Antimetabolite Agents
Which drug inhibits folic acid metabolism, preventing DNA synthesis in rapidly dividing cancer cells?
Methotrexate
Which alkylating agent can cause hemorrhagic cystitis and requires hydration and mesna administration?
Cyclophosphamide
Which selective estrogen receptor modulator (SERM) is used for estrogen-positive breast cancer prevention?
Tamoxifen — blocks estrogen receptor
Which iron supplement replaces iron stores for RBC development and can cause dark stools?
Ferrous sulfate — restores iron and hemoglobin.
Which calcineurin inhibitor suppresses T-cell activation by blocking interleukin-2 production?
Cyclosporine — calcineurin inhibitor
What nursing precaution reduces the risk of hemorrhagic cystitis from cyclophosphamide?
Encourage 2–3 L/day fluid intake
Which antineoplastic causes pulmonary toxicity and bone marrow suppression (nitrosourea class)?
Carmustine — causes pulmonary toxicity and myelosuppression.
This pyrimidine analog suppresses DNA polymerase and is primarily used in acute myelogenous leukemia.
Cytarabine
What platinum-based drug can cause nephrotoxicity and ototoxicity, and what lab values must be monitored?
Cisplatin — monitor BUN, creatinine, and audiometry
What aromatase inhibitor is used in postmenopausal women to reduce estrogen production?
Anastrozole — inhibits aromatase enzyme
Which vitamin is essential for DNA synthesis and is given lifelong to patients with pernicious anemia?
Cyanocobalamin — B12 replacement
What key laboratory values must be monitored with cyclosporine therapy due to its toxic effects?
Monitor BUN, creatinine, and liver enzymes
Why should patients taking cyclosporine avoid grapefruit juice?
Grapefruit juice increases cyclosporine levels.
Identify the drug that can cause tumor flare symptoms in early prostate cancer treatment.
Leuprolide — initial testosterone surge
Which purine analog antimetabolite is used in acute lymphocytic leukemia and can cause hepatotoxicity?
Mercaptopurine
Identify the anthracycline antibiotic that may cause red-orange urine discoloration and cardiotoxicity.
red-orange urine and cardiotoxicity
Identify the GnRH agonist used to suppress testosterone production in prostate cancer.
Leuprolide — suppresses LH/FSH to reduce testosterone.
Which vitamin prevents neural tube defects in pregnancy and is used to treat folate deficiency anemia?
Folic acid — folate supplement
Which monoclonal antibody blocks IL-2 receptor activation to prevent renal transplant rejection?
Basiliximab — IL-2 receptor antagonist
What nursing intervention helps prevent infection in patients on filgrastim?
Implement neutropenic precautions
What serious cardiac effect is associated with doxorubicin and trastuzumab?
Heart failure — caused by doxorubicin and trastuzumab
What nursing intervention helps prevent toxicity when administering methotrexate?
Administer leucovorin rescue and ensure adequate hydration
Which vinca alkaloid inhibits microtubule formation and can cause peripheral neuropathy?
Vincristine — monitor for neuropathy and constipation
What monoclonal antibody binds to HER2 receptors and carries a risk of cardiotoxicity?
Trastuzumab — binds HER2 receptor.
Name the hematopoietic growth factor that stimulates RBC production in chronic kidney disease.
Epoetin alfa — stimulates RBCs
Describe two nursing assessments required during and after basiliximab infusion.
Monitor for hypersensitivity and infection
Describe patient education for oral hygiene in patients receiving cyclosporine.
Teach frequent brushing with soft toothbrush
Describe the adverse effects of epoetin alfa related to hemoglobin elevation.
Hypertension and stroke risk.
Explain why patients receiving methotrexate require leucovorin rescue therapy.
Leucovorin provides folinic acid to normal cells while allowing methotrexate to destroy malignant ones.
Describe the primary safety precaution if doxorubicin infiltrates during IV administration.
Stop infusion immediately and apply cold compress
Explain the mechanism of action of imatinib and its primary cancer indication.
Imatinib — inhibits BCR-ABL tyrosine kinase in CML
Identify the agent that increases neutrophil production to prevent chemotherapy-induced infection.
Filgrastim — increases neutrophils
Explain why immunosuppressant therapy increases the risk of malignancy and infection.
Immunosuppression increases malignancy risk due to decreased immune surveillance.
What electrolyte imbalance can occur with desmopressin therapy, and what are key signs to monitor?
Hyponatremia — monitor for headache, confusion, or seizures
What is the primary adverse effect associated with oprelvekin therapy, and what should the nurse monitor?
Fluid retention and tachycardia