Additional Toxicities of Cancer Chemotherapy (Nursing)

by Rhonda Lawes, PhD, RN

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      Slides 08 Basic Principles of Cancer Chemotherapy.pdf
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    00:00 What? Are you kidding me? Is it not enough that people going through chemotherapy are hit in those five areas of high growth fraction cells, there's more? Yeah, there really is.

    00:14 Sometimes, you can give chemotherapy to a patient to cure them of cancer but it can knock out or kill, severely damage their heart or their kidneys.

    00:24 I had a very dear friend who had undergo chemotherapy and she sadly died, cancer-free.

    00:30 Because she had cured her of the cancer but the damage to her heart was so severe that she could not surive that.

    00:37 So keep in mind, chemotheraphy comes with significant risks.

    00:41 This invloves some pretty intense conversations between the healthcare provider, the healthcare team and the patient.

    00:48 So the patient can make an informed decision.

    00:50 We wish we knew who's gonna suffer that kind of damage but we can't alway predict who will.

    00:56 Now another one that's not as obviously life threatening or lethal is hyperuricemia.

    01:02 Now that isn't bad of a deal because that will give you gout.

    01:06 Have you ever seen somebody with true gout? It's excruciatingly painful.

    01:10 When my dad had gout, just walking by his big toe made him hurt.

    01:14 Just air currents on his feet made him hurt.

    01:18 So if they do develop a hyperuricemia, that's these crystals that start locking themselves into your joints, making them swell and be extremely painful.

    01:26 We can treat it with allopurinol.

    01:28 Again, it really doesn't really hold a candle to being toxic to your heart or your kidneys but it's still not anything you'd want a patient to have to go through.

    01:38 Whoa! I'm gonna let you absorb that picture for just a moment.

    01:44 One of the additional toxicities of cancer chemotheraphy is if the chemotherapy should suffer some reason, leak out of the vein and into the tissue.

    01:54 That's what extravasation means.

    01:56 Now, that is a really graphic picture to help you understand that there can be severe tissue damage when that happens.

    02:04 So it causes tissue necrosis and this obviously has been cleaned out but that is a really graphic representation of what can happen.

    02:12 Now we talked earlier that you know, chemotheraphy can also be carcinogenic.

    02:17 It can cause cancer in addition to really damaging important vessels, veins and organs like your heart and kidneys.

    02:26 So, I think it's time to move on from that picture.

    02:29 But hopefully, it will firmly burn that into your memory that you have to be very careful about giving chemotherapy in a vein which is why we most often use a port that's implanted underneath the skin.

    02:43 Now we don't just use cytotoxic drugs to treat cancer.

    02:47 You will also see these drugs in patients who have arthritis.

    02:51 We give it in much smaller doses.

    02:54 So see, to give chemotherapy to patients like real chemotherapy for cancer, you have to have special certifications.

    03:01 As a new nurse, you will never give chemotherapy to levels we do to treat cancer.

    03:06 You have to have a lot of experience and you have to have specialized training and become chemo certified.

    03:12 But, you might give similar drugs for someone who has arthritis.

    03:16 Here's three examples of the types of medications that are chemotherapy but we give them in very small doses to treat arthritis.

    03:25 So you are likely to interact with patients who receive these medications on a regular basis.

    03:30 They don't suffer the same intense side effects because again, they're given in much smaller doses.

    03:38 Now I'm gonna put some more names up on the screen for you.

    03:41 You'll see them appearing behind me.

    03:44 I want you to just remind yourself, put a marker in your notes to follow up on this later because I want you to be familiar and recognize that these are examples of cytotoxic drugs.

    03:55 You will know everything you need to know about these, but you know the basic things.

    04:00 They go after five areas of high growth fraction, they're gonna have the same side effects with what we've discussed and I want you to recognize these drug names as examples of cytotoxic drugs used to treat chemotherapy patients for cancer.

    About the Lecture

    The lecture Additional Toxicities of Cancer Chemotherapy (Nursing) by Rhonda Lawes, PhD, RN is from the course Cancer Medications (Nursing). It contains the following chapters:

    • Additional Toxicities of Cancer Chemotherapy
    • Cytotoxic Drugs to Treat Arthritis
    • Examples of Cytotoxic Drugs

    Included Quiz Questions

    1. Tissue necrosis
    2. Liver failure
    3. Heart failure
    4. Azotemia
    1. Azathioprine
    2. Cyclophosphamide
    3. Methotrexate
    4. Ondansetron
    5. Diphenhydramine

    Author of lecture Additional Toxicities of Cancer Chemotherapy (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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