ENDOMETRIAL CARCINOMA DRUG Doxorubicin Hydrochloride DOSAGE Initially 50 mg/ IV at 1 mg/min MECHANISM OF ACTION Cytotoxic: Binds to DNA and

inhibits DNA Synthesis in susceptible cells causing cell death INDICATION

Ovarian Carcinoma

SIDE EFFECTS AND ADVERSE REACTIONS Skin Reversible Alopecia, Hyperpimentation of nailbeds and dermal creases GI: Acute Nausea and Vomiting, Mucositis, Ulceration and necrosis of the colon which may lead to bleeding Vascular: Phlebosclerosis, Facial Flushing Local: Severe cellulitis, vesication, tissue necrosis Hematogic: Secondary acute myeloid leukemia Hypersensitvity: Fever, chills, uticaria

CONTRAINDICATIONS

NURSING RESPONSIBILITY Instruct patient to report difficulty of breathing, weight gain, pain or burning sensation at injection site, unusual bleeding or bruising Assist in obtaining a wig for patient before hair loss occurs Encourage small frequent feedings for Nausea and Vomiting

Marked Myelosuppression, previous treatment with cumulative doses of doxorubicin,

daunorubicin, idarubicin, and/or other anthracyclines and anthracenes.

Adriamycin PFS, Adriamycin RDF, Doxil

Cisplatin

Platinol AQ

Dose is often given in combin ation with another chemot herapeu tic drug

Metastatic ovarian tumors Cytotoxic: Heavy metal that inhibits cell replication by alkylating DNA; Cell cycle nonspecific

Others: Conjunctivitis and lacrimation CNS: Ototoxicity, peripheral neuropathies, seizures, loss of taste, GI: Nausea, vomiting, anorexia, liver impairment, GU: Nephrotoxicity, dose limiting Hematologic: Leukopenia, Thrombocytopenia, anemia, hypomagnesemia, hypocalcemia, hypokalemia, hypophosphatemia, hyperuricemia Hypersensitivity: Facial edema, bronchoconstriction, tachycardia, hypotension

Allergy to Cisplatin, platinum containing products, hematopoietic depression; impaired renal function, hearing impairment, renal function, pregnancy, lactation

Weight patient Evaluate VIII cranial nerve, reflexes, sensation, CBC Instruct patient to report loss of hearing, dizziness, unusual bleeding or bruising, fever, chills, sore throat, leg cramps, changes in voiding pattern

Carboplatin

Paraplatin

360 mg/ IV on day 1 every 4 weeks

Cytotoxic: Heavy metal that produces cross-link within and between strands of DNA, thus preventing cell replication; Cell cycle nonspecific

Initial treatment of advanced ovarian carcinoma Palliative treatment of patients with ovarian carcinoma recurrent after prior chemptherapy

CNS: Peripheral Neuropathies, Ototoxicity, visual disturbances, change in taste perception GI: Nausea, Vomitin, abdominal pain, diarrhea, constipation GU: Increased BUN or serum creatinine Heamtologic: Bone marrow depression, decreased serum sodium, magnesium, calcium, potassium Hypersensitivity: Anaphylactic like reactions, rash, uticaria, erythema, pruritus, bronchospasm Other: Pain, alopecia, asthenia, cancer CNS: Somnolence, confusion, hallucination, coma, depressive psychosis, dizziness, seizures

Severe allergic reactions to carboplatin, cisplatin, platinum compounds, mannitol, severe bone marrow depression, lactation

Weight Patient Skin and hair evaluation Reflexes, sensation , CBC Evaluation

Use cautiously with renal impairment, pregnancy, history of neuropathic disorders

Instruct patient to report loss of hearing, dizziness, unusual bleeding or bruising, fever, chills, sore throat, muscle twitching, changes in voiding pattern

Ifosfamide

Ifex

IV 1.2 g/ per day for 5 consecu

Cytotoxic; Exact mechanism of action is not known

Ovarian and Cervical Cancers

Allergy to ifosfamide, hematopoietic depression,

Assess reflexes, skin for lesions, hair, urinary output, renal function

tive days

although metabolite of ifosfamide Traetme alkalynates nt is DNA, repeate interferes d every with the 3 weeks replication of susceptible cells; immunosuppr essive. Lymphocytes are especially sensitive drug effects

pregnancy, lactation.
Dermatologic: Alopecia, darkening of skin and fingernails GI: Anorexia, Nausea, Vomiting, diarrhea, stomatitis GU: Hemorrhagic cystitis, bladder fibrosis, hematuria, increased urine uric acid, gonadal suppression Hematologic: Leukopenia, thrombocytopenia, anemia (RARE), increased serum uric acid levels Other: Immunosuppression, secondary neoplasia, hepatic impairment, infection Instruct patient to avoid grapefruit juice while using this drug Instruct patient to report unusual bleeding or bruising, fever, chills, sore throat, cough, shortness of breath, blood in urine, painful urination, unusual lump or masses, flank, stomach or joint pain, sores in mouth or on lips, yellow discoloration of skin and eyes.

Use cautiously with impaired hepatic or renal function

The most common chemotherapy combinations used to treat endometrial carcinoma are:

cisplatin and doxorubicin paclitaxel and doxorubicin carboplatin and docetaxel carboplatin and paclitaxel cisplatin, paclitaxel and doxorubicin