Chapter 46, Problem 1CTPQ

Summary Introduction

To describe:

The priority action of the nurse when the patient dislodges the intravenous catheter leading to infiltration of the medication during carmustine infusion.

Concept introduction:

Cancer cells are characterized by uncontrolled proliferation of abnormal cells, invasion, metastasis, and antiapoptosis. Chemotherapeutic drugs are broadly classified into two categories based on targeting the phases of the cell cycle (cell cycle specific drugs and cell cycle non-specific drugs). Alkylating drugs are cell-cycle nonspecific anticancer drugs. They are used to treat the wide range of cancers, including solid and hematological tumors. Alkylating drugs are commonly categorized into three types, namely classic alkylators (for example, chlorambucil and cyclophosphamide), nitrosoureas (for example, carmustine and lomustine), and miscellaneous alkylators (for example, altretamine and busulfan). The alkylating drugs prevent cancer progression by inhibiting the DNA synthesis through the formation of covalent bonds with DNA bases. The major adverse effects of alkylating drugs are pulmonary fibrosis, nephrotoxicity, neurotoxicity, ototoxicity, and bone marrow suppression.