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SIDE EFFECTS OF CHEMOTHERAPEUTIC DRUGS

1. STOMATITIS

-It is a form of mucositis which is an inflammatory response of the oral tissues that is

characterized by mild redness and edema or if severe by painful ulcerations, bleedingand secondary infections.

INTERENTI!N"#-$ssess the oropharyngeal cavity of patients prior to, throughout the course and aftertreatment.-Encourage and assist on oral hygiene-$dvice patients to avoid irritants such as commercial mouthwashes, alcohol beveragesand tobacco.

-%se soft bristle toothbrush.-%se normal saline mouth rinses every & hours while awa'e and every ( hours at night.-%se water soluble lip lubricant.-)rovide li*uid or pureed diet.- +edications# )alifermin2. Bone Marrow Suppression

-It results in decreased numbers of circulating platelets, leu'ocytes and erythrocytes.-ecreased number of leu'ocytes cause immunosuppression. ecreased erythrocytesand platelets cause hypoia, fatigue and increased tendency to bleed.

Interventions#-)lace client in a private room whenever possible.-+edical handwashing before and after contact with patients.-Inspect the clients mouth for every / hours.-Inspect open areas such as I sites, every 0 hours for manifestation of infection.-1hange dressings daily.-2imit number of visitors.3. ALOPECIA-The thinning or complete loss of hair. It usually begins &-3 wee's after the initiation oftreatments. Regrowth usually begin within / wee's after the last treatment.INTERENTI!N"-iscuss potential hair loss and regrowth with patient and family.-To prevent or minimize hair loss through the following#

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-1ut long hair before treatment-%se mild shampoo and conditioner-$void ecessive combing-%se sunscreen or wear hat when in the sun.-)urchase wig or hairpiece before hair loss

-Eplain that hair growth usually begins again once therapy is completed.4. NAUSEA AND VOMITTIN

-The vomiting center in the medulla can be stimulated by any of the five differentafferent pathways or by arousal of the chemotherapy trigger zone located in the 0thventricle in the brain.-The emetic potential of a particular chemotherapeutic regimen depends on the drug,dose, route of administration and the clients susceptibility to emesis.

T4REE T5)E" !6 N$%"E$ $N !+ITTIN78. $NTI1I)$T!R5 N$%"E$- may occur before the administration of therapy.&. $1%TE )!"T-T4ER$)5- occur within minutes of the first &0 hours followingtherapy.3. E2$5E 9develop after &0 hours of vomiting.

!. ANO"E#IA-1auses of anoreia with patients with cancer are alterations in taste, manifested by

increased salty, sour and metallic taste sensations. Taste alterations may result frommineral deficiencies, increase in circulating amino acids and cellular metabolites.

$. MALABSO"PTION

-1ancer patients are unable to absorb nutrients from the 7astrointestinal tract as aresult of tumor activity and cancer treatment. They may impair enzyme production orproduce fistulas. "ome tumors secretes hormones and enzymes such as gastrin thatleads to increased gastrointestinal irritation, peptic ulcer disease and decreased fatdigestion.%. CAC&E#IA

-It is related to inadea*uate nutritional inta'e, along with increasing metabolic demand,increased energy ependiture due to anaerobic metabolism of tumor, impaired glucosemetabolism, competition of tumor cells for nutrients, altered lipid metabolism andsuppressed appetite.

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-It is characterized by loss of weight, adipose tissue, visceral protein and s'eletalmuscle.INTERENTI!N"#-)osition patient properly at mealtime.

-Teach )atient to avoid unpleasant sight, odors, sound of the environment.-Encourage ade*uate fluid inta'e-4ave small fre*uent meals.-)romote relaed, *uiet environment during mealtime.-Encourage fre*uent oral hygiene.-+edications# +etoclopramide- increase gastric emptying in patients with early satietyand delayed gastric emptying.'. DIA""&EA AND CONSTIPATION

-iarrhea occurs as an increase in stool li*uid or fre*uency. It can result from 7I

mucosal damage secondary to chemotherapy.-1onstipation is described as hard, dry stool with straining or decrease in number ofdefacations.

1auses#-decrease in either fluid or fiber inta'e-change in usual bowel routine-mechanical changes such as tumor pressure on the bowel.-metabolic changes such as hypo'alemia and hypercalcemia.

Interventions#-2ow residue or li*uid diet for diarrhea-+onitor Inta'e and !utput-Increase fluid and bul' inta'e-%sing stool softeners-Increase physical activity-%se of 2aatives when necessary.

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R!%TE" 6!R 14E+!T4ER$)5 $+INI"TR$TI!N

Intrathecal 1hemotherapyIntrathecal 1hemotherapy

1hemotherapy drugs given IT

!ral

1apsule, tablet, or li*uid

I :intravenous;

)ush :bolus; or infusion over a specific time period

Intra-arterial

Intracavitary

"uch as peritoneal cavity

Intravesical

Into uterus or bladder

Topical