Name

Alkalyting
Agents

Antimetabolites

Therapeutic
Outcome
-The alkylating
agents are highly
reactive
compounds that
have the ability
to transfer an
alkyl group to a
variety of cell
constituents.
-The alkylating
agents affects
all rapidly
proliferating
cells and often
cause toxicity to
the
hematopoietic,
or bloodforming, system
of the body.

Nursing
Responsibilities
1.Monitor for signs of
hematological changes.
2. Administer 2,5003,000 mL of fluid daily.
3.Monitor for infection.
4.Persistent cough and
dyspnea may indicate
drug toxicity
5.Avoid contact of drug
with skin. Wash
thoroughly if contact
occurs.
6.Prepare solution
immediately before use.

-The
antimetabolites
are a diverse
group of agents
having the
ability to
interfere with
various
metabolic
actions of the
cell and thereby

1.Monitor client for signs

of hematologic changes.
2.Force fluids (2,5003,000 mL daily).
3.Protect solution from
light.
4.Monitor neurological
status everyday with high
doses. Although most
neurological symptoms
are reversible, some have

Cancer Therapeutic Agents

Generic Name
Brand Name

Major Indications

Route

1.Busulfan
2.Chlorambucil
3.Cyclophosphamid
e
4.Carmustine
5.Mechlorethamine

1.Myleran, Busulfex
2.Leukeran
3.Cytoxan, Neosar
4.BiCNU, Gliadel
5.Mustargen

1.Chronic Granulocyte
Leukemia
2.Chronic
Lymphocytic
Leukemia
3.Hodkins Disease,
Burkitts Lymphoma,
acute and chronic
lymphocytic
leukemias, small cell
lung CA and breast
cancer
4.Meningeal
Leukemias and Brain
Tumors (primary and
metastatic)
5.Hodgkins Disease
(MOPP regimen)

1.PO, IV
2.PO
3.PO, IV
4.IV, CNS
Implant
5.IV, IC, IP

1.Methotrexate
2.Cytarabine
3.Thioguanine
4.Fluorouracil
5.Mercaptopurine

1.Rheumatrex,
Trexall
2.Cytosar-U,
Depocyt,
TarabinePFS
3.Tabloid
4.Adrucil
5.Purinethol

1.Acute lymphoblastic
leukemias for children.
2.Acute myelogenous
leukemia, chronic
myelogenous
leukemia.
3.Acute myelogenous
leukemia.
4.Adenocarcinom as
of GI tract, carcinoma
breast, premalignant

1.IV,IM,PO,IT
2.IV,subQ,IT
3.PO,IV
4.IV
5.PO

Toxicity
1.Myelosuppression,
Pulmonary
infiltrates and
fibrosis
2.Bone Marrow
Suppression
3.Less
thrombocytopenia
more alopecia less
CNS effect
compared to
mechlorethamine.
4.Delayed
leucopenia and
thrombocytopenia
5.Nausea and
Vomiting sever
myelosuppression
may increase the
incidence of
leukemis and other
tumors.
1.Bone marrow
depression oral and
GI ulcerations,
pulmonary
infiltrates and
fibrosis.
2.Bone marrow
depression sudden
respiratory distress
with high does.
3.Bone marrow

Natural
Products

Antibiotics

result in the cells

destruction or
inability to
replicate itself.
-Are cyclespecific agents
that appear to act
only or dividing
cells during the
S phase of the
cell.
-A number of
antineoplastic
drugs act by
specifically
interfering with
cell divisin or
mitosis, the M
phase of the cell
cycle.

-Direct cell kill

by DNA
intercalation,
topoisomerase II
inhibition, and
DNA alkylation.
-Direct cell kill
by mitotic arrest.

been fatal.
5.Recontituted solution
may be kept at room
temperature for 48 hrs.
Discard solution if haze
develops.
6.Monitor liver function.

1.Monitor client for signs

of hematological
changes.
2.Avoid leakage of drug
solution into surrounding
tissue during injection.
3.Stool softeners may be
useful in preventing
constipation.
4.Reconstituted
refrigerated solution.
5.Force fluids and
encourage fiber in diet to
help offset constipation.
1.Monitor client for bone
marrow depression.
2.Avoid leakage of drug
solution into surrounding
tissue during injection.
3.Use only sterile water
without preservatives for
reconstitution.
4.Monitor client for
abdominal pain and tarry
stools.

skin hyper keratosis,

superficial basal cell
CA.
5.Acute lymphocytic
leukemia. Chronic
myelogenous
leukemia.

toxicity.
4.Bone marrow
depression o8ral and
GI ulcers sever
diarrhea.
5.Bone marrow
depression
hyperuricemia.

1.Vinblastine
2.Vincristine
3.Paclitaxel

1.Velban
2.Oncovin, Vincasar
3.Abraxane, Taxol,
Onxol

1.Testicular
carcinoma, bladder
carcinoma.
2.Acute lymphoblastic
leukemia, Hodgkins
disease (MOPP), brain
tumors, Wilms tumor.
3.Ovarian CA,
metastastic breast CA,
small cell lung CA,
squamous cell CA of
head and neck.

1.IV
2.IV
3.IV

1.Myelosuppression.
2.Neurotoxicity
especially poly
neuropathies.
3.Hypersensitivity,
neurotropenia,
peripheral
neuropathy, nausea
and vomiting
uncommon.

1.Daunorubicin
2.Doxorubicin
3.Dactinomycin

1. Daunoxome
2.Adriamycin, Doxil
3.Cosmegen

1. Acute myelogenous
leukemia.
2.Hodgkins disease,
non-hodgkins
lymphomas, ovarian
CA, breast CA,
carcinomas of the GI
tract, multiple
myeloma.
3.Wilms tumor,
sarcomas,

1.IV
2.IV
3.IV

1.Bone marrow
suppression
cardiotoxicity.
2.Myelosuppression,
cardiotoxicity.
3.Stomatitis, oral
ulcerations, bone
marrow depression.

Hormones

-Blockade of
estrogen
receptors.
-Used in
antineoplastic
therapy, as they
are often capable
of selectively
suppressing the
gro8th of certain
tissues of the
body without
exerting a
cytotoxic action.

DNA
Topoisomerase
Inhibitors

-The actions of
these drugs are
partly like those
of the antitumor
and antibiotics
discussed above,
which inhibit
topoisomerase II
and intercalate
DNA

Monoclonal
Antibodies
Bone Marrow
Stimulants
Tyrosine Kinase
Inhibitors
Synthetic Agents

5. May produce red urine

for 1-2 days, but this is
not hematuria.
1.Monitor liver function
in clients receiving longterm therapy.
2.Monitor for infection.
3.Monitor client for
development of
hematological changes.
4.Check blood pressure
frequently.
5.Protect client from
bruising.
6.Monitor laboratory
values.
7.Monitor intake and
output, weight gain, and
vaginal bleeding.
1.Monitor for infection.
2.Monitor for bleeding.
3.Monitor intake and
output, weight, nutrition.
4.Used for treatment of
ovarian cancer.
5.Premedicate with
antiemetic (See
irinotecan).

chonocarcinoma.
1.Prednisone
2.Tamoxifen
3.Flutamide

1.Deltasone
2.Nolvadex
3.Eulexin

1.Most combination
therapies for
leukemias.
2.Breast Cancer.
3.Prostate Cancer.

1.IV,PO
2.PO
3.PO

1.None
2.Hot flashes,
vaginal bleeding,
hypercalcemia.
3.Fluid retention,
gynecomastia.

1.Topotecan

1.Hycamtin

1.Lung cancer and

metastatic cancer of
the ovary.

1.IV

1.Bone marrow
suppression.

Proteasome
Inhibitors