Drol Susej Z.

Picazo
BSN 2-A-4
Pharmacology

WEEK 14
Renovo Mirador
 DRUG DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATION NURSING
ACTION CONSIDERATIONS
ALKYLATING DRUGS
NITROGEN MUSTARDS
CHLORAMBUCIL Oral Alkylating agents work Body as a Whole: Drug fever, Lactation. -Lab tests: CBC, Hgb,
(LEUKERAN) Hodgkin's disease by three different skin rashes, papilledema, total and differential
Adult: 200 g daily for mechanisms: 1) alopecia, peripheral leukocyte counts, and
8 wk. The daily dose attachment of alkyl neuropathy, sterile cystitis, serum uric acid
should not exceed 100 groups to DNA bases, pulmonary complications, initially and at least
mcg/kg if the bone resulting in the DNA seizures (high doses).  once weekly during
marrow presents w/ being fragmented by treatment.
lymphocyte infiltration repair enzymes in their GI: Low incidence of gastric
or is hypoplastic. attempts to replace the discomfort, hepatotoxicity.  -Leukopenia usually

Maintenance: 30-100 alkylated bases, develops after the

mcg/kg daily, once preventing DNA Hematologic: Bone marrow third week of

remission is synthesis and RNA depression: leukopenia, thro treatment; it may

established. transcription from the mbocytopenia, anemia.  continue for up to 10

Elderly: Initiate at the affected DNA, 2) DNA d after last dose, then

lower end of the damage via the formation Metabolic: Sterility, rapidly return to

dosage range. of cross-links (bonds hyperuricemia. normal.

between atoms in the

-Avoid or reduce to
Oral DNA) which prevents
minimum injections
Non-Hodgkin's DNA from being
and other invasive
lymphoma separated for synthesis
procedures (e.g.,
Adult: 100 mcg/kg or transcription, and 3)
rectal temperatures,
daily for 4-8 wk. Daily the induction of
enemas) when platelet
dose should not exceed mispairing of the
count is low because
100 mcg/kg if the bone nucleotides leading to
of danger of bleeding.
marrow presents w/ mutations.
lymphocyte infiltration
-Monitor for S&S of
or is hypoplastic.
skin rashes, which are
Maintenance: 30-100
rare, but appear to
mcg/kg daily, once
show a consistent
remission is
pattern: pustular
 DRUG DOSAGE THERAPEUTIC ADVERSE EFFECTS CONTRAINDICATION NURSING
ACTION CONSIDERATIONS
ALKYLATING DRUGS
NITROGEN MUSTARDS
MECHLORETHAMINE HCL Advanced Hodgkin's Alkylating agents work CNS: Neurotoxicity: vertigo, Myelosuppression; -Establish baseline
(MUSTARGEN) Disease by three different tinnitus, headache, infectious granuloma; data for body weight,
Adult: IV 6 mg/m2 on mechanisms: 1) drowsiness, peripheral known infectious I&O ratio and
day 1 and 8 of a 28 d attachment of alkyl neuropathy, light-headedness, diseases, acute herpes pattern, and blood
cycle groups to DNA bases, paresthesias, cerebral zoster; intracavitary use labs as reference for
resulting in the DNA deterioration, coma.  with other systemic bone design of drug and
Other Neoplasms being fragmented by marrow suppressants; care regimens.
Adult: IV 0.4 mg/kg repair enzymes in their GI: Stomatitis, xerostomia, pregnancy (category D),
given as a single dose attempts to replace the anorexia, nausea, lactation. -Lab tests: Monitor

or in divided doses of alkylated bases, vomiting, diarrhea.  CBC with differential

0.1–0.2 mg/kg/d, may preventing DNA and platelet count.

repeat course in 3–6 synthesis and RNA Hematologic: Leukopenia, th Periodic serum uric

wk transcription from the rombocytopenia, lymphocyto acid levels.

affected DNA, 2) DNA penia, agranulocytosis, anem

-Record daily weight.
damage via the formation ia, hyperheparinemia. 
Alert physician to
of cross-links (bonds
sudden or slow,
between atoms in the Skin: Pruritus,
steady weight gain.
DNA) which prevents hyperpigmentation, herpes
DNA from being zoster, alopecia. 
-Monitor and record
separated for synthesis
patient's fluid losses
or transcription, and 3) Urogenital: Amenorrhea,
carefully. Prolonged
the induction of azoospermia, chromosomal
vomiting and diarrhea
mispairing of the abnormalities,
can produce volume
nucleotides leading to hyperuricemia. 
depletion.
mutations.
Mechlorethamine is cell Body as a Whole: Weakness, -Report immediately
cycle phase-nonspecific. hypersensitivity petechiae,
reactions. With ecchymoses, or
extravasation: painful abnormal bleeding
inflammatory reaction, tissue from intestinal and