CHEMOTHERAPY
• kills or inhibits the reproduction of neoplastic cells and kills normal cells
• may cause bone marrow depression.
Nursing interventions:
1. Antiemetic (e.g. Zofran/ Ondansetron) for nausea and vomiting.
2. Good oral care for stomatitis.
3. Wig, head scarf, hat may be worn if alopecia occurs
4. Frequent rest periods is essential if anemia occurs.
5. Increase fluid intake to prevent hemorrhagic cystitis.
External Radiation Therapy
● administered through X-ray or high-energy machine
● uses high doses of radiation to destroy cancer cells and shrink
tumors
● Treatment is painless painless sya kasi they uses beam radiation
ganito yung itchura niya and pwede itong mamove.
● ADLs may be resumed immediately after treatment
● No need for isolation after treatment. After the treatment, pwede
na siyang gumawa ng daily activities niya
Skin care in external radiation therapy includes the following:
1. Keep area dry.
2. Wash area with water, no soap. Mild soap is allowed.
3. Avoid applying ointments, powders or lotion on the area. Pero
pwede yung mga Unperfumed lotion and cornstarch are allowed to
be used.
4. Do not apply heat or cold directly on the area.
5. Avoid exposure of the area to direct sunlight.
6. Use soft cotton fabrics for clothing.
Internal Radiation Therapy dito they uses radioactive implants, such as
seed implants, placed inside the body near a tumor
Types:
A. Sealed Source (Brachytherapy) naka enclosed yung radiation
sources sa capsule or seed and nilalagay yung source sa loob ng
katawan malapit sa tumor site.
● Ginagamit ito If half - life of radioisotope is long (in a bead, seed,
icedle, ribbon, catheter) e.g. Cobalt Radiation
● Hindi ratiation contaminated yung mga body secretions
● Practice standard precaution when handling body secretions (wear
gloves)
B. Unsealed Source inaadminister to through oral or IV
● Ginagamit ito If half - life of radioisotope is short
● Body secretions are radiation contaminated
● Flush toilet twice
● Rinse sink well after toothbrushing
Principles of Radiation Protection (Internal Radiation Therapy)
1. Distance
- Kelangan Maintain a distance of at least 3 feet from the patient.
2. Time
- We need Minimize contact with patient. Like 5 mins lang each
time.
3. Shielding
- Wear lead shield when entering patient's room.
REMEMBER‼️
● A patient undergoing radiation therapy experiences social
isolation. Minsan kasi iniisip ng patient kung what if maexposed
yung ibang tao na makakausap nila sa radiation kaya nagkakaroon
sila ng social isolation
● Pregnant nurses should not be assigned to care for patients
undergoing internal radiation therapy. Para maprevent yung
congenital defects.
● Use disposable eating utensils for the patient.
● The nurse wears dosimeter badge eto yung device na ginagamit to
measure amount of radiation exposure when caring for a patient
with internal radiation therapy.
MEDICATIONS:
Here are the Antineoplastic medications:
Alkylating Medications (eto yung mga medications under the alkylating
medicaitions, part eto ng chemotherapeutic regimens for the treatment)
● Nitrogen Mustards
○ Chlorambucil
○ Cyclophosphomide
○ Ifosphamide
○ Mechlorethamine
○ Melphalan
● Nitrosoureas
○ Carmustine
○ Lomustine
○ Streptozocin
● Alkylating - like medications
○ Altretamine (Hexalen)
○ Busulfan (Myleran, Busuflex)
○ Carboplatih (Paraplatin)
○ Cisplatin (Platinol)
○ Dacarbazine (DTIC - Dome)
○ Oxaliplatin (Eloxatin)
○ Temozolomide (Temodar)
○ Thiotepa (Thioplex)
Antitumor Antibiotic Medications mga CHEMOTHERAPY DRUGS
● Bleomycin Sulfate (Blenoxane)
○ Dactinomycin (Cosmegen)
○ Daunorubicin (Daunoxone)
○ Doxorubicin (Adriamycin, Doxil)
○ Epirubicin (Ellence)
○ Idarubicin
○ Mitomycin (Mutamycin)
○ Mitoxantrone (Novantrone)
IlI. Antimetabolite Medications it target rapidly dividing cells, but they
can also affect healthy cells, leading to side effects like bone marrow
suppression, gastrointestinal issues, and hair loss
○ Capecitabine (Xeloda)
○ Cladribine (Leustatin)
○ Cytarabine (DepoCyt, Tarabine PFS)
○ Floxudine (FUD'R)
○ Fludarabine (Fludara)
○ Fluorouracil (Adrucil)
○ Gemcitabine (Gemzar)
○ Hydroxyurea (Hydrea, Mylocel)
○ Mercaptopurine (Purinethol)
○ Methotrexate (Rheumatrex, Trexall)
○ Pentostatin (Nipent)
○ Thioguanine (Tabloid)
IV. Antimitotic Medications also known as (Mitotic Inhibitors) pag
mitotic inhibitors kasi binoblock niya yung cell growth by stopping
mitosis or yung cell division. ginagamit para matreat yung mga
cancers like breast, lung, and ovarian cancers.
● Vinca Alkaloids
○ Vinblastine Sulfate (Velban)
○ Vincristine Sulfate (Oncovin, Vincasar PFS)
○ Vinorelbine (Navelbine)
● Taxanes
○ Docetaxel (Taxotene)
○ Paclitaxel (Abraxane, Taxol, Onxol)
V. Topoisomerase Inhibitors
● Etoposide (VePesid, Toposar, Etophopos)
○ Irinotecan (Camptosar)
○ Teniposide (Vumon)
○ Topotecan (Hycamtin)
● Block the enzyme needed for DNA synthesis and cell division.
VI. Hormonal Medications and Enzymes
● Estrogens
○ Diethylstilbestrol (DES)
○ Estramustine (Emeyst)
○ Ethinyl Estradiol (Estinyl)
● Antiestrogens
○ Anastrozole (Arimidex)
○ Exemestane (Aromasin)
○ Fulvestrant (Faslodex)
○ Letrozole (Femara)
○ Raloxifene (Evista)
○ Tamoxifen citrate (Nolvadex)
○ Testolactone (Teslac)
○ Torimifene (Fareston)
● Androgens
○ Fluoxymesterone
○ Testosterone
● Antiandrogens
○ Bicalutamide (Casodex)
○ Flutamide (Eulexin)
○ Goserelin acetate (Zoladex)
○ Nilutamide (Nilandron)
○ Triptorelin (Trelstar)
● Progestins
○ Medroxyprogesterone (Depo-Provera)
○ Megestrol Acetate (Megace)
● Other Hormonal Antagonists and Enzymes
○ Aminoglutethimide (Cytadren)
○ Asparaginase (Elspar)
○ Leuprolide Acetate (Lupron)
○ Mitötane (Lysodren)
VIL. Immunomodulator Agents:
● Biological Response Modifiers (BRM's)
○ Aldesleukin (proleukin, Interleukin-2)
○ Interferon Alfa - 2a
○ Interferon Alfa - 2b
○ Interferon Alfa -n3 (Alferon N)
○ Levamisole (Ergamisole)
○ Recombinant Interferon Alfa - 2a (IntronA)
○ Recombinant Interferon Alfa -26 (Roferon -A)
● Common Monoclonal Antibodies
○ Alemtuzumab (Campath)
○ Gemtuzumab Ozogamicin (Mylotarg)
○ Ibritumobab (Zevalin)
○ Rituximab (Rituxan)
○ Trastuzumab (Herceptin)
VII. Colony - Stimulating Factor (CSFs)
● Granulocyte - Macrophage CSF
○ Sargramostin (Leukin)
● Granulocyte CSF
○ Filgrastim (Neupogen)
● Erythropoetin
○ Epoetin Alfa (Epogen)
○ Darbepoetin Alfa (Aranesp)
IX. Gene Therapy
- Is used to render tumor cells more susceptible to damage by other
treatments and make the client's immune system better able to
recognize cancer cells as non-self.
- Is still experimental but early response rates indicate a potential
success for this therapy..
X. Targeted Therapy
● Monoclonal Antibodies
○ Rituximab (Rituxan)
○ Tositumomab (Bexxar)
○ Transtuzumab (Herceptin)
○ Alemtuzumab (Campath)
○ Cetuximab (Erbitux)
XI. Other Antineoplastic Medications
● Altretamine (Hexalen): used to treat ovarian cancer
● Demileukin diftitox (Ontak): used to treat cutaneous T-cell
lymphoma
● Gemcitabine (Gemzar): used to treat non-small cell lung cancer
and adenocarcinoma of the pancreas and metastatic breast cancer
and lung cancer (in combination with Paclitaxel)
● Irinotecan: used to treat culorectal or rectal cancer
● Paolitaxel: used to treat ovarian or metastatic breast cancer.
● Topotecan: used to treat metastatic ovarian cancer (after other
therapies have
● Trustuzumab: used to treat breast cancer in combination with
chemotherapy.
● Bexarotene: used to treat advanced stage cutaneous T-cell
lymphoma
