DRUG STUDY

Generic Name Doxorubicin hydrochloride

Brand name Adriamycin
Classification Antibiotic antineoplastic
Mechanism of Action Cytotoxic binds to DNA and inhibits DNA synthesis in
susceptible cells, causing cell death
Indication Doxorubicin has been used successfully to produce
regression in disseminated neoplastic conditions such
as acute lymphoblastic leukemia, acute myeloblastic
leukemia, Wilms' tumor, neuroblastoma, soft tissue
and bone sarcomas, breast carcinoma, ovarian
carcinoma, transitional cell bladder carcinoma, thyroid
carcinoma, gastric carcinoma, Hodgkin's disease,
malignant lymphoma and bronchogenic carcinoma in
which the small cell histologic type is the most
responsive compared to other cell types.
Contraindication Patients should not be treated with Doxorubicin if they
have any of the following conditions: baseline
neutrophil count <1500 cells/mm3; severe hepatic
impairment; recent myocardial infarction; severe
myocardial insufficiency; severe arrhythmias; previous
treatment with complete cumulative doses of
Doxorubicin, daunorubicin, idarubicin, and/or other
anthracyclines and anthracenediones; or
hypersensitivity to Doxorubicin, any of its excipients,
or other anthracyclines or anthracenediones
Adverse Effects CV: cardiac toxicity
Dermatologic: complete by reversible alopecia
GI: nausea, vomiting, mucositis
GU: red urine
Hematologic: myelosuppression
Hypersensitivity: anaphylaxis
Local: Severe local cellulitis
Dosage 60-75mg/m2 as a single IV injection administered at
21 days interval
Nursing >Dont give IM because severe local reaction and
Responsibilities tissue necrosis occur
>Monitor injection site for extravasation
>Monitor patient’s response frequently at beginning of
therapy
>Ensure adequate hydration during the course of
therapy to prevent hyperuricemia
>Encourage patient to report difficulty of breathing,
sudden weight gain, swelling pain at injection site,
and unusual bleeding or bruising
Generic Name Cisplatin
Brand name Platinol
Classification Alkylating drug - antineoplastic
Mechanism of Action Heavy metal that inhibits cell replication by alkylating
DNA; cell cycle non-specific
Indication Metastatic ovarian tumor, endometrial cancer
Contraindication Cisplatin is contraindicated in patients with preexisting
renal impairment. Cisplatin should not be employed in
myelosuppressed patients, or patients with hearing
impairment.
Cisplatin is contraindicated in patients with a history of
allergic reactions to cisplatin or other platinum-
containing compounds.
Adverse Effects CNS: ototoxicity
GI: nausea vomiting anorexia
GU: nephrotoxicity
Hematologic: leukopenia, Thrombocytopenia, anemia
Hypersensitivity: anaphylactic- like reactions
Dosage The usual cisplatin dose for the treatment of
metastatic ovarian tumors in combination with
cyclophosphamide is 75 to 100 mg/m2 IV per cycle
once every four weeks (DAY 1).
Nursing >arrange for tests to evaluate serum creatinine, BUN,
Responsibilities creatinine clearance, magnesium, calcium, and
potassium levels before initiating therapy
>Monitor renal function, e severe toxicity related to
dose is possible
>have epinephrine and corticosteroid available in
case the patient has anaphylaxis like reactions
>Do not use needle of IV sets containing aluminium
parts as this can cause precipitate and loss of drug
potency
>instruct patient to report loss of hearing, dizziness ,
unusual bleeding , fever, chills, sore throat, leg
cramps, muscle twitching and changes in voiding
patterns
Generic Name paclitaxel
Brand name Taxol
Classification antineoplastic
Mechanism of Action Inhibits the normal dynamic reorganization of the
microtubule network that is essential for dividing cells
leads to cell death in rapidly dividing cells
Indication Treatment of metastatic carcinoma, of the ovary after
failure of first line or subsequent therapy
Contraindication TAXOL is contraindicated in patients who have a
history of hypersensitivity reactions to TAXOL or other
drugs formulated in Cremophor® EL
(polyoxyethylated castor oil).
TAXOL should not be used in patients with solid
tumors who have baseline neutrophil counts of <
1500 cells/mm3 or in patients with AIDS-related
Kaposi's sarcoma with baseline neutrophil counts of <
1000 cells/mm3.
Adverse Effects GI: nausea , vomiting
CN: peripheral sensory neuropathy
CV: bradycardia
Hematologic: bone marrow depression and infection
Dosage TAXOL administered intravenously over 3 hours at a
dose of 175 mg/m2 followed by cisplatin at a dose of
75 mg/m2; or TAXOL administered intravenously over
24 hours at a dose of 135 mg/m2 followed by cisplatin
at a dose of 75 mg/m2.
Nursing >assess patient for neurologic status, vital signs, skin
Responsibilities colors, hair distribution, abdominal examination, renal
function and CBC
>do not administer the drug unless blood counts are
within acceptable parameters
>Wear gloves when handling the drug
>Premedicate corticosteroid to prevent
hypersensitivity reactions
Generic Name Carboplatin
Brand name paraplatin
Classification alkylating drug- antineoplasctic drug
Mechanism of Action Heavy metal that produces cross-links within and
between strand of DNA, thus preventing cell
replication
Indication Initial treatment of advance ovarian carcinoma
Palliative treatment of patient’s with ovarian
carcinoma, recurrent after prior chemotherapy
Contraindication Carboplatin Injection is contraindicated in patients
with a history of severe allergic reactions to cisplatin
or other platinum-containing compounds. Carboplatin
Injection should not be employed in patients with
severe bone marrow depression or significant
bleeding.
Adverse Effects CNS: peripheral neuropathies
GI: nausea, vomiting abdominal pain,diarrhea,
constipation
GU: increased BUN or serum creatinine
Hematologic: bone marrow depression
hypersensitivity: anaphylactic-like reactions,
brochospasm
Dosage 300 mg/m2 IV on day 1 every four weeks for six
cycles
Nursing >Evaluate bone marrow functions before and during
Responsibilities therapy
>Ensure that epinephrine, corticosteroid and anti-
histamine are readily available in case of anaphylactic
like reactions
> instruct patient to report loss of hearing, dizziness ,
unusual bleeding , fever, chills, sore throat, leg
cramps, muscle twitching and changes in voiding
patterns
>instruct patient to have frequent, regular medical
follow up including frequent blood tests to monitor
drug effects:
Generic Name ondansetron hydrochloride
Brand name Zofran
Classification antiemetics
Mechanism of Action Selective antagonist of 5-HT, located in the CNS at the
chemoreceptor trigger zone and in the peripheral nervous
system on nerve terminals of the vagus nerve.
Indication Prevention of nausea and vomiting associated with
initial and repeat courses of emetogenic cancer
chemotherapy, including high-dose cisplatin.
Contraindication ZOFRAN Injection and ZOFRAN Injection Premixed
are contraindicated for patients known to have
hypersensitivity to the drug
Adverse Effects CNS: dizziness, fatigue, headache. Malaise, sedation
CV:arrhythmias
GI:constipation, diaarhea, abdominal pain
GU:gynecologic disorders
Musculoskeletal:pain
Respiratory:hypoxia
Skin:priritus, rash
Dosage The recommended I.V. dosage of ZOFRAN for adults
is a single 32-mg dose or three 0.15-mg/kg doses. A
single 32-mg dose is infused over 15 minutes
beginning 30 minutes before the start of emetogenic
chemotherapy.
Nursing >monitor liver function test result. Don’t exceed 8mg
Responsibilities in patient with hepatic impairment
>instruct patient to immediately report difficulty
breathing after drug administration
>tell patient receiving drugs IV, to report discomfort at
insertion site
>for patient taking ODTS, tell him to open blister just
before use by peeling backing off and not by pushing
through foil blister, and tell him that taking it with liquid
isn’t required.
Generic Name
Brand name
Classification
Mechanism of Action
Indication
Contraindication
Adverse Effects
Dosage
Nursing
Responsibilities