Alkylating agents: Nursing pharmacology

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ALKYLATING AGENTS, PART 1/2 | |||
DRUG NAME | cyclophosphamide, ifosfamide, bendamustine | carmustine, lomustine, streptozocin | dacarbazine, temozolomide |
CLASS | Nitrogen mustard derivatives | Nitrosoureas | Triazenes |
MECHANISM of ACTION | DNA damage in all phases of cell-cycle → cancer cell death
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INDICATIONS | Cancer treatment
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ROUTE(S) of ADMINISTRATION |
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SIDE EFFECTS | Common side effects for all medications:
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Cyclophosphamide:
Ifosfamide:
Bendamustine:
| Carmustine
Lomustine:
Streptozocin:
| Dacarbazine:
Temozolomide:
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CONTRA-INDICATIONS & CAUTIONS |
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ALKYLATING AGENTS, PART 2/2 | ||
DRUG NAME | busulfan | procarbazine |
CLASS | Other alkylating drugs | Other alkylating drugs |
MECHANISM of ACTION | DNA damage in all phases of cell-cycle → cancer cell death
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INDICATIONS | Cancer treatment
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ROUTE(S) of ADMINISTRATION |
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SIDE EFFECTS | Common side effects for all medications:
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CONTRAINDICATIONS & CAUTIONS |
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NURSING CONSIDERATIONS for ALKYLATING AGENTS | ||
ASSESSMENT & MONITORING | Assessment
Administration
Monitoring
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CLIENT EDUCATION |
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Transcript
Alkylating agents are medications that are mainly used to treat cancer. They are effective against hematologic malignancies, such as leukemia, lymphoma, and multiple myeloma, as well as solid tumors, like breast, ovarian, uterus, lung, and bladder cancer.
The most commonly used alkylating agents are nitrogen mustards like cyclophosphamide, bendamustine, and ifosfamide; nitrosoureas like carmustine, lomustine, and streptozocin; triazenes, such as dacarbazine and temozolomide; and other alkylating agents, including busulfan and procarbazine.
Alkylating agents are cell-cycle phase nonspecific, which means they work by causing damage to the DNA of cancer cells in all phases of the cell-cycle, ultimately leading to cancer cell death. There are two primary ways they do this. First, they can attach an alkyl group to one of the DNA bases of cancer cells. Repair enzymes recognize there’s something wrong, so they jump in to replace the alkylated bases and cause DNA fragmentation, which eventually results in DNA damage and cancer cell death.
The second mechanism is the crosslinking of DNA, which means the alkylating agent links two DNA bases together, forming cross-bridges. Cross-linking prevents DNA from being separated for essential cell processes, like replication or transcription, eventually resulting in cancer cell death and stopping the multiplication of cancer cells.
Summary
Alkylating agents are antineoplastic drugs that work by inhibiting the transcription of DNA to RN by alkylation. Alkylation is the process of adding an alkyl group ( �CH3) to DNA. This process prevents the DNA from being used in protein synthesis and the production of new cells, including cancer cells. Some common alkylating agents include cyclophosphamide, chlorambucil, and melphalan.