Pharm, part 45: Immune Medications - Cancer

September 24, 2021 Updated: October 10, 2021 5 min read

Full Transcript

Hi, I'm Cathy, with Level Up RN. In this video, I'm going to continue my coverage of immune system medications.

Specifically, I will be talking about medications used for cancer. Be sure to stay till the end of the video because I'm going to give you guys a quiz to test your knowledge of some of the key concepts I'll be covering in this video. Also, if you have our pharmacology flashcards, pull those out so you can follow along with me. It definitely takes repetition to learn this information.And before I get started into talking about specific medications for cancer, I wanted to go over some side effects that are common across many or all of the medications I'm about to cover.

So one side effect common to every single one of these medications I'm going to cover is gastrointestinal upset. So nausea and vomiting. So as a nurse, you're going to want to provide antiemetics to your patient prior to administration of these medications. You don't want to wait until nausea and vomiting is happening. Also, many of these medications have a side effect of alopecia, which is hair loss. And then also, many of these medications have a side effect of bone marrow suppression, and this bone marrow suppression causes anemia, neutropenia, and thrombocytopenia. So we're going to have decreased red blood cells, white blood cells, and platelets. So what does this mean for your patient? Well, that anemia may cause them to have shortness of breath and be fatigued. They may have pallor.

With neutropenia, because we have decreased white blood cells, your patient is going to be at higher risk for infection.

And with thrombocytopenia, your patient will have decreased platelets, which puts them at risk for bleeding. So I just wanted you to keep these things in mind so I didn't go through the same information over and over when we go through these specific medications.

There are obviously hundreds and hundreds of medications that could be used to treat cancer. I'm going to go through six specific medications that I think are most important to know. I'm not going to go through all the details that you can find on our flashcards, but I will definitely try to hit some of the highlights. The first medication I want to go over is doxorubicin.

Doxorubicin would be used to treat solid tumors.

Side effects of doxorubicin include GI upset, alopecia, and red discoloration of the patient's urine, sweat, and tears.

This medication also carries a black box warning due to the risk for bone marrow suppression, cardiac toxicity, and it could also cause the patient to get leukemia. So definitely a potent medication with some very serious side effects.

In terms of nursing care, you're going to want to monitor the patient for infection. You're definitely going to want to monitor their cardiac function as well as their CBC levels.

In terms of our cool chicken hint for how to remember this medication and some of the key side effects, if you look at doxorubicin, it's got that ruba like ruby, which is red. And if you remember that ruby means red, then that will help you remember that this medication causes red discoloration of secretions. Red can also help you remember that this medication can affect the heart and cause cardiac toxicity.

Our next medication is vincristine, which is used to treat a variety of tumors and cancers. It does not cause bone marrow suppression, unlike a lot of other cancer medications.

However, it does cause peripheral neuropathy, as well as GI upset, and alopecia.

It also carries a black box warning due to the risk for phlebitis, which is inflammation of the vein at the administration site.

So our little cool chicken hint for remembering this medication and a key side effect of this medication, if you look at vincristine, it starts with vin, it means wine in French. So if you drink too much wine, you won't be able to feel your arms and legs. So that helps you remember vincristine causes peripheral neuropathy.

Okay. Next, we have cyclophosphamide.

This is also used to treat a variety of tumors and cancers. It does cause bone marrow suppression.

Other side effects include GI upset as well as alopecia. And the unique side effect with this medication is that it causes hemorrhagic cystitis, which is inflammation and bleeding from the bladder.

So in terms of nursing care, you're going to want to advise your patient to increase their fluid intake to help counteract that risk for hemorrhagic cystitis. Also, you're going to want to monitor the patient's CBC levels. At any time you're administering this medication, you want to wear gloves and immediately wash your hands after administration. So I don't have a little trick for remembering cyclophosphamide. So if you do have a trick, then definitely leave it in the comments.

The last medication I want to cover in this video is interferon alpha-2b, which is a medication that is used to treat cancers, as well as viral infections such as hepatitis.

It works by enhancing the body's immune response to tumors or viruses, and it helps to slow cancer proliferation as well.

This medication has many, many side effects, including flu-like symptoms, which includes fever, chills, malaise, fatigue, and body aches. It can also cause bone marrow suppression, cardiotoxicity, hepatotoxicity, dyspnea, so difficulty breathing, alopecia, and GI upset.

As if that wasn't enough, it also carries a black box warning due to psychiatric, autoimmune, ischemic, and infectious disorders. So very serious medication with some very serious side effects.

So nursing care will include monitoring the patient's liver function, their cardiac function, and their blood levels as well.

A little cool chicken hint for remembering this medication is that interferon interferes with cancer by enhancing the body's immune response.

All right. Time for Quiz. I have three questions for you. First question, what cancer medication causes red discoloration of the urine, sweat, and tears? The answer is doxorubicin. Question number two, what cancer medication causes peripheral neuropathy? The answer is vincristine. Question number three, what cancer medication causes hemorrhagic cystitis? The answer is cyclophosphamide.

Okay. I hope you did well on that quiz. Hope you're enjoying these little quiz questions. If you need to review the material again, it's totally okay. Just go back and look at the flashcards, take them on a walk. With a little repetition, you got this. Take care and good luck studying.


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