DRUG STUDY

NAME OF ROUTE, DOSAGE MECHANISM

INDICATION CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATIONS
DRUG AND FREQUENCY OF ACTION
Brand Name: Breast Cancer Action: Uses: Contraindications: Side effects:  Observe the patient’s 10 rights of
Ibrance PO: Adults, Elderly: Inhibits Used in Hypersensitivity to Frequent (41%–21%): medication administration.
125 mg once daily for proliferation of combination with Palbociclib.  Fatigue
Baseline Assessment:
Generic Name: 21 days, followed by tumor cells that an aromatase  Nausea
Palbociclib a 7-day rest period to overexpress inhibitor (e.g., Cautions:  Obtain baseline ANC, CBC.
 Alopecia
complete a 28-day HER2 by letrozole) for Baseline anemia,  Confirm estrogen receptor–positive,
 Diarrhea
cycle. Use in blocking cellular treatment of lymphopenia, neutropenia, HER2-negative status.
Classification: combination with an progression from postmenopausal thrombocytopenia. Occasional (16%–  Verify pregnancy status before start of
Therapeutic: aromatase inhibitor G1 into S phase women with History of pulmonary 13%): each cycle.
Antineoplastic (e.g., letrozole) once of cell cycle. estrogen receptor– embolism. Avoid  Decreased appetite  Screen for history of pulmonary
daily throughout 28- Promotes cellular positive, human concomitant use of strong  Vomiting embolism.
Pharmacologic: day cycle or with death (apoptosis). epidermal growth or moderate CYP3A  Asthenia  Receive full medication history and
Kinase inhibitor fulvestrant 500 mg on factor receptor 2 inhibitors, strong or screen for interactions.
days 1, 15, 29 and Therapeutic (HER2)–negative moderate CYP3A Adverse effect/  Assess hydration status.
once monthly Effect: advanced breast inducers. Toxic reactions:  Screen for active infection. Offer
thereafter. Continue Inhibits tumor cancer as initial  Anemia emotional support.
until disease cell growth and endocrine-based  Leukopenia
progression or metastasis. therapy for  Neutropenia Intervention/Evaluation:
unacceptable toxicity. metastatic disease  Thrombocytopenia  Monitor ANC, CBC at start of each
or in combination  CTCAE grade 3 cycle and on day 14 on the first two
with fulvestrant in neutropenia reported cycles.
women with in 57% of pts.  If any grade 3 or 4 hematologic toxicity
disease  The median onset of occurs, repeat CBC 7 days after
progression neutropenia was 15 interruption of therapy and at start of
following days. next cycle.
endocrine therapy.  Pulmonary embolism  If neutropenia occurs specifically,
(5% of pts) recommend treatment interruption, dose
 Upper respiratory reduction, or delay in starting treatment
tract infections for next cycle.
including (31% of  Monitor for neurotoxicity (peripheral
pts): neuropathy), epistaxis.
o Influenza  If chest pain, dyspnea, tachycardia
o Laryngitis occurs, provide supplemental O2 and
o Nasopharyngitis obtain radiologic testing to rule out
 o Pharyngitis pulmonary embolism.
o Rhinitis
o Sinusitis Patient/Family Teaching:
 Peripheral neuropathy  Blood levels will be monitored
(31% of pts) regularly.
 25% of pts:  Treatment may cause fetal harm.
o Cheilitis  Women of childbearing potential
o Glossitis should use effective contraception
o Glossodynia during treatment and up to 2 wks
o Mouth ulceration following discontinuation.
Immediately report suspected
o Stomatitis
pregnancy. Do not breastfeed.
 Epistaxis (11% of
 Immediately report chest pain,
pts) were reported.
difficult breathing, fast heart rate,
rapid breathing; may indicate life-
threatening blood clot in the lungs.
 Report symptoms of bone marrow
suppression or infection such as
bruising easily, chills, cough,
dizziness, fainting, fever, shortness of
breath, weakness.
 Swallow capsules whole; do not chew,
crush, cut, or open capsules.
 Take each dose with food.
 Treatment may increase risk of
infection, nosebleeds.
 Drink plenty of fluids.
 Do not ingest grapefruit products or
herbal supplements.
 Avoid crowds, those with active
infection.
References:
Kizior, R. J. & Hodgson, K. J. (2019). Saunders Nursing Drug Handbook 2019. Elsevier Inc.