This document discusses several types of oncological and hematological medications. It covers antineoplastic medications which kill or inhibit cancer cells. It describes common side effects like nausea, alopecia, and myelosuppression. The document outlines general interventions for issues like anaphylaxis. It provides details on specific classes of antineoplastic agents like alkylating agents, antitumor antibiotics, antimetabolites, mitotic inhibitors, and topoisomerase inhibitors. It also discusses hormonal medications, immunotherapies, and medications used to treat anemia.

1. Oncological and
Hematological
Medications
Harold Leonardo Suárez Rojas
RN- MsC

2. Antineoplastic Medications
Antineoplastic medications kill or inhibit the
reproduction of neoplastic cells.
Antineoplastic medications are used to cure,
increase survival time, and decrease life-
threatening complications.
The effect of antineoplastic medications may
not be limited to neoplastic cells; normal cells
also are affected by the medication.
Cell cycle phase–specific medications affect
cells only during a certain phase of the
reproductive cycle.
Cell cycle phase–nonspecific medications
affect cells in any phase of the reproductive
cycle

3. Side and adverse effects
1. Mucositis 2. Alopecia
3. Anorexia,
nausea, and
vomiting
4. Diarrhea 5. Anemia
6. Low white blood
cell count
(neutropenia)
7.
Thrombocytopenia
8. Infertility, sexual
alterations
9. Neuropathy

4. General interventions
Physiological
integrity
Safe and
effective care
environment
Psychosocial
integrity
Health
promotion
and
maintenance
Anaphylactic
reactions

5. Anaphylactic
Reaction
Occurring
from
Medication
Assess respiratory
status.
Stop the medication.
Contact the primary
health care provider
(PHCP) and the
Rapid Response
Team if necessary.
Administer oxygen.
Maintain the
intravenous (IV)
access with normal
saline.
Raise the client’s feet
and legs, if not
contraindicated.
Administer
prescribed
emergency
medications, such as
epinephrine.
Monitor vital signs.
Document the event,
actions taken, and
the client’s response.

6. Alkylating Medication
Description
1. Break the DNA helix, thereby interfering with DNA replication
2. Cell cycle phase–nonspecific medications
Side and adverse effects
1. Anorexia, nausea, and vomiting may occur.
2. Stomatitis may occur.
3. Rash may occur.
4. Client may feel IV site pain during IV administration.
5. Busulfan may cause hyperuricemia.
6. Chlorambucil and mechlorethamine may cause gonadal suppression
and hyperuricemia.
7. Cisplatin, a platinum compound, may cause ototoxicity, tinnitus,
hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity.

8. Antitumor Antibiotic Medications
Description
• 1. Interfere with DNA and
RNA synthesis
• 2. Cell cycle phase–
nonspecific medications
Side and adverse
effects
• 1. Nausea and vomiting
• 2. Fever
• 3. Bone marrow
depression
• 4. Rash
• 5. Alopecia
• 6. Stomatitis
• 7. Gonadal suppression
• 8. Hyperuricemia
• 9. Vesication (blistering of
tissue at IV site)

9. Interventions
1. Assess results of
pulmonary function tests.
2. Monitor for
electrocardiographic
changes.
3. Assess lung sounds
for crackles.
4. Assess for signs of
heart failure, including
dyspnea, crackles,
peripheral edema, and
weight gain.
5. Assess results of chest
radiography and renal and
liver function studies.
6. Assess for myocardial
toxicity, dyspnea,
dysrhythmias,
hypotension, and weight
gain when administering
doxorubicin or
idarubicin.
7. Monitor pulmonary
status when
administering bleomycin.

10. Antimetabolite Medications
Description
1. 1. Antimetabolite medications halt the synthesis of cell protein; their presence impairs cell division.
2. 2. Antimetabolite medications are cell cycle phase– specific and affect the S phase.
Side and adverse effects
1. 1. Anorexia, nausea, and vomiting
2. 2. Diarrhea
3. 3. Alopecia
4. 4. Stomatitis
5. 5. Depression of bone marrow
6. 6. Cytarabine may cause alopecia, stomatitis, hyperuricemia, and hepatotoxicity.
7. 7. Fluorouracil may cause alopecia, stomatitis, diarrhea, phototoxicity reactions, and cerebelar dysfunction.
8. 8. Mercaptopurine may cause hyperuricemia and hepatotoxicity.

11. 1. Monitor renal function studies.
2. Monitor for cerebellar dysfunction.
3. Assess for photosensitivity.
4. When administering fluorouracil, assess for signs of
cerebellar dysfunction, such as dizziness, weakness,
and ataxia, and assess for stomatitis and diarrhea,
which may necessitate medication discontinuation.
5. When administering fluorouracil or methotrexate,
instruct the client to use sunscreen and wear
protective clothing to prevent photosensitivity
reactions.

12. Mitotic Inhibitor Medications (Vinca Alkaloids)
A. Description
•1. Mitotic inhibitors prevent mitosis,
causing cell death.
•2. Mitotic inhibitors are cell cycle
phase–specific and act on the M
phase.
B. Side and adverse effects
•1. Leukopenia
•2. Neurotoxicity with vincristine,
manifested as numbness and
tingling in the fingers and toes;
constipation, and paralytic ileus can
also occur.
•3. Ptosis
•4. Hoarseness
•5. Motor instability
•6. Anorexia, nausea, and vomiting
•7. Peripheral neuropathy
•8. Alopecia
•9. Stomatitis
•10. Hyperuricemia
•11. Phlebitis at IV site

13. Topoisomerase Inhibitors
Description
1. Block an enzyme needed for DNA synthesis and cell division
2. Cell cycle phase–specific; act on the G2 and S phases
B. Side and adverse effects
1. Leukopenia, thrombocytopenia, and anemia
2. Anorexia, nausea, and vomiting
3. Diarrhea
4. Alopecia
5. Orthostatic hypotension
6. Hypersensitivity reaction

14. Hormonal Medications and Enzymes
A Description
1. Suppress the immune system and block normal hormones in hormone-
sensitive tumors
2. Change the hormonal balance and slow the growth rates of certain tumors
B. Side and adverse effects
1. Anorexia, nausea, and vomiting
2. Leukopenia
3. Impaired pancreatic function with asparaginase
4. Sex characteristic alterations
a. Masculinizing effect in women: Chest and facial hair, menses stops
b. Feminine manifestations in men: Gynecomastia

15. I. Immunomodulator
(Immunotherapy)
Agents: Biological
Response Modifiers
Description
1. Immunomodulators stimulate the immune system
to recognize cancer cells and take action to eliminate
or destroy them.
2. Interleukins help various immune system cells to
recognize and destroy abnormal body cells.
3. Interferons slow tumor cell division, stimulate
proliferation, and cause cancer cells to differentiate
into nonproliferative forms.
B. Colony-stimulating factors induce more rapid
bone marrow recovery after suppression by
chemotherapy

16. Medications to Treat Anemia
Iron-deficiency anemia: Iron,
oral or intravenous
Vitamin B12 -deficiency
anemia: Vitamin B12 , oral or
intramuscular
Folate-deficiency anemia:
Folate, oral
Acute blood loss anemia:
Blood transfusion, packed
red blood cells, platelets, or
fresh frozen plasma
depending on cause
Anemia of chronic disease:
Iron, oral or intravenous,
erythropoietic growth factors,
leukopoietic growth factors,
and thrombopoietic growth
factors (see Chapter 55 for
more information).