Antimetabolites: Nursing Pharmacology
Notes
ANTIMETABOLITES, PART 1/2 | ||
DRUG NAME | methotrexate (Otrexup, Rasuvo, Trexall, Xatmep) *High Alert Medication* | fluorouracil, cytarabine *High Alert Medications* |
CLASS | Folic acid analogs | Pyrimidine analogs |
MECHANISM of ACTION | Mimic folic acid or nucleobases or inhibit enzymes → disrupt DNA synthesis pathway → DNA replication and cell proliferation come to a halt → cancer cell death | |
INDICATIONS | Cancer treatment:
| |
ROUTE(S) of ADMINISTRATION |
|
|
SIDE EFFECTS | Boxed warnings:
| Both:
Fluorouracil
Cytarabine
|
Other common side effects for all medications: drowsiness, fatigue, alopecia, photosensitivity, and ulcerative stomatitis | ||
CONTRAINDICATIONS & CAUTIONS |
|
ANTIMETABOLITES, PART 2/2 | ||
DRUG NAME | mercaptopurine, cladribine, fludarabine *High Alert Medication* | hydroxyurea (Droxia, Hydrea, Siklos) *High Alert Medication* |
CLASS | Purine analogs | Ribonucleotide reductase inhibitors |
MECHANISM of ACTION | Mimic folic acid or nucleobases or inhibit enzymes → disrupt DNA synthesis pathway → DNA replication and cell proliferation come to a halt → cancer cell death | |
INDICATIONS | Cancer treatment:
| |
ROUTE(S) of ADMINISTRATION |
|
|
SIDE EFFECTS | All:
Mercaptopurine
Cladribine
Fludarabine
|
|
Other common side effects for all medications: drowsiness, fatigue, alopecia, photosensitivity, and ulcerative stomatitis | ||
CONTRAINDICATIONS & CAUTIONS |
|
NURSING CONSIDERATIONS for ANTIMETABOLITES | ||
ASSESSMENT & MONITORING | Assessment & monitoring: hydroxyurea Assessment
Monitoring
| |
CLIENT EDUCATION |
|
Sources
- "Focus on Nursing Pharmacology" LWW (2019)
- "Pharmacology" Elsevier Health Sciences (2014)
- "Mosby's 2021 Nursing Drug Reference" Mosby (2020)
- "Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2016)
- "Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2019)
- "Lewis's Medical-Surgical Nursing" Mosby (2019)
- "METHOTREXATE TREATMENT FOR YOUR HYDATIDIFORM MOLE" 2017 ()
- "Treating Gestational Trophoblastic Disease" 2017 ()
- "Molar Pregnancy" 2018 ()
- "Chronic Myeloid Leukemia (CML)" (2020)