NAME CLASSIFICATION MECHANISM OF INDICATIONS & SIDE EFFECTS NURSING

ACTION CONTRAINDICATIONS RESPONSIBILITIES

Generic Name: Antineoplastic Exhibits cell phase INDICATIONS The following • Reconstitute with
Gemcitabine Agent; specificity, primarily Locally or metastatic adverse reactions preservative-free
Hydrochloride Antimetabolite; killing cells adrenocarcinoma of are for weekly sodium chloride
Immunosuppresan undergoing DNA the pancreas administration of 0.9%.
Brand Name: t synthesis in the S- single-agent
• Reconstituted
Gemzar phase. It also blocks CONTRAINDICATION gemcitabine as a 30-
the progression of S min infusion for solution may be
Availability: cells through the G1/S- treatment of a wide administered
Powder for injection, phase boundary. - Hypersensitivity to variety of directly or further
lyophilized 200 mg gemcitabine, severe malignancies. diluted with
- Powder for injection, thrombocytopenia, sodium chloride
lyophilized 1,000 mg acute infection, Cardiovascular 0.9% to a final
pregnancy, lactation Hemorrhage (17%); gemcitabine
Dosage: mild blood loss, concentration at
Pancreatic petechiae (16%); least 0.1 mg/mL.
Adenocarcinoma arrhythmias, CHF, • Administer by IV
Adults gangrene, MI, infusion over 30 
peripheral vasculitis min. Prolonging
IV 1,000 mg/m 2 once (postmarketing). infusions past 60
weekly for 7 wk min increases the
followed by 1 wk of CNS
risk of
rest. Somnolence (11%);
paresthesia (10%); myelosuppressio
asthenia (common). n.
Storage/Stability
• Reconstituted
Dermatologic gemcitabine is a
Store at controlled
Rash (30%); alopecia clear, colorless to
room temperature
(68° to 77°F). (18%); pruritus light straw-
Reconstituted (13%); bullous skin colored solution.
solutions are stable eruptions, cellulitis, Do not administer
for up to 24 h at desquamation if particulate
controlled room (postmarketing). matter or
temperature (68° to discoloration is
77°F). Do not GI found.
refrigerate Nausea and vomiting • Store at controlled
reconstituted (71%); constipation room temperature
product; crystals may (31%); diarrhea (68° to 77°F).
form in the bag or (30%); stomatitis Reconstituted
bottle. (14%); anorexia solutions are stable
(common). for up to 24 h at
Pregnancy controlled room
Category: D Genitourinary temperature (68°
to 77°F). Do not
Proteinuria (45%); refrigerate
hematuria (35%); reconstituted
increased BUN product; crystals
(16%); elevated may form in the
creatinine (8%); bag or bottle.
hemolytic uremic • Monitor and record
syndrome (0.25%); BP carefully after
renal failure initial dose; and
(postmarketing). periodically here
after
Hematologic- • Monitor Lab Tests:
Lymphatic CBC with
Anemia (73%); differential and
leukopenia (71%); platelet count prior
neutropenia (63%); to each dose.
thrombocytopenia • Monitor baseline
(47%). and periodic renal
and hepatic
Hepatic function
Elevated AST (78%); • Monitor Input and
increased alkaline Output
phosphatase (77%); quantitatively
elevated ALT (72%); • Inform patient
elevated bilirubin about common
(26%); elevated adverse effects and
gamma-glutamyl measure to control
transferase, liver or minimize when
failure possible.
(postmarketing). • Report any
significant side
Respiratory effects
immediately to the
Dyspnea (23%);
physician
bronchospasm (2%);
parenchymal toxicity • Report pregnancy
including adult to physician
respiratory distress immediately
syndrome, • Do not breastfeed
interstitial while taking this
pneumonitis, drug without
pulmonary edema, consulting
pulmonary fibrosis physician.
(postmarketing).

Miscellaneous
Pain (48%); fever
(41%); peripheral
edema (20%); flu-
like syndrome
(19%); infection
(16%); edema
(13%); injection-site
reaction (4%);
radiation recall
reactions
(postmarketing).
 NAME CLASSIFICATION MECHANISM OF INDICATIONS & ADVERSE NURSING
ACTION PRECAUTIONS REACTIONS RESPONSIBILITIES
Generic Name: Antineoplastic The mechanism of INDICATIONS • The most common • Teach or provide
Erlotinib Agent; clinical antitumor TARCEVA adverse reactions the training and
Kinase Inhibitor action of erlotinib is monotherapy is (>20%) in pancreatic support to ensure
Brand Name: not fully indicated for the cancerare the safety of
Tarceva characterized. maintenance fatigue, patients taking on
Erlotinib inhibits the treatment of patients rash, the responsibility of
Availability: intracellular with locally advanced nausea, taking oral
available in three phosphorylation of or metastatic non- anorexia, chemotherapy at
dosage strengths tyrosine kinase small cell lung cancer diarrhea, home. Reiterate
25 mg, associated with the whose disease has not abdominal pain, the importance of
100 mg and epidermal growth progressed after four vomiting, compliance in
150 mg erlotinib factor receptor cycles of platinum- weight decrease, taking the
(EGFR). Specificity of based first-line infection, medication
Dosage: inhibition with regard chemotherapy edema,
ORAL to other tyrosine pyrexia, • Inform patient
kinase receptors has CONTRAINDICATION constipation, tarceva should be
Pancreatic Cancer not been fully S bone pain, taken on an empty
characterized. EGFR is NONE dyspnea, stomach at least
The recommended stomatitis
expressed on the cell one hour before or
daily dose of PRECAUTIONS AND myalgia.
TARCEVA for surface of normal cells two hours after the
WARNING ingestion of food.
pancreatic cancer is and cancer cells.
• Pulmonary toxicity The following signs or
100 mg taken on an
• Renal failure symptoms occur,
empty stomach at
patients should be:
least one hour before • Hepatotoxicity • advised to seek
or two hours after the
medical advice
ingestion of food, in • Patients with
• Onset or
combination with hepatic
worsening of skin
gemcitabine. impairment
rash
• Gastrointestinal • Severe or
Pregnancy perforation persistent
Category: D diarrhea, nausea,
• Bullous and anorexia, or
exfoliative skin vomiting
disorders • Onset or
• Ocular disorders worsening of
unexplained
• Elevated shortness of
International breath or cough
Normalized Ratio • Eye irritation
and potential • Given that skin
 reactions are
bleeding
anticipated when
• Use in pregnancy taking TARCEVA,
(adequate proactive
contraceptive intervention may
methods should be include alcohol-
used during free emollient
therapy and for at cream and use of
least 2 weeks after sunscreen or
completing avoidance of sun.
therapy) • The management
of rash should be
discussed with the
patient. This may
include topical
corticosteroids or
antibiotics with
anti-inflammatory
properties.

• Acne preparations
with drying
properties may
aggravate the dry
skin and
erythema.
Treatment of rash
has not been
formally studied
and should be
based on rash
severity.

• Women of
childbearing
potential should
be advised to
avoid becoming
pregnant while
taking TARCEVA

• Smokers should
be advised to stop
smoking while
taking TARCEVA
as plasma
concentrations of
erlotinib are
reduced due to
the effect of
cigarette smoking