Alkylating agents Nsg considerations: Dont use needles or IV administration sets that containaluminum because it will displace platinum,

causing a loss of potency and formationof black precipitate.Immediately give epinephrine, corticosteroids, or antihistaminesfor anaphylactoid reactions.

NURSINGCONSIDERATIONCause infertilityproblemMustard is a vesicantCisplatin is irritant

Antimetabolities Nursing Considerations Monitor for adverse reactions, such as stomatitis, diarrhea, intestinal perforation, N/V, renal failure, anemia, leukopenia, thrombocytopenia, acute hepatic toxicity, pulmonary fibrosis, urticaria, and sudden death. Assess the underlying neoplastic disease before therapy and reassess regularlythroughout therapy. Follow facility policy for reconstitution and administration. NURSING CONSIDERATIONCan cause nephrotoxicity

monitor labresultsEncourage fluid intakeMay take folic acid

increase protectionof normal cell

radioactive drugs NURSINGCONSIDERATIONRequire isolationprecaution

preventradiation contamination

antibiotic Nsg. Responsibilities: Try to ease anxiety in the patient and his family beforetreatment.Keep epinephrine, corticosteroids, and antihistaminesavailable during therapy. Anaphylactoid reacttions may occur. Aromatase Nursing Responsibilities: Dont give the drug with estrogen-containing drugs becausedoing so could interfere with the drugs intended action.Administer the drug after meals

Ethyleminines Nsg considerations: The drug may be given IV in doses of 0.3 to 0.4 mg/kg atintervals of 1 to 4 weeks.If pain occurs in the IV site use local anesthetic or dilutethe solution further.Discard IV solution that appears grossly opaque or contains precipitate. The solution should be clear to slightly opaque.Refrigerate and protect dry powder from direct sunlight.Report a WBC count below 3,000/mm 3 or a platelet count below 150,000/mm 3 and stop the drug.Can be use with Allopurinol.Can cause Infant toxicity

triazene

Nsg responsibilities: Administer antiemeticDiscard the drug if the solution turns pink a sign of decomposition 3

If the IV sites infiltrates, discontinue immediately andapply ice to the area 24 28 hours and notify prescriber.Advise patient to avoid sunlight and sun lamps for the first2 days after treatment.Reassure patient that the flulike symptommmay be treatedwith mild antipyretics (acetaminophen

Nitro

Intervention: follow established procedures for safe and proper handling,administration, and disposal of chemotherapeutic drugs.Give antiemetic before giving the drug.Administer the drug per facility policy for reconstitution, mixing, storage,and admiistration. Monitor for effects.Use carmustine only in glass containers. The solution is unstable in plasticcontainers. Avoid contact with skin because it will cause brown discoloration. If ithappens wash it thoroughly.Use double gloves when handling carmustine wafer in the operating room.Hydrate and monitor I&OAllopurinol may be used to prevent hyperurecemia and uric acidneuropathy.May cause infant toxicityInstitute infection control and bleeding precautions

Alkyl; sulfonate Interventions: follow established procedures for safe and proper handling, administration,and disposal of chemotherapeutic drugs. Give drug same time each day/ Treat extravasation promptly. Administer as ordered and monitor for effects. Hydrate and monitor I&O Dosage is adjusted based on weekly WBC counts and prescriber may stop the drug if severe leukopenia develops. Therapeutic effects are commonly accompanied by toxicity.- Usually given allopurinol to prevent hyperurecemia with resulting uricacidnephropathy.- Can cause infant toxicity