Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (Second Ed.)

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Foreword xv
Preface xvii
Acknowledgments xix
Chapter 1. Cellular Mechanisms of Chemotherapy 1
Introduction 1
Normal and Malignant Cell Growth 1
Immunology: Host Defense 4
Cellular Transformation to Malignancy 6
Growth Factor Receptors and Tyrosine Kinase Signaling in Cancer Cells 6
Histology of Cancer 7
Cancer Physiology 8
Goals of Chemotherapy 9
Evaluation of Response 9
Cell Cycle Specificity 10
Factors Affecting Chemotherapy Response 13
Summary 15
References 15
Chapter 2. Pharmacologic Principles of Chemotherapy 19
Introduction 19
Drug Resistance 20
Treatment Goals 21
Cell-Cycle Response of Chemotherapy 22
Classification of Antineoplastic Agents 22
Alkylating Agents 22
Toxicity of Alkylating Agents 29
Antimetabolites 30
Antimetabolite Toxicity 30
Antitumor Antibiotics 31
Biologic Agents 32
Hematopoietic Growth Factors 32
Hormones 32
Plant Alkaloids 33
Molecular-Targeted Therapies 33
Monoclonal Antibodies 34
Summary 34
References 35
Chapter 3. Principles and Standards of Chemotherapy Administration 39
Introduction 39
Safe Handling of Cytotoxic Agents 39
Latex Sensitivity 43
Work Practices 43
Hazardous Drug Spills 44
Accidental Exposure 44
Storage and Transport of Hazardous Drugs 44
Chemotherapy Disposal 45
Safe Handling Policies 45
Chemotherapy Preparation and Administration 45
Chemotherapy Preparation 48
Chemotherapy Administration 48
Vesicant Drug Administration 50
Chemotherapy Protective Agents 52
Patient and Significant Other Education and Support 52
Summary 54
References 55
Chapter 4. Targeted Therapy 57
Introduction 57
History and Evolution of Targeted Therapies 58
Side-Effect Management 70
Role of the Oncology Nurse in Targeted Therapy 71
Patient and Family Education 72
Summary 72
References 7
Chapter 5. Antineoplastic Agents 77
History 77
Abbreviations Used in Chapter 5 79
Chemotherapeutic Agents 81
Hormonal Therapies 263
Biotherapeutics 297
Summary 357
Bibliography 357
Chapter 6. Chemotherapy Regimens 363
Introduction 363
Adenocarcinoma of Unknown Primary 364
AIDS-Related Cancers 364
Brain Tumors 364
Breast Cancer 367
Colorectal Cancer 367
Gastric Cancer 37
Genitourinary Malignancies 378
Gynecologic Malignancies 379
Head and Neck Cancers 385
Leukemia 385
Lung Cancer 394
Lymphoma 395
Melanoma 404
Multiple Myeloma 404
Pancreatic Cance 404
Sarcoma 406
Summary 407
References 40
Chapter 7. Botanical and Drug Interactions in Oncology 427
Introduction 427
Contraindications and Problems Associated With Herb-Drug Use 428
Summary 454
References 454
Chapter 8. Complementary and Alternative Medicine Therapy: An Overview 463
Defining Complementary and Alternative Medicine Therapy 463
Background 465
CAM Use by Patients With Cancer in the United States 469
Patient Decision Making and CAM 469
CAM Evidence-Based Practice 472
Regulation 474
Reliable Resources for Cancer CAM Information 475
Future Trends in CAM 475
Summary 477
References 477
Chapter 9. Clinical Trials 481
Introduction 481
Institutional Review Boards 483
Drug Development Process 484
Informed Consent 486
Educational Resources 487
Summary 487
References 488
Chapter 10. Maximizing Outpatient Chemotherapy Reimbursement 491
Introduction 491
National Statistics 491
Historical Chronology 492
Response to the Changes 495
Hospital-Based Outpatient Centers 496
Pharmacy 499
Off-Label Drug Use 501
Denials 502
Restructuring a Billing System 503
Claims Submissions 504
Billing System 504
Continuing Education 505
Medicare Prescription Drug Plan 505
Summary 508
References 509
Chapter 11. Legal Issues in Chemotherapy Administration 513
Introduction 513
Sources of Law 513
Nursing Liability 515
Liability Issues for Nurses 517
Liability Regarding Chemotherapy Administration 520
Lack of Knowledge About Medication and Administration 522
Insufficient Patient Preparation and Monitoring 522
Regulatory Issues 523
Suggestions for Reducing Nurses’ Risk of Malpractice 524
Summary 525
References 525
Chapter 12. Vascular Access Devices 527
Introduction 527
Peripheral Access Devices 529
Central Vascular Access Devices 529
Tunneled Central Venous Catheters 531
Implanted Ports and Reservoirs 533
Peripherally Inserted Central Catheters 535
Alternative Administration Devices 536
Catheter Maintenance Procedures of Vascular Access Devices 541
Patient/Family Education Regarding Vascular Access Devices 563
Pertinent Documentation for Vascular Access Devices 563
Liability Issues and the Role of the Oncology Nurse 565
Research Questions 565
Summary 566
References 566
Chapter 13. Symptom Management 571
Introduction 571
Nausea and Vomiting 572
Anorexia/Cachexia 580
Mucositis 582
Taste Changes 586
Fatigue 586
Sleep-Wake Disturbances 589
Pain 592
Myelosuppression 594
Summary 600
References 600
Chapter 14. Psychosocial Support of the Patient Receiving Chemotherapy 607
Introduction 607
Support of Patients and Caregivers 610
Systems Theory for Support Group Development 613
Support Groups 613
Cancer Survivorship Issues 616
Physical and Psychosocial Challenges 617
Financial and Insurance Challenges 618
Employability and Legality Issues 620
Sexuality Challenges 620
Spiritual Challenges 621
Cultural Challenges 622
Summary 623
References 623
Chapter 15. Public and Professional Cancer Resources 627
Introduction 627
Public Resources 628
Professional Resources and Organizations 633
Related Professional Associations 637
Patient and Professional Information Resources Via the World Wide Web 639
Index 643
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