Question

Hydroxyurea prototype card

What is the expected pharmacological action?

Therapeutic use?

Complications?

Contraindications/Precautions?

Interactions?

Evaluation of Medication Effectiveness?

Medication Administration?

Nursing Interventions?

Client education?

Answer 1

Hydroxyurea prototype card(Anti cancerous Drug)

Hydroxyurea is a drug of choice for treating chronic myeloid leukemia, certain types of skin cancer (squamous cell cancer of the head and neck) and ovarian cancer.

Pharmacological action

• Interrupts with DNA synthesis and also alter characteristics of RBCs.
• Hydroxyurea also inhibits the production of granulocytes in the bone marrow which has a less immunosuppressive effect particularly at vascular sites where sickle cells have blocked blood flow.
• Causes the death of rapidly replicating cells, particularly malignant ones

Therapeutic Uses

• Chronic myeloid leukemia
• Melanoma
• Head and neck cancer (used with radiation therapy)
• Essential thrombocytosis and polycythemia vera
• Refractory ovarian cancer (ovarian cancer that has not responded or progressed after standard therapy).
• Polycythemia vera

Complications/ Side effects

· Nausea

· Vomiting

· Weight gain

· Loss of appetite

· Diarrhea

· Pale skin

· Headache

· Dizziness

· Sores in the mouth and throat

· Constipation

· Changes in skin and nails

· Rash

· Hair loss

Contraindications/Precautions

• Inform the doctor is allergic to this drug or to any other drugs
• Collect the medication history especially of kidney disease, blood/bone marrow disorders (such as bone marrow suppression, neutropenia, thrombocytopenia, anemia), HIV infection, liver disease, high uric acid level in the blood, radiation treatment.
• Should not take the immunization/vaccination
• Use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports to reduce the chance of getting cut, bruised, or injured
• Older adults are more sensitive to the side effects of the drug
• Use cautiously among child bearing potentials.Advice not get pregnant while using hydroxyurea
• Hydroxyurea has ability to pass into breast milk and may have undesirable effects on a nursing infant. Breast-feeding while using this drug is not recommended.

Interaction

• When hydroxyurea used with didanosine and stavudine agent that depresses bone marrow
• It decreases antibody responses increases the risk of adverse reactions to live vaccines and increases risk for pancreatitis and hepatomegaly.   

Nursing intervention

• Wash hands before and after handling capsules.
• Wear disposable gloves when handling capsules.
• Do not open capsule; exposure to powder may cause serious skin toxicities.
• If powder from capsule is spilled, wipe up immediately with damp disposable towel and discard in a closed container, such as a plastic bag.

Client education

• Drink at least two to three quarts of fluid every 24 hours
• More risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your health care provider.
• Regularly Wash hands
• To treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
• Maintain good nutrition.
• Hydroxyurea causes little nausea. But if you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also help.
• Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
• Get plenty of rest.
• Use an electric razor and a soft toothbrush to minimize bleeding.
• Avoid contact sports or activities that could cause injury.