Question

List down 6 drugs use for chemotherapy with their specific use and 2 common side effects of the medications and establish 2 nursing interventions FOR EACH to ensure pharmacotherapeutics of the drugs.

Answer 1

1.METHOTREXATE(Mtx):

• USE:CHORIOCARCINOMA
• SIDE EFFECT: 1)MEGALOBLASTIC ANAEMIA IN LOW DOSES,                                                     2)HIGH DOSES PRODUCE PANCYTOPENIA
• NURSING INTERVENTION:1)USE OF FOLINIC ACID PERMITS HIGH DOSE OF METHOTREXATE-Mtx i.v OVER 6 HOUR FOLLOWED BY 3-15mg CALCIUM LEUCOVORIN WITHIN 3HOURS.                                                                                                                                    2) ANTIEMETICS ARE GIVEN BEFORE INTAKE OF Mtx.

2. 6-MERCAPTOPURINE(6-MP):

• USE:ACUTE LYMPHOCYTIC LEUKEMIA
• SIDE EFFECT:1)BONE MARROW DEPRESSION.                                                   2)HYPERURICAEMIA
• NURSING INTERVENTION:1)ALLOPURINE IS USED ALONG WITH 6-MP AS IT PREVENT HYPERURICAEMIA                                                                                                                                                             2)ALSO ALLOPURINE INTERFERES WITH THE METABOLISM OF 6-MP BY INHIBITING ENZYME XANTHINE OXIDASE AND INCREASES ITS ANTINEOPLASTIC EFFECT.

3.CYCLOPHOSPHAMIDE:

• USE:LYMPHOMA
• SIDE EFFECT:1)HAEMORRHAGIC CYSTITIS.    2)ALOPECIA
• NURSING INTERVENTION:1)ADEQUATE HYDRATION TO REDUCE TOXICITY             2)CO-ADMINISTRATION OF i.v MESNA(2-MERCAPTOETHANE SULPHONATE) INACTIVATES ACROLEIN AND THUS PREVENT HEMORRHAGIC CYSTITIS

4.CISPLATIN:

• USE:METASTATIC TESTICULAR AND OVARIAN TUMORS
• SIDE EFFECT:1)NEPHROTOXICITY      2)HIGHLY EMETIC
• NURSING INTERVENTION:1)ANTIMEMETICS(5-HT3 ANTAGONIST) SUCH AS ONDASETRON OR GRANISETRON ARE GIVEN BEFORE THE ADMINISTRATION OF CISPLATIN TO PREVENT EMESIS    2)SALINE INFUSION AND MANNITOL GIVEN TO REDUCE INCIDENCE OF NEPHROTOXICITY

5.VINCRISTINE:

• USE:INDUCING REMISSION IN CHILDHOOD ACUTE LYMPHOBLASTIC LEUKAEMIA
• SIDE EFFECT:1) PERIPHERAL NEURITIS WITH PARESTHESIA     2)CONSTIPATION
• NURSING INTERVENTION:1)INCREASE FLUID INTAKE,DIETARY FIBRE, EXERCSE TO MINIMISE CONSTIPATION.LAXATIVES CAN BE GIVEN            2)IT MAY HAVE TERATOGENIC EFFECTS SO CONTRACEPTION MUST BE USED DURING AND FOR ATLEAST 2 MONTHS AFTER THERAPY CONCLUDED

6.BLEOMYCIN:

• USES:TESTICULAR TUMOR
• SIDE EFFECT:1)PIGMENTATION OF SKIN          2)PULMONARY FIBROSIS
• NURSING INTERVENTION:1) FIRST TEST DOSE IS GIVEN AND MONITOR 24 HOUURS TO FIND OUT ANY ACUTE REACTION.                                                                                       2)LOCAL ANAESTHETICS ARE GIVEN FOR STOMATIS,ADMINISTERED 10 MIN BEFORE INTAKE OF FOOD TO REDUCE PAIN AND THUS HELPS TO IMPROVE FOOD INTAKE