtain kidney, and liver function tests. Nurses are the hospitality of the hospital. These new agents bring different mechanisms of action, different side effects, and new home care nursing implications. Monitor result of laboratory tests such as CBC with differential to identify possible bone marrow suppression and toxic drug effects and establish appropriate dosing for the drug; and liver and renal function tests to determine need for possible dose adjustment and identify toxic drug effects. The quality of the patient-provider relationship also can profoundly affect compliance. Specific prescription forms tailored to oral chemotherapy also can be developed by the caregivers. Unfortunately, although the side-effect profiles of many oral chemotherapy agents are relatively favorable, serious systemic side effects can still occur, making early recognition with prompt intervention critical. Chemotherapy induced nausea and vomiting (CINV) is a common and extremely unpleasant side effect for children receiving chemotherapy. In more traditional antineoplastic chemotherapy, normal cells are also affected. Routine antiemetics, such as prochlorperazine (Compazine), metoclopramide (Reglan), ondansetron (Zofran), or granisetron (Kytril), can be used as needed. Which is an absolute contraindication in patients receiving nilotinib, a cancer cell-specific agent? They interfere with cellular DNA synthesis by inserting themselves between base pairs in the DNA chain. To allow for easy reference, a tabular format is used to present systematically organized adverse reactions related to cancer chemotherapy. Acute pain related to GI, CNS, and skin effects of the drug, Disturbed body image related to alopecia, skin effects, and impaired fertility, Risk for infection related to bone marrow suppression. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways. A sense of increased flexibility and autonomy can be an emotional boost for patients. Estrogen-receptor sites on the tumor react with circulating estrogen, and this reaction stimulates the tumor cells to grow and divide. If you're getting IV chemo, there might be a disposable pad under t… The important thing is to stress to the patient that it is important to call his/her physician or nurse at any sign of a symptom or side effect. Dr. Marshall: You are in a position to see patients because they are going on clinical trials. 3. Announcement!! Antimetabolites are S phase-specific. Therefore, they are commonly administered as part of combination therapy. Gail M. Wilkes. 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