Monoclonal Antibodies (MABs)

– Exogenous antibodies genetically engineered in labs by combining antibody producing B cells

with a CA cell
– It is designed to target only cancer cells
– Given IV

Example:

 Bevacizumab (Avastin) in combination with fluoracil is a first line tx for metastatic carcinoma of
the colon or rectum
 Rituximab (Rituxan) tx for relapsed or refractory (unresponsive) non-Hodgkin’s lymphoma
 Trastuzumab ( Herceptin) combined with paclitaxel is a first line tx for metastatic CA

Side Effects:

 Fever, chills, headache, dizziness, N/V, itching, rash, generalized pain

 Severe reactions can be minimized by acetaminophen (Tylenol), diphenhydramine (Benadryl)
and meperidine (Demerol)
 Angioedema, hypotension, dyspnea, bronchospasm (stop infusion) , anaphylaxis, cardiac
arrhythmia, angina, cardiomyopathy, hypertensive crisis, acute renal failure, hematological
toxicity (decrease wbc), GI perforation and GI bleeding

Radioactive Isotopes
Treatment: tx for certain types of CA, injected to the affected side like radio gold in the tx of ascites
caused by CA

Example:

 Radioactive Sodium Iodine (Iodine 131)

Routes of Administration:

 Administered PO or IV to treat thyroid CA or implanted in the body in the form of capsules,

needles or seeds

Health care Precautions:

 Special Precaution for health care workers to prevent radioactive exposure

Isolation Precautions:

 Follow protocol for the protection of patient and health care worker
 Proper isolation precaution like proper handling of linens

Cautions and Responsibilities

  Administer as prescribed
– on time, as exactly as prescribe, keep patient comfortable, check and review drug inserts
 Carefully check IV sited
– Check sites for site necrosis and infiltrations
 Don’t let medications contact skin or eyes
– Patient or health care worker if it happens flush with water immediately
 Use of antiemetic
– Minimize N/V
 Thorough oral hygiene
– Minimize discomfort and oral ulceration
 Soft foods and cool liquids
– For comfort
 Accurate I & O
– Adequate hydration and assessment
 Report Symptoms and Side Effects
– Proper treatments and prevent incidence of emergencies
 Aseptic technique
– Prevent infection
 Assessment of Vital Signs
– To avoid further complications
 Verbal and nonverbal Communications
 Careful attention to detail
 Reassurance by support personnel

Patient Education

 Expected side effects

 Comfort measures
 Appropriate diet
 Aseptic technique
 Oral hygiene
 Observe for bleeding
 Reporting of side effects
 Available community resources
 Obtaining information
 Right of patient to terminate therapy

Cytotoxic Drug Dangers

 Safe Handling Methods

– Protect and secure packages
– Inform and educate personnel
 – Prevent leakage of drugs from containers
– Avoid inadvertent ingestion, inhalation, and skin/ eye contact

Specific Recommendations

 Wear personal protective equipment

 Precautions when administering drug
 Disposal of supplies
 Protection when handing excreta
 Don’t treat patient if pregnant, breastfeeding, or trying to conceive