“ANTINEOPLASTIC ANTIBIOTICS

AND
MITOTIC INHIBITORS”

Reported by GROUP 8: Carmela Salinas, Sarah Lou Sajulga,

Irish Love Sanchez, Rickmon Selibio, Ferdinand Salon
 A =anticancer drugs cause
 N =nausea and vomiting
 T =treatment regimen must be followed
 I =individualized dosage
 N =new drugs appear on the market
 E =exposure time kept to a minimum
 O =only a physician can administer
 P =protect yourself
 L =look, listen, and learn
 A =assessment of laboratory tests
 S =safe dosage based on weight
 T =toxicities
 I =inform patients
 C =classification of agents
ANTINEOPLASTIC ANTIBIOTIC AGENTS

 Both targets bacterial and human cells

 More toxic to rapidly multiplying cells
 Cells in the bone marrow, GIT, skin
 Useful in treating certain cancers
 too toxic to treat infections
 Are cell-cycle specific drugs
 Main adverse effects are seen in cells that
rapidly multiply
ANTINEOPLASTIC ANTIBIOTIC AGENTS

 Indications:
 Used in combination chemotherapy regimens
 Used to treat a variety of solid tumors and some
hematologic malignancies
 Leukemia, ovarian, breast, bone, others
 Squamous cell carcinomas
 AIDS-related Kaposi’s sarcoma (when intolerant to
other treatments)
ANTINEOPLASTIC ANTIBIOTIC
AGENTS
 Examples:
 Anthracycline antibiotics
 daunorubicin, doxorubicin, idarubicin, others
 Anthracenedione antibiotics
 mitoxantrone
 Other cytotoxic antibiotics
 bleomycin, dactinomycin, mitomycin, plicamycin,
others
 Therapeutic Actions

 Cytotoxic antibiotics
 Interfere with a malignant cell’s ability to
grow and reproduce
 Interferes with DNA synthesis by inserting
themselves b/w base pairs in the DNA chain
causing a mutant DNA molecule leading to
cell death
 Pharmacokinetics
 Not absorbed well in the GIT
 Given IV or injected into specific site
 Metabolized in the liver and excreted in the
liver
 Many of its kind have very long half-lives
 They do not cross the blood-brain barrier
 Widely distributed in the body
 Taken up by the heart, lungs, kidneys and spleen
 Contraindications &
Cautions
 Contraindicated to patient with known
allergy, pregnant and lactating women
 Care should be taken to patients with:
 Bone marrow suppression
 Suppressed renal or hepatic function
 GI ulcerations or ulcerative dses
 Pulmonary problems w/ bleomycin or mitomycin
 Cardiac problems w/ idarubicin or mitoxantrone
 Adverse Effects
 B – bone marrow suppression w/ leukopenia,
thrombocytopenia, anemia, pancytopenia
 R – renal or hepatic toxicity (esp. w/use of
antimetabolites)
 A – Alopecia
 G – GI effects: nausea, vomiting, diarrhea,
mucous membrane deterioration
 T – toxic to the heart & lungs
 Nursing Considerations
for Patients Receiving Antineoplastic Antibiotics

 Assesment:
 Screen for contraindicated & cautioned patients
 vital signs
 to evaluate respiratory & cardiovascular effects
 orientation & reflexes
 to evaluate any CNS effects
 Bowel sounds & mucous membrane status
 to monitor GI effects
 Evaluate CBC w/ differential & renal & liver
function tests
 to evaluate toxic drug effects used to monitor dosage adjustments
 Nursing Considerations
for Patients Receiving
Antineoplastic Antibiotics
 Diagnoses:
 Acute pain related to GI, CNS, local effects of drug
 Disturbed body image related to alopecia, skin
effects
 Fear, anxiety related to diagnosis and treatment
 Deficient knowledge regarding drug therapy
 Nursing Considerations
for Patients Receiving
 Antineoplastic Antibiotics
Implementation:
 Monitor blood tests & cardiac & respiratory function
 Protect patient from exposure to infection
 Administer medications according to scheduled
protocol & in combination with other drugs as
indicated
 Ensure that patient is keep & well hydrated
 Provide small, frequent meals; frequent mouth care; &
dietary consultation as appropriate
 Arrange for proper head covering at extremes of
temperature
 Provide patient teaching
 Nursing Considerations
for Patients Receiving
Antineoplastic Antibiotics
 Evaluation:
 Monitor patient’s response to the drug
 Monitor for adverse effects
 Evaluate the effectiveness of the teaching plan
 MITOTIC INHIBITOR AGENTS

 Are drugs that kill cells as the process of

mitosis begins
 Its main adverse effects occurs to cells that
rapidly multiply
 Examples: docetaxel (Taxotere), etoposide
(Toposar, VePesid), paclitaxel (Taxol, Onxol),
teniposide (Vulmon), vinblastine (Oncovin,
Vincasar), vinorelbine (Navelbine)
 Therapeutic Actions

 A cell-cycle specific drug that inhibit DNA

synthesis
 Work in the M phase of the cell cycle that
block or alter DNA synthesis needed for
reproduction of the cell
 Used for the treatment of a variety of tumors
and leukemias
 Pharmacokinetics

 Not well absorbed in the GI tract

 Given intravenously
 Metabolized in the liver & excreted in the
feces
 safer for patients w/ renal impairment
 Contraindications &
Cautions
 Caution to patients w/ known allergy to drug,
during pregnancy and lactation
 Care should be taken to patients who have:
 Bone marrow depression
 Renal or hepatic dysfunction
 Known GI ulcerations or ulcerative diseases
 Adverse Effects

 Bone marrow depression – w/ leukopenia,

thrombocytopenia, anemia & cytopenia
 GI effects – nausea, vomiting, anorexia, diarrhea &
mucuos membrane deterioration
 Hepatic or renal toxicity
 Alopecia
 Extrasavation – cause necrosis & cellulitis, use
antidote
 Nursing Considerations
for Patients Receiving Mitotic
 Assessment:
Inhibitors
 Screen for contraindications and cautions
 Physical assessment - orientation & reflexes, hair &
hair distribution, respiratory rate & adventitious
sounds, bowel sounds & mucuos membrane status
 Evaluate CBC w/differential & renal & liver function
tests
 Regular evaluation of injection sites
 Nursing Considerations
for Patients Receiving Mitotic
 Diagnoses:
Inhibitor
 Acute pain related to GI, CNS, local effects of drug
 Disturbed body image related to alopecia, skin
effects
 Fear, Anxiety related to diagnosis & treatment
 Deficient knowledge regarding drug therapy
 Nursing Considerations
for Patients Receiving Mitotic
 Implementation: Inhibitor
 Arrange for blood test
 Avoid direct skin or eye contact w the drug – wear protective
clothing & goggles
 Administer medication according to scheduled protocol & in
combination w/other drugs
 Ensure that patient is well hydrated
 Monitor injection sites for extrasavation-click here!
 Protect patient from exposure to infection
 Provide small, frequent meals; frequent mouth care; & dietary
consultation as appropriate
 Arrange for proper head covering at extremes of temperature
 Provide patient teaching
 Nursing Considerations
for Patients Receiving Mitotic
Inhibitor
 Evaluation:
 Monitor patient’s response to the drug
 Monitor for adverse effects
 Evaluate the effectiveness of the teaching plan