MACHICA, CLAIRE C. JAN.

5, 2022
BSN IV ONCO - VRLE
DRUG STUDY

ALKYLATING AGENTS
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Carmustine Multiple This drug is a ● Hodgkin ● Thrombocyt GI: Assessment:

Gen. Name myeloma and cell-cycle-phase disease openia Nausea, vomiting, ● Bone marrow
Brain tumors nonspecific that ● NHL ● Leukopenia anorexia, stomatitis, depression: monitor
BiCNU, Adult: ● Multiple ● Anemia hepatotoxicity CBC, differential and
inhibits DNA, RNA
Gliaddel IV 150-200 myeloma ● Renal GU: platelets weekly
Brand Name synthesis by ● Brain tumors impairment Azotemia, renal ● Only to be used by an
mg/m2 single
cross-linking with ● Hepatic failure experienced clinician in
dose q6wk or
Nitrosoureas DNA RNA strands, impairment HEMA: use of cancer, immune
75-100 mg/m2/d
Classification preventing cell Anemia, suppression.
for 2 days q6wk thrombocytopenia, ● Pulmonary
division.
Child: leukopenia, fibrosis/infiltrate:
IV: 200-250 myelosuppression monitor pulmonary
mg/m2 q4-6wk INTEG: function tests, chest x-ray
Pain, burning, film before, during
Hodgkin hyperpigmentation at therapy;
inj site, alopecia Patient/family education:
disease or NHL
RESP: ● Teach patient to avoid
Adult: Fibrosis, pulmonary use of products
IV 100 mg/m2/d infiltrate containing aspirin or
q6wk SYST: ibuprofen, razors,
Secondary malignant commercial mouthwash,
neoplastic disease since bleeding may
occur; to report
symptoms of bleeding
(hematuria, tarry stools)
● Instruct patients to report
signs of anemia.
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Cyclophosp All This drug inhibits ● Hodgkins and ● Hypersensiti CNS: Assessment:
hamide IV 300-1500 protein synthesis non-hodgkin vity Headache, dizziness ● Assess symptoms
Gen. Name mg/m2 by interfering with lymphoma ● Severe CV: indicating severe allergic
PO 1-5 mg/kg/d Cardiotoxicity, reactions
DNA replication by ● Acute and urinary
Cytoxan, myocardial fibrosis, ● Bone marrow
Neosar alkalinization of chronic outflow congestive heart suppression: monitor
Breast Cancer
Brand Name DNA. lymphocytic obstruction failure, pericarditis CBC, differential, platelet
Adult:
IV 500-1000 leukemia ● Bladder GI: count weekly.
Nitrogen Also, it is a severe ● Multiple obstruction Nausea, vomiting, ● Hemorrhagic cystitis:
MG/M2 q15d
mustard vesicant that myeloma ● Myelosuppr diarrhea, weight loss, assess for signs of
Classification PO 100-200 colitis, hepatotoxicity hemorrhagic cystitis
mg/m2/d causes tissue ● Breast and ession
GU: ● Monitor temp q4hr.
necrosis if it ovarian ● Tumor lysis
Hemorrhagic cystitis, ● Hepatotoxicity: monitor
infiltrates the carcinoma syndrome hematuria, liver function test
tissues. ● Lung cancer ● Liver or neoplasms ● Bleeding: assess for
● Retinoblasto kidney HEMA: signs of bleeding.
It also prevents ma disease Thrombocytopenia, Patient/family education:
progressive renal ● Lupus ● Hemorrhagi leukopenia, ● Advise patient
scarring, nephritis c cystitis myelosuppression contraception is needed
INTEG: during treatment and for
preserves renal ● Heart failure
Alopecia, dermatitis several months after the
function, induces RESP: completion of therapy
renal remission, Pulmonary fibrosis, ● Teach patient to take
and decreases interstitial pneumonia adequate fluids to
end-stage renal eliminate product
failure.
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Busulfan Adult: Interferes with ● Myelocytic ● PO CNS: Assessment:

Gen. Name PO 4-8mg/d DNA replication, leukemia treatment Cerebral ● Obtain baseline
Child: and RNA without a hemorrhage, coma, necessary values for
Busulfex seizures future comparison
PO 0.06 -0.12 transcription. definitive
Brand Name CV:
mg/kg/d Therefore, it diagnosis of ● Assess for oral cavity for
Hypotension,
Alkyl interferes with CML thrombosis, chest onset of stomatitis
sulfonates normal DNA ● Compromis pain, tachycardia, ● Initiate antiemetics as
Classification function. ed bone atrial fibrillation prescribed
marrow GI: ● Monitor daily pattern of
reserve Nausea, vomiting, bowel activity and stool
diarrhea, weight loss consistency
● History of
GU:
seizure ● Monitor for seizures and
Renal toxicity
disorder HEMA: cerebral hemorrhage
● Head Thrombocytopenia, Patient/family education:
trauma leukopenia, ● Advise patient to maintain
pancytopenia, adequate daily fluid
severe bone marrow intake
depression ● Advise patient to report
RESP: signs of infection and
Pulmonary fibrosis,
bleeding
alveolar hemorrhage
● Advise patient to talk to
the physician first before
getting an immunization.
● Advise patient to take
medication same time
each day
 PLATINUM COMPOUNDS

DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT

ACTION INDICATIONS REACTIONS

Oxaliplatin Advanced This drug inhibits ● Stage III ● History of CNS: Assessment:
Gen. Name Colorectal DNA replication by colon cancer allergy to Peripheral/sensory ● Obtain a detailed
Cancer cross-linking with after platinum neuropathy medication history
Eloxatin GI: including prescription,
Adults: DNA strands. Cell complete compounds
Brand Name Nausea, vomiting,
IV 85 mg/m2 cycle-phase resection of OTC medicines, dietary
diarrhea,
q2wks until non-specific primary tumor constipation, supplements, vitamins
disease treatment of abdominal pain, and herbal supplements
progression or advanced anorexia ● Assess baseline
unacceptable colon cancer GU: information about the
toxicity ● Ovarian Renal toxicity patient’s physical status
HEMA: ● Obtain baseline
(in combination cancer
Thrombocytopenia,
with fluorouracil/ ● Pancreatic necessary values such
leukopenia,
leucovorin). cancer pancytopenia, as, WBC, platelet count,
● Hepatobiliary severe bone marrow renal function test for
Stage III Colon cancer depression future comparison and
Cancer ● Testicular RESP: monitor as well during
Adults: cancer Pulmonary fibrosis, treatment
alveolar hemorrhage Patient/family education:
IV 85 mg/m2
q2wks for total ● Advise the patient to
of 6 months (in avoid ice or drinking and
combination holding glass of cold
with fluorouracil/ liquid during infusion and
leucovorin). for 5 days following
completion of infusion
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Cisplatin Bladder This drug inhibits ● Metastatic ● Hearing CNS: Assessment:

Gen. Name Carcinoma DNA and to a testicular impairment Peripheral ● Obtain a detailed
Adult: lesser extent RNA tumors ● Myelosuppr neuropathy medication history
Platinol-AQ GI: including prescription,
IV (Single protein synthesis ● Metastatic ession
Brand Name Nausea, vomiting,
agent) 50– by cross-linking ovarian ● Pre Existing OTC medicines, dietary
loss of taste, loss of
70 mg/m2 with DNA strands. tumors renal appetite supplements, vitamins
q3–4wks Cell cycle-phase ● Advanced impairment GU: and herbal supplements
non-specific. bladder Renal toxicity ● Assess baseline
Ovarian carcinoma HEMA: information about the
Tumors Myelosuppression patient’s physical status
ENT: ● Obtain baseline
Adult:
Ototoxicity
IV 75–100 necessary values such as
MISC:
mg/m2 Anaphylactic CBC, serum chemistry
q3–4wks reaction tests, urinalysis for future
(combination comparison and monitor
therapy) or 100 as well during treatment
mg/m2 q4wks Patient/family education:
(single agent). ● Advise patient to be well
hydrated before and 24
Testicular hrs after medication to
Tumors ensure adequate urine
Adult: output
IV 20 mg/m2 ● Advise patient to report
daily for signs of ototoxicity and
5 days repeated peripheral neuropathy
q3wks.
 ANTIMETABOLITES

DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT

ACTION INDICATIONS REACTIONS

Fluorouracil Adult: It is cell ● Breast cancer ● Myelosuppr CNS: Assessment:

Gen. Name IV 300-1000 cycle-specific ● Colorectal ession Headache, ● Maintain strict medical
mg/m2/d for 4-5 during the S and cancer ● malnutrition drowsiness, blurred asepsis during dressing
Adrucil vision changes and and
continuous G1 phases. It ● GI cancers ● Potentially
Brand Name GI:
infusion q4wk prevents ● Head and serious invasive procedure
Nausea, vomiting,
Pyrimidine Topical 1%-5% thymidine neck cancers infections diarrhea, ● Monitor blood counts and
analogues cream once or synthase ● Pregnancy constipation, laboratory values
Classification twice a day for production, ● Dihydropyri anorexia, ulceration, ● Administer antiemetics
3-12 wks interferes with midine weight loss 30-60 mins before the
RNA synthesis dehydrogen GU: drug to prevent nausea
Renal failure and emesis
and function and ase
HEMA:
has some effect deficiency ● Monitor I & O
Myelosuppression,
on DNA. bleeding, bone Patient/family education:
marrow suppression, ● Advise patient not to
thrombocytopenia interact with people who
INTEG: have respiratory infection
Alopecia, skin ● Emphasize protective
pigmentation, precautions such as
impaired wound handwashing, wearing
healing, nail
mask and personal
changes, dry
cracked skin hygiene
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Fludarabine Adult: This drug inhibits ● CLL ● Hemolytic GI: Assessment:

Gen. Name IV 25 mg/m2/d DNA synthesis by ● Non-hodgkin' anemia Nausea, vomiting, ● Obtain a detailed
for 5 d q28d interfering with s lymphoma ● Renal diarrhea, bleeding medication history
Fludara GU: including prescription,
PO40 mg/m2/d DNA polymerase ● Relapse ALL disease
Brand Name Renal failure
for 5 d qd4wk alpha, or AML OTC medicines, dietary
HEMA:
Purine ribonucleotide Severe hematologic supplements, vitamins
Analogues reductase, and toxicity, hematuria and herbal supplements
Classification DNA primase, RESPI: ● Assess baseline
therefore, induces Cough, pneumonia information about the
cell death. INTEG: patient’s physical status
Chills ● Obtain baseline
necessary values such as
CBS, serum creatinine,
ALT, AST, electrolytes,
uric acid for future
comparison and monitor
those as well during
treatment
Patient/family education:
● Advise the patient to
avoid crowds and
exposure to infection
● Advise the patient to
maintain strict oral
hygiene
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Methotrexate Adult and It inhibits AICAR ● ALL ● Breastfeedin CNS: Assessment:

Gen. Name Child: transformylase ● NHL g Headache, dizziness ● Obtain a detailed
PO/IM/IV 3.3 which provides ● Sarcomas ● Pregnancy GI: medication history
Otrexup, Nausea, vomiting, including prescription,
mg/m2/d for 4-6 antiinflammatory ● Solid tumors ● Hepatic
Rheumatrex diarrhea, GI toxicity
wk followed by properties that ● Head and disease OTC medicines, dietary
Brand Name GU:
maintenance result in neck cancers ● Alcoholism Severe supplements, vitamins
Folic Acid dosing metabolites. ● Choriocarcino ● Immunodefi nephrotoxicity and herbal supplements
Antagonist mas ciency HEMA: ● Assess baseline
Classification NHL Also, it competes ● Lymphomas syndrome Myelosuppression information about the
Adult and with enzymes ● Some ● Preexisting RESPI: patient’s physical status
Pulmonary toxicity ● Obtain baseline
Child: necessary to autoimmune blood
INTEG:
IV 200 reduce folic acid to disorders dyscrasias necessary values for
Erythema at psoriatic
mg/m2/days 8 tetrahydrofolic ● Psoriasis site, rash, alopecia, future comparison
and 15 q21d in acid, a component ● Rheumatoid dermatologic toxicity
a combination essential to DNA arthritis Patient/family education:
regimen synthesis, repair, ● Advise the patient to
and cellular maintain strict oral
Osteogenic replication. hygiene
sarcoma ● Advise the patient to not
Adult and have immunization
Child: without the physician’s
IV 12g/m2 q2wk approval
● Advise the patient to
avoid crowds and those
with infection
● Advise the patient to not
take aspirin or alcohol
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Trimetrexate Adult: It promotes the ● Trophoblastic ● Allergies CNS: Assessment:

Gen. Name IV Sterile inhibition of neoplasms ● NSAID Headache, dizziness ● Monitor Pulmonary
lyophilized dihydrofolate ● Leukemia hypersensiti EENT: Function
Neutrexin Photosensitivity ● Monitor for any unusual
powder in reductase. ● Breast, head, vity
Brand Name GI:
single-dose necl lung weakness and fatigue
Nausea, vomiting,
Folate vials of 25mg. carcinomas GU: ● Assess dizziness that
antagonist ● Severe Hepatotoxicity might affect the gait,
Classification Psoriasis HEMA: balance and functional
● Rheumatoid Aplastic anemia, activities of the patient
arthritis leukopenia
INTEG: Patient/family education:
Stomatitis, alopecia, ● Advise the patient to
rashes, skin
maintain strict oral
ulceration, urticaria,
chills, soft tissue hygiene
necrosis ● Advise the patient to
avoid crowds and those
with infection
● Advise the patient to not
take aspirin or alcohol
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Floxuridine Intra-Arterial It Inhibits DNA and ● Hepatic ● Hypersensiti CNS: Assessment:

Gen. Name Adult: RNA synthesis by metastasis of vity Headache, dizziness ● Monitor for any unusual
Powder for preventing gastrointestin ● Pregnancy GI: weakness and fatigue
FUDR Nausea, vomiting, ● Assess dizziness that
Injection: thymidine al carcinoma ● lactation
Brand Name gastritis, anorexia,
500mg/vial production. might affect the gait,
ulcer
Antineoplast HEMA: balance and functional
ic Adenocarcino Bleeding, anemia, activities of the patient
Classification ma with leukopenia ● Monitor signs of
Metastasis to INTEG: leukopenia
Liver, Stomatitis, alopecia, ● Monitor patients’ CBC
rashes, erythema,
Gallbladder,
maculopapular rash
Bile Ducts Patient/family education:
Adult: ● Advise the patient to
0.1-0.6 mg/kg/d maintain strict oral
continuous hygiene
arterial infusion ● Advise the patient to
avoid crowds and those
with infection
● Advise the patient to not
take aspirin or alcohol
 ANTITUMOR ANTIBIOTICS

DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT

ACTION INDICATIONS REACTIONS

Doxorubicin Adult: This drug inhibits ● Breast cancer ● Anthracyclin CV: Assessment:
Gen. Name IV 60-75 mg/m2 DNA and RNA ● Gastric e cardiotoxicity ● Obtain a detailed
once q21d as a synthesis and has cancer hypersensiti GI: medication history
Adriamycin Nausea, vomiting, including prescription,
single agent immunosuppressa ● Lung cancer vity
Brand Name diarrhea,
20-75 mg/m2 nt activity. It is cell ● Ovarian ● Hepatic OTC medicines, dietary
constipation,
Anthracyclin q21-28d if used cycle specific for cancer disease anorexia, supplements, vitamins
es in combination the S phase. ● Hematogeno ● MI GU: and herbal supplements
Classification with other drugs us tumors ● Severe Reddish colored ● Assess baseline
● Soft tissue myocardial urine information about the
and bone insufficiency HEMA: patient’s physical status
Myelosuppression, ● Obtain baseline
sarcomas ● Neutropenia
INTEG:
● Leukemia necessary values such as
Complete alopecia,
Lymphoma stomatitis, rash, CBC with differentials,
hyperpigmentation of uric acid, electrolytes,
nail beds, chills, serum bilirubin and
dermal creases hepatic and renal and
ECG future comparison
and monitor those as well
during treatment
Patient/family education:
● Advise the patient to
report immediately if
experiencing cardiac
abnormalities and signs
of infection
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Idarubicin AML This drug inhibits ● AML ● Myelosuppr CV: Assessment:

Gen. Name Adult: DNA/RNA ● ALL ession Cardiotoxicity ● Obtain a detailed
IV 8-12 synthesis by ● Cardiotoxicit GI: medication history
Idamycin Nausea, vomiting, including prescription,
mg/m2/d for 3 d intercalating y
Brand Name diarrhea, abdominal
between DNA OTC medicines, dietary
cramping, diarrhea
Anthracyclin APL base pairs HEMA: supplements, vitamins
es Adult: therefore, Myelosuppression and herbal supplements
Classification IV 12 mg/m2/d producing INTEG: ● Assess baseline
3d apoptosis of Hyperpigmentation information about the
rapidly dividing of nail beds patient’s physical status
cells. ● Obtain baseline
necessary values such as
renal and hepatic
function, CBC and EKG
for future comparison and
monitor those as well
during treatment
Patient/family education:
● Inform patient that this
drug will cause complete
alopecia
● Teach the client about the
urine color changes to
prevent client from
panicking
● Advise the patient to
maintain a strict oral
hygiene
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Mitomycin Adult: This drug ● Gastric ● Coagulation CV: Assessment:

Gen. Name IV 20 mg/m2 q6 cross-links with cancer disorders Cardiotoxicity ● Obtain a detailed
8 wk strands of DNA ● Pancreatic ● Bleeding GI: medication history
Mutamycin Nausea, vomiting, including prescription,
and inhibits cancer tendencies
Brand Name anorexia
DNA/RNA ● Platelet OTC medicines, dietary
GU:
Antitumor synthesis. count less Renal toxicity supplements, vitamins
antibiotics than 75,000 HEMA: and herbal supplements
Classification mm3 Myelosuppression ● Assess baseline
RESPI: information about the
Pulmonary toxicity patient’s physical status
INTEG: ● Obtain baseline
Stomatitis, rash,
necessary values such as
alopecia
CBC with differential, PT,
bleeding time for future
comparison and monitor
those as well during
treatment
Patient/family education:
● Advise client to avoid
crowds and people with
infection or those who
have received live virus
vaccine
● Advise client to not get
immunization without
physician’s approval
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Bleomycin Squamous Cell Blocks DNA, RNA, ● Squamous ● History of INTEG: Assessment:
Gen. Name Carcinoma, and protein cell hypersensiti Redness, darkening ● Closely monitor the
Testicular synthesis. carcinomas of vity or of the skin, stretch patient during the first 24
Blenoxane marks on the skin, hours of initiating
Carcinoma head, neck, idiosyncrasy
Brand Name nail thickening, hair
Adult/Child: penis, cervix, to bleomycin treatment (Vital signs)
loss
Antitumor SC, IM, IV and vulva ● Women of ● Monitor and report
antibiotics 10–20 U/m2 or ● Lymphomas childbearing unexplained bleeding,
Classification 0.25–0.5 U/kg ● Testicular age bruising, deterioration of
1–2 times/wk carcinoma ● Pregnancy renal function Check
(max: 300–400 ● Malignant (category D) patients’ weight
U) pleural ● Lactation. periodically
effusions ● Assess and monitor
Lymphomas patient for signs of skin
Adult/Child: toxicity
SC, IM, IV Patient/family education:
10–20 U/m2 ● Advise the patient to
1–2 times/wk report immediately if
after a 1–2 U experiencing cardiac
test dose times abnormalities and signs
2 doses of infection

Hodgkin's
Disease
Adult/Child:
SC, IM, IV 1 U
IM or IV/d or 5
U/wk
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Epirubicin Adult: It Inhibits DNA and ● Axillary tumor ● Hypersensiti CV: Assessment:
Gen. Name injectable RNA synthesis by following vity cardiotoxicity ● Assess and Monitor
solution forming a complex resection of ● Cardiomyop HEMA: patients’ heart rate, ECG
Pharmorubic Leukophenia, and blood pressure
2mg/mL powder with the DNA. primary athy
in anemia
for breast cancer ● Heart especially during activity.
Brand Name INTEG:
reconstitution Failure Alopecia, flushing, ● Report significant findings
Anthracyclin 50 mg 200 mg ● Recent itching, rash, to the attending physician
es Myocardial phlebitis, tissue such as arrhythmias,
Classification For Adjuvant Infarction necrosis, hot flashes dyspnea, peripheral
Breast Cancer ● Severe MISC: edema, jugular vein
Anaphylaxis distention, fainting and or
Treatment arrhythmias
reaction, nfection
Adult: ● Severe severe fatigue/weakness.
IV 100 mg/m² Myocardial ● Monitor signs of
Repeat q28 insufficiency anaphylaxis
days x 6 cycles ● Severe ● Monitor IV injection site
persistent for pain, swelling or
drug inflammation and
induced possible tissue necrosis.
myelosuppr ● Monitor patients’ CBC,
ession creatinine levels.
Patient/family education:
● Advise the patient to
report immediately if
experiencing cardiac
abnormalities and signs
of infection
 PLANT ALKALOIDS

DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT

ACTION INDICATIONS REACTIONS

Vincristine Adult: This drug affects ● Hodgkin ● Hypersensiti CNS: Assessment:

Gen. Name IV 1.4 mg/m2 cells in the M and disease vity Dizziness, ● Obtain a detailed
q7 for 4wk S phase of the cell ● Non hodgkin ● Pregnancy neurosensory and medication history
Oncovin neuromotor including prescription,
Child <10 kg: cycle-specific by lymphoma ● Demyelinati
Brand Name disturbances
IV 0.05 mg/m2 inhibiting ● Neuroblastom ng form of OTC medicines, dietary
CV:
Plant q7d microtubule a charcot-mari Hypotension supplements, vitamins
Alkaloids Child >10 kg: formation. It also ● Rhabdomyos e-tooth GI: and herbal supplements
Classification IV 0.05 mg/kg inhibits cell arcoma syndrome Nausea, vomiting, ● Assess baseline
q7d division and RNA, ● Wilms tumor constipation, cramps information about the
DNA, and protein ● Acute HEMA: patient’s physical status
Neutropenia, ● Obtain baseline
synthesis. lymphocytic
anemia,
anemia necessary values such as
thrombocytopenia
INTEG: CBC , liver and renal
Alopecia, dermatitis, function tests, serum
stomatitis, sodium and serum
bilirubin for future
comparison and monitor
those as well during
treatment
Patient/family education:
● Emphasize the
importance of notifying
physician for breathing
difficulties
● Advise patient to promptly
report signs of infection
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Docetaxel Breast cancer This drug disrupts ● Breast cancer ● History of CNS: Assessment:
Gen. Name Adult: the microtubule ● Prostate severe Peripheral ● Obtain a detailed
IV 175 mg/m2 cell network which cancer hypersensiti neuropathy, loss of medication history
Taxotere deep tendon including prescription,
q3wk is essential for ● Gastric vity to drugs
Brand Name reflexes,
cellular function. It cancer formulated OTC medicines, dietary
neurotoxicity,
Anti-Microtu All other inhibits cellular ● Head and with sensory loss supplements, vitamins
bules/Taxane cancers mitosis. neck cancers polysorbate CV: and herbal supplements
s Adult: ● NCLC 80 Phlebitis, ● Assess baseline
Classification IV 75 mg/m2 ● Neutrophil hypotension information about the
q3wk count less GI: patient’s physical status
Nausea, vomiting, ● Obtain baseline
than 1500
constipation, cramps
cells/mm3 necessary values such as
GU:
Hepatic veno CBC , liver and renal
occlusive disease function tests, serum
INTEG: sodium and serum
Alopecia bilirubin for future
comparison and monitor
those as well during
treatment
Patient/family education:
● Advise the patient to
maintain strict oral
hygiene
● Advise the patient to
not have
immunization without
physician’s approval
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Thalidomide ENL This drug has ● Multiple ● Pregnancy CNS: Assessment:

Gen. Name Adult and immunodulatory myeloma ● Women of Drowsiness, ● Obtain a detailed
Child > 12 y: and ● ENL childbearing dizziness, mood medication history
Contergan changes, peripheral including prescription,
PO 100-300 antiangiogenic potential
Brand Name neuropathy,
mg/d at bedtime properties. This OTC medicines, dietary
headache
Immunomod action may be due CV: supplements, vitamins
ulators Multiple to selective Phlebitis, and herbal supplements
Classification myeloma inhibition of hypotension, ● Assess baseline
Adult: production of thromboembolism information about the
PO 200 mg/d at tumor necrosis GI: patient’s physical status
Nausea, vomiting, ● Obtain baseline
bedtime factor-alpha. .
constipation, dry
necessary value for future
mouth, weight gain
HEMA: comparison and monitor
neutropenia those as well during
INTEG: treatment
Alopecia, dry skin, Patient/family education:
rash ● Advise the patient to
avoid tasks requiring
alertness, motor skills
until response to drug is
established
● Advise the patient to
avoid the use of alcohol
and other drugs causing
drowsiness
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Vinblastine Antineoplastic Binds to proteins ● Lymphomas, ● Allergy to GI: Assessment:

Gen. Name Adult: of mitotic spindle, ● Nonseminom vinblastine Nausea, vomiting, ● Ensure that the patient is
IV 3.7 mg/m2 causing atous ● Leukopenia, GU: noti pregnant before
Alkaban-AQ/ Difficult urination administering; advise
infused over 1 metaphase arrest. testicular acute
Velban HEMA:
min q wk, may Cell replication is carcinoma infection patients to use
Brand Name Neutropenia
increase up to stopped as a ● Advanced ● Pregnancy RESPI: contraceptive measures
Plant 18.5mg/m2 if result breast cancer ● Lactation. Cough, hoarseness ● Consult with a physician if
Alkaloid tolerated (cell-cycle–specific ● Liver INTEG: antiemetic 1s are needed
Classification Child: for M phase). disease. Chills for severe nausea and
IV 2.5 mg/m2 vomiting.
infused over 1 ● Check CBC before each
min q wk dose.
Patient/family education:
● Advise the patient to
avoid tasks requiring
alertness, motor skills
until response to drug is
established
● Advise the patient to
avoid the use of alcohol
and other drugs causing
drowsiness
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Paclitaxel Breast Cancer This drug is an ● Ovarian ● Pregnancy CV: Assessment:

Taxanes Adult: antimicrotubule cancer (category X) Ventricular ● Monitor for
Gen. Name IV 175 mg/m2 agent that ● breast cancer and tachycardia, hypersensitivity reactions,
ventricular ectopy, especially during first and
over 3 h q3wk interferes with the ● Kaposi's lactation.
Taxol transient
Abraxane: IV microtubule sarcoma ● hypersensiti second administrations of
Brand Name bradycardia, chest
260 mg/m2 over network essential ● non-small cell vity to pain. the paclitaxel.
Antineoplast 30 min q3wk for interphase and lung cancer paclitaxel CNS: ● Monitor vital signs
ic; taxane mitosis. Induces (NSCLC). ● baseline Fatigue, headaches, frequently, especially
Classification Solid Tumors, abnormal spindle neutrophil peripheral during the first hour of
Malignant formation and count <1500 neuropathy, infusion.
weakness, seizures. ● Monitor hematologic
Melanoma multiple asters cells/mm3;
GI:
Adult: during mitosis. In with AIDS. status throughout the
Nausea, vomiting,
IV 250 mg/m2 addition, normal diarrhea, taste course of treatment.
24-h infusion functioning changes, mucositis, Patient/family education:
repeated q3wk microtubules are elevations in serum ● Immediately report to
essential for cell triglycerides. physician S&S of
Kaposi's shape and HEMA: paclitaxel hypersensitivity.
Neutropenia, ● Be sure to have periodic
Sarcoma organelles present
anemia, blood work as prescribed.
Adult: within cells. thrombocytopenia
IV 135 mg/m2 ● Avoid aspirin, NSAIDs,
INTEG:
infused over 3 h Alopecia, tissue and alcohol to minimize
q3wk or 100 necrosis with GI distress
mg/m2 infused extravasation
over 3 h q2wk
 HORMONAL AGENTS

DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT

ACTION INDICATIONS REACTIONS

Fluoxymeste Women: This drug is a ● Hypogonadis ● Hypersensiti CNS: Assessment:

rone PO 10-40 mg/d synthetic m in Males vity Headache ● Obtain a detailed
Gen. Name in divided doses androgenic ● Metastatic ● Males with GI: medication history
Nausea, vomiting, including prescription,
anabolic steroid Breast breast or
Halotestin constipation,
and is Cancer in prostate OTC medicines, dietary
Brand Name INTEG:
approximately 5 Females carcinoma Skin color changes, supplements, vitamins
androgens times as potent as ● Primary ● Serious oily skin, hair loss, and herbal supplements
Classification natural hypogonadis cardiac acne, unusual facial ● Assess baseline
methyltestosteron m ● Renal or or body hair growth information about the
e. It produces ● Testicular hepatic patient’s physical status
retention of failure disease ● Obtain baseline
nitrogen, sodium, ● Hypogonadot ● Pregnancy necessary value such as
potassium, and ropic liver function and serum
phosphorus; hypogonadis electrolytes, Hgb, Hct,
increases protein m and serum and urine
anabolism; ● Idiopathic calcium
decreases amino gonadotropin Patient/family education:
acid catabolism ● Advise the patient to have
and decreases good personal hygiene,
urinary excretion ● Report menstrual
of calcium. irregularities.
● Report priapism
(prolonged erection) to
physician promptly, it is a
symptom of overdosage.
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Medroxypro Adult: This drug inhibits ● Endometrial ● Carcinoma CNS: Assessment:

gesterone IM depot secretion of cancer of breast Fatigue, dizziness, ● Obtain a detailed
Gen. Name 400-1000 pituitary ● Renal cell ● History of or cerebral embolism medication history
RESPI: including prescription,
mg/wk attempt gonadotropins. cancers active
Depo-Prover Pulmonary embolism
to decrease to Therefore, ● Prevention of thrombotic OTC medicines, dietary
a GI:
Brand Name 400 mg/mo preventing pregnancy disorders Weight change, supplements, vitamins
follicular ● Endometriosi ● Known or nausea, vomiting and herbal supplements
Hormonal maturation and s-associated suspected HEMA: ● Assess baseline
agonist and ovulation. pain pregnancy Transient menstrual information about the
antagonist ● Missed abnormalities patient’s physical status
Classification ● Obtain baseline
abortion
● Severe necessary value such as
hepatic weight, serum glucose
impairment and BP for future
● Undiagnose comparison and monitor
d abnormal those as well during
vaginal treatment
bleeding Patient/family education:
● CVA ● Assess for rash and
urticaria
● Advise the patient to
report immediately if
there is chest pain,
sudden shortness of
breath and sudden
decrease in vision,
migraine headache and
pain.
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Anastrozole Adult: This drug ● Advanced ● Pregnancy CNS: Assessment:

Gen. Name PO 160 mg/d decreases breast cancer ● Patients Fatigue, dizziness, ● Obtain a detailed
circulating in who may headache medication history
Arimidex CV: including prescription,
estrogen level by postmenopau become
Brand Name Thrombophlebitis
inhibiting sal pregnant OTC medicines, dietary
RESPI:
Hormonal aromatase, the womenwho Cough supplements, vitamins
agonist and enzyme that have GI: and herbal supplements
antagonist catalyzes the final developed Weight change, ● Assess baseline
Classification step in estrogen progressive nausea, vomiting, information about the
production. disease while constipation, patient’s physical status
abdominal pain ● Obtain baseline
Therefore, it receving
HEMA:
inhibits growth of tamoxifen necessary value for future
Anemia, leukopenia,
breast cancers therapy vaginal hemorrhage comparison and monitor
that are stimulated ● Advance or (rare 2%) those as well during
by estrogens by metastatic SKEL: treatment
lowering serum breast cancer Bone pain Patient/family education:
estradiol ● Ovarian INTEG: ● Assist with ambulation if
Hot flashes needed
concentration. cancer
● Endometrial/ ● Assess for headache and
uterine pain
cancer ● Administer antiemetic and
antidiarrheal medication
as prescribed
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Goserelin Prostate A synthetic form of ● Prostate ● Hypersensiti CNS: Assessment:

Gen. Name Cancer luteinizing cancer vity Fatigue, dizziness, ● Monitor for signs and
Adult: hormone–releasin ● Advanced headache, symptoms of MI
Zoladex weakness, insomnia ● Assess blood pressure
3.6 mg SC q28 g hormone. breast cancer
Brand Name CV:
days Inhibits the ● Endometriosi periodically and compare
MI, chest pain,
LHRH production of s hypertension, to normal values
agonist Breast Cancer gonadotropins by palpitations ● Monitor the vital signs
Classification Adult: the pituitary gland. RESPI: every 30 minutes.
3.6 mg implant Initially, levels of Dyspnea Patient/family education:
SC q28 days luteinizing GI: ● Assist with ambulation if
Anorexia, nausea, needed
hormone (LH),
vomiting, ● Assess for headache and
Endometriosis follicle-stimulating constipation,
Adult: hormone (FSH), pain
diarrhea, ulcer
3.6 mg implant and testosterone ● Administer antiemetic and
SC q28 days increase. antidiarrheal medication
as prescribed
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Nafarelin Endometriosis Acts as a synthetic ● Central ● Hypersensiti CNS: Assessment:

Gen. Name Adult: analogue of precocious vity Fatigue, dizziness, ● Monitor signs of
1 spray (200 gonadotropin-rele puberty in ● Pregnancy headache, hypersensitivity reactions.
Synarel weakness, insomnia, ● Assess peripheral edema
mcg/spray) in asing hormone children ● Lactation
Brand Name RESPI:
one nostril qAM, (GnRH). Initially ● Endometriosi ● PCOS using girth
Dyspnea
Hormonal 1 spray in the increases pituitary s ● Osteoporosi GI: measurements, volume
agonist and other nostril production of s Anorexia, nausea, displacement, and
antagonist qPM (total 400 luteinizing ● Undiagnose vomiting, measurement of pitting
Classification mcg/day) on hormone (LH) and d vaginal constipation, edema
days 2-4 of follicle-stimulating bleeding diarrhea, weight gain ● Monitor personality or
INTEG: behavioral changes,
menstrual cycle hormone (FSH), ● dyslipidemia
acne, hot flashes
(2 sprays/day) which cause including emotional
SKEL:
ovarian steroid Decreased bone instability, depression,
Central production. density sleep loss, or other
Precocious changes in mood.
Child ≥2 years: ● Periodically assess body
2 sprays weight and other
(200 mcg/spray) anthropometric measures
in Patient/family education:
each nostril ● Assist with ambulation if
twice daily (total needed
1600 mcg/day) ● Assess for headache and
pain
● Administer antiemetic and
antidiarrheal medication
as prescribed
 MONOCLONAL ANTIBODIES

DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT

ACTION INDICATIONS REACTIONS

Abciximab Adult: This drug binds to ● B-cell chronic ● Not known CNS: Assessment:
Gen. Name 100 ml solution CD52, cell surface lymphocytic Tremors, fatigue ● Obtain a detailed
as a 2-hr IV glycoprotein, leukemia CV: medication history
Campath hypotension including prescription,
infusion. found on surface ● Refractory,
Brand Name GI:
of B- and cutaneous, OTC medicines, dietary
Nausea, vomiting,
Monoclonal T-lymphocytes, peripheral constipation, supplements, vitamins
antibody most monocytes, ● T-cell diarrhea, anorexia and herbal supplements
Classification macrophages, leukemia; INTEG: ● Assess baseline
natural autoimmune Rash, urticaria, information about the
killer cells, ● Conditioning pruritus patient’s physical status
SKEL: ● Obtain baseline
granulocytes. regimen for
Skeletal pain
Therefore, stem cell necessary value such as
HEMA:
producing transplantatio Hematotoxicity CBC and platelet count
cytotoxicity thus, n Respi: such for future
reducing ● Relapsing-re Respiratory toxicity comparison and monitor
tumor size. mitting MISC: those as well during
multiple Serious infection treatment
sclerosis. Patient/family education:
● Advise the patient to have
good personal hygiene,
● Report menstrual
irregularities.
.
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Trastuzumab Breast Cancer This drug binds to ● HER2 ● Pre-existing CNS: Assessment:
Gen. Name (Metastatic) HER2 protein, overexpressin cardiac and Headache ● Obtain a detailed
Adult: overexpressed in g breast pulmonary GI: medication history
Herceptin Nausea, vomiting, including prescription,
IV :Initially, 4 25%–30% of cancer disease
Brand Name diarrhea, abdominal
mg/kg as primary breast ● Metastatic OTC medicines, dietary
pain, anorexia
Monoclonal 90-min infusion, cancers, inhibiting breast cancer INTEG: supplements, vitamins
antibody then 2 mg/kg as proliferation of ● Metastatic Chills and herbal supplements
Classification 30-min tumor cells. gastric SKEL: ● Assess baseline
infusion weekly Therefore, Inhibits cancer. Skeletal pain information about the
until disease growth of tumor HEMA: patient’s physical status
Hematotoxicity ● Obtain baseline
progression. cells, mediates
RESPI:
antibody-depende necessary value such as
Cough, dyspnea
Stomach nt cellular MISC: EKG, MUGA scan and
Cancer cytotoxicity. Fever, pain, infection CBC for future
Adult: comparison and monitor
IV Initially, 8 those as well during
mg/kg treatment
over 90 min, Patient/family education:
then 6 mg/kg ● Advise the patient to have
over 30–90 good personal hygiene,
min q3wks until ● Advise the patient to not
disease have immunization
progression. without physician’s
approval
.
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Rituximab NHL This drug binds to ● CD20-positiv ● Hypersensiti CNS: Assessment:

Gen. Name (Relapsed/Refr CD20, the antigen e non vity to Headache ● Obtain a detailed
actory, found hodgkin's murine CV: medication history
Rituxan Angioedema, including prescription,
Low-Grade or on the surface of lymphomas proteins
Brand Name hypotension,
Follicular B lymphocytes, ● B-cell NHL ● HBV OTC medicines, dietary
arrhythmias
Monoclonal CD20-Positive B-cell ● CD20 positive infection GI: supplements, vitamins
antibody B-cell) non-Hodgkin’s chronic Nausea, vomiting, and herbal supplements
Classification Adult: lymphoma (NHL). lymphocytic constipation, ● Assess baseline
IV375 mg/m2 Activates leukemia diarrhea, anorexia information about the
weekly for 4 or B-cell cytotoxicity. ● Moderate to INTEG: patient’s physical status
Rash, pruritus ● Obtain baseline
8 doses. Therefore, it severe
HEMA:
produces rheumatoid necessary value such as
Hematotoxicity
NHL (Diffuse cytotoxicity, arthritis RESPI: CBC, platelet count and
Large B-cell) reduces ● GPA bronchospasm renal function tests such
Adult: tumor size. ● MPA for future comparison and
IV 375 mg/m2 . ● Hemolytic monitor those as well
on day 1 of anemia during treatment
each ● ITP ● Monitor for an
cycle up to 8 infusion-related
doses. symptoms complex
Patient/family education:
● Advise the patient to have
good personal hygiene,
● Advise the patient to
report signs of infection
and bleeding
.
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Belimumab Active, A monoclonal ● Active ● Patients CNS: Assessment:

Gen. Name autoantibody-p antibody produced autoantibody- with suicidal Depression, ● Monitor signs of allergic
ositive, SLE by recombinant positive thoughts insomnia, migraine reactions and
Benlysta GI: anaphylaxis
Aged 5 and up: DNA technique systemic ● New
Brand Name Nausea, vomiting,
10 mg/kg/dose that specifically lupus Primary ● Be alert for signs of
constipation,
Monoclonal IV infused over binds to erythematosu malignancy diarrhea, anorexia leukopenia and infections
antibody 1 hour every 2 B-lymphocyte s (SLE) in ● Hypersensiti INTEG: ● Periodically assess
Classification weeks for the stimulator protein patients vity Rash, pruritus symptoms of SLE
first 3 doses, (BLyS), thereby currently ● Immunosup HEMA: ● Monitor personality
then every 4 inactivating it. receiving pression Leukopenia changes (Suicidal
MISC: thougts)
weeks . standard ● Progressive
Pain, allergic
thereafter. therapy. multifocal Patient/family education:
reactions,
SC 200 mg leukoencep ● Advise the patient to have
anaphylaxis,
subcutaneously halopathy infection, infusion good personal hygiene,
once weekly. ● Infection reactions, fever ● Advise the patient to
● Vaccination report signs of infection
● Infants and bleeding
● Neonates .
● Pregnancy
● Lactation
DRUG NAME DOSAGE MECHANISM OF INDICATIONS CONTRA ADVERSE NURSING ALERT
ACTION INDICATIONS REACTIONS

Daclizumab Renal Immunosuppressa ● Prophylaxis ● Hypersensiti CNS: Assessment:

Gen. Name Transplant nt IgG-1 of acute vity to Tremor, headache, ● Monitor carefully for and
Adult/Child: monoclonal organ daclizumab dizziness immediately report S&S
Zinbryta CV: of opportunistic infection
IV >11 mo, 1 antibody produced rejection in ● murine
Brand Name Chest pain,
mg/kg. Start first by recombinant renal protein or anaphylactoid reaction
hypertension,
Monoclonal dose no more DNA technology. transplant hypersensiti hypotension, ● Use effective
antibody than 24 h prior Binds to vity tachycardia, contraception before
Classification to transplant, interleukin-2 (IL-2) ● pregnancy thrombosis beginning daclizumab
then repeat receptor complex (category C) GI: therapy, during therapy,
q14d for 4 more of lymphocytes. ● lactation. Dyspepsia, and for 4 mo after
abdominal distention, completion of therapy.
doses
epigastric pain,
Patient/family education:
flatulence, gastritis,
● Advise the patient to have
hemorrhoids
HEMA: good personal hygiene,
Bleeding ● Advise the patient to
RESPI: report signs of infection
Dyspnea, pulmonary and bleeding
edema, cough, ● Avoid vaccinations during
atelectasis daclizumab therapy. Do
GU:
not breastfeed while
Oliguria, dysuria,
renal tubular taking this drug.
necrosis .