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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