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856

AClITE CARE HANDBOOK FOR PHYSICAL THERA1'ISTS

Table IV-1S .B. COlltillued

Generic Name

(Trade Name)

Side Effects

Daunorubicin

Nausea, vomiting, myelosuppression, tissue necrosis, sto

(Cerubidine)

matitis, alopecia, cardiotoxicity

Doxorubicin

Nausea, vomiting, myelosuppression, tissue necrosis,

(Adriamycin)

stomatitis, alopecia, cardiotoxiciry

Mitomycin

Nausea, vomiting, myelosuppression, tissue necrosis,

(Mutamycin)

stomatitis, pulmonary and renal toxicity

Mitoxantrone

Myelosuppression, cardiotoxicity (congestive heart

(Novantrone)

failure, arrhythmias), nausea, vomiting, diarrhea,

abdominal pain, hepatic dysfunction, seizures

Plicamycin

Myelosuppression, central nervous system and renal

(Mithracin)

toxicity, nausea, vomiting, coagulation abnormalities,

tissue necrosis, weakness, malaise

Sources: Dam from C Ciccone (cd). Cancer Chemotherapy. Philadelphia: FA Davis, 1 996;

and D Moreau (ed). Nursing '96 Drug Handbook. Springhouse, PA: Springhouse, 1996.

Table IV-IS.C. Antimetabolite Agents (Chemotherapy Agents)

Indications: Malignant neoplasms, metastatic disease

Mechanism of action: Interfere with normal metabolites during DNA and

RNA biosynthesis

Generic Name

(Trade Name)

Side Effects

Cladribine (2-chlorode

Neutropenia, anemia, leukopenia, nausea, rash,

oxyadenosine)

chills, diaphoresis, arthralgia, myalgia, malaise

Cytarabine (Cyrosar-U)

Neurotoxicity, ataxia, nystagmus, keratitis,

nausea, vomiting, thrombocytopenia, flulike

syndrome

Floxuridine (FUDR)

Anorexia, stomatitis, cramps, araxia, vercigo,

nystagmus, seizures, nausea, vomiting, diarrhea,

bleeding, leukopenia, anemia, thrombocytopenia, erythema, alopecia, hiccups, jaundice

S -Fluorouracil (Adrucil) Ataxia, weakness, malaise, stomatitis, nausea,

vomiting, diarrhea, anorexia, leukopenia, thrombocytopenia, anemia, alopecia, dermatitis,

erchema, pain, burning, scaling, pruritus, confusion, disorientation

APPENDIX IV: PHAR..\1ACOLOGIC AGENTS

857

Generic Name

(Trade Name)

Side Effects

Hydroxyurea (Hydrea)

Anorexia, vomiting, diarrhea, leukopcnia, thromb�

ocytopenia, anemia, nausea, myelosuppression,

skin rash, renal and neuroroxicity

Mercapropurine

Nausea, vomiting, anorcxia, thrombocytopenia,

(Purinethol)

anemia, jaundice, hepatic necrosis, rash,

leukopenia

Methorrexate (Folex,

Pharyngitis, nausea, anemia, leukopenia, pulmo�

Mexatc, Rheumatrcx)

nary fibrosis

Thioguanine (Lanvis)

Leukopenia, anemia, thrombocytopenia, hepato�

roxicity, nausea

Sources: D:na (rom C Ciccone (cd). Cancer Chemotherapy. Philadelphia: FA Davis,

1 996; 0 Moreau (cd). Nursing '96 Drug Handbook. Springhouse, PA: Springhouse,

1 996; and lM Tierney, Sj McPhee, MA I)apadakis (cds). Current Medical Diagnosis

and Treatment. New York: McGraw·Hill, 2000.

Table IV-IS.D. Hormones (Chemotherapy Agents)

Indications: Malignanr neoplasms, mctastatic disease

Mechanism of action: Inhibit growth of neoplasm; usually combined with

other chcmorherapy agems

Generic Name

(Trade Name)

General Side Effects

Anriestrogens

Tamoxifcn (Nol·

Nausea, vomiting, tmnsiem fall in

vadex)

white blood cell and platelet counts

Toremifene

Occasional fluid retemion, rare throm·

bosis, weight gain

Estrogens

Chlororrianisene

Nausea, leg cramps, thromboembolism,

(TACE)

cerebrovascular accident, pulmonary

embolism, myocardial infarction

Dieth ylstilbesrrol Nausea, leg cramps, thromboembo

(DES)

lism, cerebrovascular accidcnt,

pulmonary embolism, myocardial

infarction

Estradiol

Thromboembolism, nausea, leg cramps

(Oestradiol,

Valerate)

Medroxyproges·

Occasional fluid retention, rare throm·

terone

basis, weight gain

858

ACUTE CARE HANDBOOK FOR PHYSICAL THERAPISTS

Table lV-IS.D. Continued

Generic Name

(Trade Name)

General Side Effecrs

Ad renocortico-

Prednisone (DeI-

Euphoria, insomnia, muscle weakness,

steroids

tasone, Ora-

osteoporosis, congestive heart failure,

sone)

hypertension, delayed wound healing

Prednisolone

Euphoria, insomnia, muscle weakness,

(Delra-Corref)

osteoporosis, congestive heart failure,

hypertension, delayed wound healing

Androgens

Fluoxymesterone Edema, nausea, vomiring, thrombo-

(Android-F)

cytopenia

Anriandrogcns

Flutamide

Drowsiness, confusion, numbness,

(Eulexin)

diarrhea, nausea, vomiting, hor

flashes

Anasrra:z.ole

Occasional fluid retention, rare thrombosis, weight gain

Aromarase

Aminoglure-

Skin rash, weight gain, fluid retenrion,

inhibitor

thimide

leg cramps, jaundice

Gonadorropin-

Leuprolide

HOt flashes, pulmonary embolism,

releasing

(Lupron)

arrhythmia, angina, myocardial

hormone

infarction

drugs

Goserelin acetate Hot flashes, pulmonary embolism,

arrhythmia, angina, myocardial

infarction

Goserelin

Lethargy, pain, arrhythmia, congestive

(Zoladex)

heart failure, hypertension,

myocardial infarction, chronic

obstructive pulmonary disease, upper

respiratory tract infections

Megestrol

Hypertension, edema, thrombo

(Megace)

phlebitis, nausea, vomiting, carpal

runnel syndrome

Anticachetics

Megestrol

Occasional fluid retenrion, rare thromacetate

bosis, weight gain

Sources: Data from C Ciccone (cd). Cancer Chemotherapy. Philadelphia: FA Davis,

1 996; D Moreau (ed). Nursing '96 Drug Handbook. Springhouse, PA: Springhouse,

1996; and LM Tierney, SJ McPhee, MA Papadakis (cds). Current Medical Diagnosis and

Treannem. New York: McGraw-Hili, 2000.

APPE.NDIX IV: I'HARMACOLOGIC AGENTS

859

Table I V-1 5_E_ Plant Alkaloids (Chemorherapy Agents)

Indications: Malignant neoplasms, metastatic disease

Mechanism of action: Disrupt the mitotic apparatus and cause death of the

ca ncerous cell

Generic Name (Trade Name)