Preparation and handling of chemotherapy agents

Preparation and handling of chemotherapy agents
- May pose an occupational hazard
- Drugs may be absorbed through
  - Skin
  - Inhalation during preparation, transportation, and administration
- Only properly trained personnel should handle cancer drugs
Chemotherapy methods of administration
- Oral
  - More available options today
  - Storage and side effects
- IM – Intramuscular
- IV – Intravenous (most common)
  - Central venous access device (CVAD)
- CVAD administration
  - Placement in large blood vessels
  - Frequent, continuous, or intermittent administration
  - Can be used to administer other fluids (blood, electrolytes, etc.)
Regional administration
- Delivery of drug directly into
  tumor site
- Higher concentrations of drug can be delivered with less systemic toxicity
- Types of regional delivery methods
  - Intraarterial
    - Delivers drug through arteries supplying tumor
  - Intraperitoneal
    - Delivers drug to peritoneal cavity for treatment of peritoneal metastases
  - Intrathecal or intraventricular
    - Involves lumbar puncture and injection of chemotherapy into subarachnoid space
  - Intravesical bladder
    - Agent added to bladder by urinary catheter and retained for 1 to 3 hours
Effects on normal tissue
- General and drug-specific adverse effects are classified
  - Acute
  - Delayed
  - Chronic
Radiation therapy
- One of the oldest nonsurgical methods of cancer treatment
- 50% of all cancer patients will receive radiation therapy at some point in their treatment
- Radiation is emission of energy from a source and travels through space or some material
- Different types of ionizing radiation are used to treat cancer
- Technologic advances
  - Low-energy beams
    - Expend energy quickly
    - Penetrate a short distance
    - Useful for skin lesions
  - High-energy beams
    - Greater depth of penetration
    - Suitable for optimal dosing of internal targets while sparing skin
- Total doses divided into fractions
- Typically delivered once a day for 5 days a week for 2 to 8 weeks
  - Standard fractionation

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