Chemotherapy and Radiation Therapies

 

Radiation therapy

ionizing radiation disrupts cellular growth

Two types of ionizing radiation

  1. Electromagnetic rays
  2. Ionizing radiation

 

Cell types that undergo frequent division are affected by radiation:

  1. bone marrow
  2. lymph tissues
  3. epithelium of gi tract, hair cells and gonads

 

External Radiation

  • delivery methods depend on tumor depth

 

Types and Locations of Internal Radiation Therapy

  1. internal radiation implantation – brachytherapy, high dose to localized area
  2. radioisotope implantation – have a specific to half-life and are in the form of needles, seeds, beads, catheters

used in the :

  1. vagina
  2. abdomen
  3. pleura
  4. interstitial compartments – breast

 

Chemo Mucous membrane protection – avoid the following:

  1. ointments
  2. lotions
  3. powders

 

Chemotherapeutic agents:

  1. cell-cycle specific
  2. cell cycle non-specific

 

Two main Chemotherapy side effects

  1. Nausea
  2. Vomiting

 

Vomiting centers in brain stimulated by the following:

  1. chemo receptor trigger zone in medulla
  2. stimulation of peripheral autonomic pathways – GI tract and pharynx
  3. stimulation of vestibular pathways (inner ear imbalances, labyrinth input)
  4. cognitive stimulation – CNS disease, anticipatory nausea and vomiting

 

Antiemetics:

  1. Serotonin blockers
  2. Ondansetron
  3. Granisetron
  4. Dolasetron
  5. dopaminergic blks
  6. phenothiazines, sedatives, corticosteroids and histamines are used in combination

 Cardiotoxic and Renopathic Side effects

  • some chemo agents are cardiotoxic – monitor ejection fraction
  • renopathic – monitor urea, nitrogen, creatinine

 

Assessments

  1. fluid and electrolytes
  2. infection
  3. bleeding
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