Oral drugs are more convenient for the patient and can be taken at home. However, there are many problems with oral anticancer drugs. One of the biggest
... [Show More] problems is the misperception by patients and nononcology nurses that these drugs are less toxic than IV chemotherapy, which is not true. Oral anticancer drugs are just as toxic to the patient taking the drug and to the person handling the drug as are standard chemotherapy drugs. The responsibility for administering these drugs often shifts from the oncology clinic to the home or to nononcology acute care settings, and issues of protection, correct administration, adherence, and recognition and management of side effects are major concerns. There is a critical need for patient education and support to self-manage this therapy, including the accidental ingestion by another person. Not all patients are able to accept the responsibility of self-management, and this must be considered during patient selection for oral chemotherapy
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How to administer- Because these oral agents can be absorbed through skin and mucous membranes and exert toxic effects, the person who handles and administers them needs to use PPE in the same way as during IV chemotherapy administration. This becomes a more critical issue when nononcology nurses are administering the drugs. The ONS practice guidelines stress nurse education for competence to administer these drugs. All nurses administering these drugs must know the indications for drug use, dosage ranges, side effects and adverse effects, schedules, and specific precautions. Oral agents must not be crushed, split, broken, or
chewed. These drugs are biohazardous and must be discarded in accordance with agency policy. Teach patients or whoever prepares the dosages how to avoid touching the drugs. Tablets and capsules in blister packs are pressed into a small paper cup. Those in traditional medication bottles are “poured” first into the bottle cap and then into a paper cup. The patient then “drinks” the tablet/capsule from the cup into his or her mouth. These drugs are to be taken separately from all other drugs.
Consult a drug handbook or a pharmacist for timing of the drug in relation to meals and what to do if a dose is missed. For many of these oral drugs, missed doses are not taken when remembered. The patient just takes the next scheduled drug dose.
Oncology Emergencies
• Spinal cord compression- tumor is pressing on the spinal cord. weakness, pain, neuropathy
: surgery [Show Less]