DRUG NAME MECHANISM OF INDICATION Contraindications Side Effect/Adverse Effect Nursing Consideration

ACTION
RAND NAME: Disrupts nuclei acid function PO: Treatment of chronic Hypersensitivity; Failure Side Effects: Baseline Assessment:
Busulfan and protein synthesis (cell- myelogenous leukemia to respond to previous Nausea, vomiting, CBC with differential, hepatic/renal function
cell phase-nonspecific). (CML) and bone marrow courses; OB, Lactation: hyperuricemia, studies should be performed weekly (dosage
GENERIC NAME: disorders. Potential for serious side myelosuppression, skin based on hematologic values).
Busulflex effects in fetus or infant. hyperpigmentation,
IV: With cyclophosphamide alopecia, anorexia, weight INTERVENTION/EVALUATION:
AVAILABLE FORM: as a conditioning regimen loss, diarrhea, stomatitis Monitor lab values diligently for evidence
Injection Solution: 6 before allogenic of bone marrow depression. Assess mouth
mg/ml. hematopoietic progenitor Adverse Effect: Major for onset of stomatitis (redness/ulceration of
cell transplantation for adverse effect is oral mucous membranes, gum inflammation,
DOSAGES: CML. myelosuppression difficulty swallowing). Initiate antiemetics
PO: ADULTS, resulting in hematologic to prevent nausea/vomiting. Monitor daily
ELDERLY, toxicity (anemia, severe pattern of bowel activity,
CHILDREN: 1 mg/kg/ leukopenia, severe stool consistency.
dose (IBW) q6h for 16 thrombocytopenia). Very
doses. high dosages may produce
blurred vision, muscle
twitching, tonic-clonic
seizures. Long-term therapy
(more than 4 yrs) may
produce pulmonary syn-
drome (“busulfan lung”),
characterized by persistent
cough, congestion,
adventitious breath sounds
(rales, crackles), dyspnea.
Hyperuricemia may produce
uric acid nephropathy, renal
calculi, acute renal failure.
RAND NAME: Inhibits DNA synthesis by Advanced ovarian Hypersensitivity to Baseline Assessment:
Carboplatin producing cross-linking of carcinoma (with other carboplatin, cisplatin, or Side Effects: Offer emotional support. Do not repeat
parent DNA strands (cell-cell agents). Palliative treatment mannitol; OB: Pregnancy Nausea, vomiting, treatment until WBC recovers from previous
GENERIC NAME: phase-nonspecific). of ovarian carcinoma or lactation nephrotoxicity, therapy. Transfusions may be needed in
Paraplatin-AQ unresponsive to other myelosuppression, alopecia, those receiving prolonged therapy
modalities peripheral neuropathy, (myelosuppression increased in those with
AVAILABLE FORM: hypersensitivity, ototoxicity, previous therapy, renal impairment).
Injection Solution: 10 asthenia (loss of strength,
mg/ml. energy), diarrhea, INTERVENTION/EVALUATION:
constipation Monitor hematologic status, pulmonary
DOSAGES: function studies, hepatic/renal function tests,
IV: ADULTS: 300mg/m2 Adverse Effect: CBC, serum electrolytes. Monitor for fever,
(with cyclophosphamide) Myelosuppression may be sore throat, signs of local infection, unusual
on day 1, every 4 wks. Do severe, resulting bruising/bleeding from any site, symptoms
not repeat dose until in anemia, infection (sepsis, of anemia (excessive fatigue, weakness).
neutrophil and platelet pneumonia),
counts are within major bleeding. Prolonged
acceptable levels. treatment may
result in peripheral
neurotoxicity.

DRUG NAME MECHANISM OF
ACTION
RAND NAME: Converted in tissue to 5-
Capecitabine fluorouracil (5-FU), which
inhibits DNA and RNA
GENERIC NAME: synthesis by preventing
Xeloda thymidine production. The
enzyme responsible for the
AVAILABLE FORM: final step in the conversion to
Tablets: 150 mg, 500 mg. 5-FU may be found in higher
INDICATION
Metastatic colorectal cancer.
Adjuvant treatment for
Dukes’ C colon cancer
following primary resection.
Metastatic breast cancer that
has worsened despite prior
therapy with anthracycline
(daunorubicin, doxorubicin,
Contraindications Side Effect/Adverse Effect Nursing Consideration
Hypersensitivity to Side Effects: Nausea, BASELINE ASSESSMENT:
capecitabine or 5-FU; vomiting, diarrhea, Assess sensitivity to capecitabine or 5-flu-
Dihydropyridimine stomatitis, orouracil. Obtain baseline Hgb, Hct, serum
dehydrogenase myelosuppression, palmar- chemistries, renal function.
deficiency (enzyme plantar
metabolizes 5-FU to erythrodysesthesia INTERVENTION/EVALUATION
nontoxic compounds); syndrome, dermatitis, Monitor for severe diarrhea, nausea,
Severe renal impairment; fatigue, anorexia vomiting; if dehydration occurs, fluid and
 concentrations in some idarubicin) (to be used in OB: Potential for fetal electrolyte replacement therapy should be
DOSAGES: tumors. combination with docetaxel). harm or death; Lactation: Adverse Effectts: initiated. Assess hands/feet for erythema
PO: ADULTS, Metastatic breast cancer that Potential for serious Serious reactions include (chemotherapy induced). Monitor CBC for
ELDERLY: Initially, is resistant to both paclitaxel adverse effects in nursing myelosuppression evidence of bone marrow depression.
2,500 mg/m2/day in 2 and an anthracycline or is infants. (neutropenia, Monitor renal/hepatic function. Monitor for
equally divided doses resistant to paclitaxel and thrombocytopenia, anemia), blood dyscrasias (fever, sore throat, signs of
approximately q12h for 2 further anthracycline therapy cardiovascular toxicity local infection, unusual bruising/bleeding
wks. Follow with a 1-wk is contraindicated. (angina, cardiomyopathy, from any site), symptoms of anemia
rest period; given in 3-wk deep vein thrombosis), (excessive fatigue, weakness).
cycles. respiratory toxicity
(dyspnea, epistaxis,
pneumonia), lymphedema.

RAND NAME: Baseline Assessment:

Inhibits DNA synthesis by IV: Used mainly in Pregnancy or lactation;
Cytarabine Obtain baseline CBC, platelet count,
inhibiting DNA polymerase combination Active meningeal Side Effects: renal/hepatic function tests. Leukocyte count
chemotherapeutic regimens infection (IT only Anorexia, nausea, vomiting,
GENERIC NAME: decreases within 24 hrs after initial dose,
Depo-Cyt for the treatment of stomatitis, esophagitis, continues to decrease for 7–9 days followed
leukemias and non- diarrhea, by brief rise at 12 days, decreases again at
AVAILABLE FORM: Hodgkin’s lymphomas. myelosuppression, alopecia, 15–24 days, then rises rapidly for next 10
Injection, Powder for rash, fever, neuropathies, days. Platelet count decreases 5 days after
Reconstitution (Ara-C): abdominal pain drug initiation to its lowest count at 12–15
100 mg, 500 mg, 1 g, 2 g. days, then rises rapidly for next 10 days.
Injection, Solution (Ara- Adverse Effects:
C): 20 mg/ml, 100 mg/ml. Major toxic reaction is INTERVENTION/EVALUATION:
Injection, Suspension myelosuppression resulting Monitor BUN, serum creatinine, uric acid,
(Depo-Cyt): 10 mg/ml. in blood dyscrasias AST, ALT, bilirubin, alkaline phosphatase.
(leukopenia, anemia, Monitor CBC for evidence of myelosup-
DOSAGES: thrombocytopenia, megalo- pression. Monitor for blood dyscrasias,
IV: ADULTS, blastosis, reticulocytopenia) symptoms of anemia. Monitor for signs of
ELDERLY, occurring minimally after neuropathy.
CHILDREN: single IV dose. Leukope-
(Induction): 100 nia, anemia,
mg/m2/day continuous thrombocytopenia should be
infusion for 7 days or 100 expected with daily or
mg/m2/dose q12h for 7 continuous IV therapy.
days. Cytarabine syndrome (fever,
myalgia, rash,
conjunctivitis, malaise,
chest pain), hyperuricemia
may occur. High-dose
therapy may produce severe
CNS, GI, pulmonary
toxicity.

DRUG NAME MECHANISM OF INDICATION Contraindications Side Effect/Adverse Effect Nursing Consideration
ACTION
BRAND NAME: Inhibits DNA and RNA Treatment of lymphomas, Hypersensitivity, OB: Side Effects: BASELINE ASSESSMENT:
Bleomycin synthesis squamous cell carcinoma, lactation, potential for Nausea, vomiting, anorexia, Obtain baseline chest X-ray.
testicular embryonal cell fetal, infant harm stomatitis,
GENERIC NAME: carcinoma, hyperpigmentation, alopecia, INTERVENTION/EVALUATION:
Blenoxane choriocarcinoma, pruritus, hyperkeratosis, Adventitious breath sounds may
teratocarcinoma urticaria, pneumonitis indicate pulmonary toxicity (rales,
AVAILABLE FORM: progression to fibrosis, rhonchi). Observe for dyspnea.
Injection, Powder for weight loss, rash Monitor hematologic, pulmonary,
Reconstitution: 15 units, hepatic, renal function tests.
30 units. Adverse Effects: Assess skin daily for cutaneous
Interstitial pneumonitis toxicity (erythema, rash,
DOSAGES: occurs in 10% of pts, vesiculation). Monitor for stomatitis
IV, IM, Subcutaneous: occasionally progresses to (burning, erythema of oral mucosa at
ADULTS, ELDERLY: pulmonary fibrosis. Appears inner margin of lips), hematologic
10–20 units/m2 to be dose-, age-related toxicity (fever, sore throat, signs of
(0.25–0.5 units/kg) 1–2 (older than 70 yrs, those local infection, unusual
times a wk. receiving total dose greater bruising/bleeding), symptoms of
than 400 units). anemia (excessive fatigue, weakness)
Nephrotoxicity,
hepatotoxicity occur in
frequently.

BRAND NAME: Inhibits DNA and RNA A component of adjuvant Hypersensitivity to BASELINE ASSESSMENT:
Epirubicin synthesis by forming a therapy for evidence of epirubicin, other Side Effects: Obtain WBC, platelet, erythrocyte
 complex with DNA. axillary tumor involvement anthracyclines, or related Anemia, leukopenia, counts before and at frequent
GENERIC NAME: following resection of compounds, baseline neutropenia, infection, intervals during therapy. Obtain EKG
Pharmorubicin primary breast cancer. neutrophil count, severe mucositis before therapy, serum hepatic
myocardial insufficiency function studies before each dose.
AVAILABLE FORM: or recent MI, severe Antiemetics may be effective in
Injection Solution: 2- hepatic dysfunction Adverse Effects: Risk of preventing, treating nausea.
mg/ml single-use vials cardiotoxicity, increases
(25 ml, 100 ml). when total cumulative dose INTERVENTION/EVALUATION:
exceeds 900 mg/m2. Monitor for stomatitis (may lead to
DOSAGES: Extravasation during ulceration of mucous membranes
IV (ADULTS): 60 administration may result in within 2–3 days). Monitor blood
mg/m2 on days 1 and 8 severe local tissue necrosis. counts for evidence of
q28days for 6 cycles or Myelosuppression may myelosuppression, renal/hepatic
100 mg/m2 on day 1 produce hematologic function studies, cardiac function.
q21days for 6 cycles in toxicity, manifested princi- Monitor daily pattern of bowel
combination with 5- pally as leukopenia and, to activity, stool consistency. Monitor
fluorouracil (5-FU) and lesser extent, anemia, for hematologic toxicity, symptoms
Cytoxan. thrombocytopenia. of anemia (excessive fatigue,
weakness).
Monitor EKG changes. Assess
injection site for extravasation, local
skin reactions.
Alkylating Agents
Antimetabolites
Antineoplastic
Antibiotics