Fundamentals
of
Chemotherapy
Immunotherapy
Administration
Hematologic
cancer
(blood
cancer)
-
ANS
-cancer
that
begins
in
bone
marrow
or
immune
system
cells.
-Ex:
leukemia,
lymphoma,
multiple
myeloma
Leukemia
-
ANS
cancer
starts
in
blood-forming
tissues
like
bone
marrow
-causes
lots
of
abnormal
blood
cells
to
be
produced
and
enter
bloodstream
Lymphoma
-
ANS
-cancer
that
begins
in
immune
system
(WBC=lymphocytes)
-hodgkin
and
non-hodgkins
-B
lymphocytes
(B
cells)
-
make
antibodies
(bacteria
and
viruses,
most
common
lymphoma
-T
lymphocytes
(T
cells)
-
boost/slow
immune,
destroy
germs
and
abnormal
cells
Hodgkin
lymphoma
-
ANS
Reed-Sternberg
cell
(cancer
cells
in
classic)
-typically
starts
in
B
cells
Non-Hodgkin's
Lymphoma
-
ANS
-large,
diverse
group
of
cancers
in
immune
system
cells
-indolent
(slow
growing)
or
aggressive
(fast) Myeloma
-
ANS
Cancer
in
plasma
cells
(WBC
that
produce
antibodies)
Chemotherapy
-
ANS
All
antineoplastic
agents
used
to
treat
cancer,
given
through
oral
and
parenteral
routes
or
other
routes
as
specified
in
the
standard,
not
including
hormonal
therapies.
Who
can
order
chemotherapy?
-
ANS
Written
and
signed
by
licensed
independent
practitioners
(MD/DO,
PA,
Oncology
NP)
Can
you
use
verbal
orders
for
chemotherapy?
-
ANS
NO!
Only
when
holding/stopping
admin.
Who
can
mix
Chemotherapy?
-
ANS
Pharmacist,
Pharmacy
tech,
MD/DO,
qualified
RN
Who
can
administer
chemotherapy?
-
ANS
Registered
Nurses
with
specialized
education,
prep
and
training.
See
specific
state
laws
and
statutes
How
often
is
chemo
competency
reassessed>
-
ANS
Annual
continuing
ed
and
competency
assessment
is
recommended
What
is
the
dose
verification
process?
-
ANS
-confirm
plan
with
patient -two
practitioners
verify:
drug
name,
dose,
volume,
rate,
route,
expiration
date,
appearance
-document
verification
in
chart
What
PPE
is
required
for
IV
Chemotherapy?
-
ANS
-Gloves:
two
pairs,
HD
tested
-Gown:
disposable,
back
closed,
long
sleeved
-Respirator:
NIOSH
approved
-Eye
&
Face:
face
shield/mask
Neoadjuvant
therapy
(tumor
burden)
-
ANS
Chemo
BEFORE
primary
treatment
(common
in
breast
and
colon)
Adjuvant
therapy
-
ANS
Chemo
AFTER
primary
treatment
(common
in
solid
tumor)
Bone
Marrow
-
ANS
soft,
sponge-like
tissue
in
center
of
most
bones,
produce
WBC,
RBC,
and
platelets.
Myelosuppression
-
ANS
bone
marrow
activity
is
decreased,
causing
less
RBC,
WBC
and
Platelets.
Myeloablation
-
ANS
severe
myelosuppression
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