Chemotherapy of chronic myelogenous leukemia head and neck cancers ovarian

Chemotherapy of chronic myelogenous leukemia head and

This preview shows page 18 - 22 out of 63 pages.

Chemotherapy of chronic myelogenous leukemia, head and neck cancers, ovarian cancer, and malignant melanoma. Side Effects N/V/D/constipation Anorexia Hepatitis Stomatitis bone marrow suppression Hyperuricemia
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19 Neutropenia Skin ulcers gangrene Nursing Considerations: Assess for infection CBC and Renal Function Panel Chemo precaution when handling and for body fluids of patient No alcohol; ASA; NSAIDs Fluid intake 2-3 L/day Very negative pregnancy test prior to treatment Contraception to avoid pregnancy Teaching Inform that long term use may increase risk of secondary cancer Instruct patient to inspect oral mucosa for erythema and ulceration. Interactions with increased hepatotoxicity with didanosine and stavudine Contraindications With other BM suppressive treatment or live viruses Caution with previous chemo/radiation CHELATING AGENT//ANTIDOTE Deferasirox MOA: Binds with iron and excretes it in stool Uses of medication Sickle Cell Anemia Chronic iron overload due to blood transfusions Side Effects HA Dizziness hearing loss visual disturbances Cough GI bld Liver failure N/V/D abd pain
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20 Hepatitis RF Stevens Johnson Syndrome BM suppression fever Nursing Considerations: Assess hearing and vision CBC Renal function panel, ferritin levels, and Liver Function Tests every 2 weeks Teaching Take on an empty stomach Dissolve tablets in OJ, H2O, Apple juice Acts in 1.5-4 hours (half-life 8-16hrs) Interactions with CYP drug aluminum antacids NSAIDs Corticosteroids Bisphosphonate anticoagulants WATER SOLUBLE VITAMINS/ANTIANEMIC Folic Acid MOA: dietary supplement absorbed in the sm intestine used for nucleoproteins & maintenance of RBCs, neurons, and proteins works with bone marrow productions of RBC/WBC/PLT Uses of medication Folate deficiency Macrocytic/megaloblastic anemia Prevention of neural tube defects Side Effects
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21 warm/flush w/ IV dosing Rare Irritability Depression loss of appetite Rash Urticaria Dyspnea Nursing Considerations: Obtain diet history. Foods high in folic acid = vegetables, fruit, organ meats. Heat destroys folic acid. Monitor for hypervitaminosis Teaching Discuss overuse of supplementation Benefits to childbearing women Interactions with ethanol interferes with folate metabolism in liver methotrexate (folic acid inhibitor) Phenytoin - increased seizure activity Contraindications patients with allergies to vit B; caution with patient receiving tetracycline ATB VITAMIN SUPPLEMENT Cyanocobalamin (Vitamin B12) MOA: Reverses vitamin B12 deficiency and results in rapid improvement of anemia symptoms, normal RBC production resumes Uses: Vitamin B12 deficiency anemia Side Effects Uncommon Hypokalemia Rashes, itching, other signs of allergy Feeling of swelling body Anaphylaxis possible but rare
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