| Drug and Dosage | Use | Action | Assessment: Side Effects |
|---|---|---|---|
| 6-Mercaptopurine (Purinethol)—PO 2.5 mg/kg/day; may increase to 5 mg/kg after 4 wk; maintenance 1.5–2.5 mg/kg/day | Leukemia (ulcerative) | Antineoplastic | Bone marrow depression, severe hepatotoxicity |
| NURSING IMPLICATIONS: Monitor: bleeding, infection, liver function tests, skin care, nausea and vomiting | |||
| Methotrexate (Rheumatrex)—PO, IM 15–30 mg/day for 5 days; repeat after 1 wk for 3–5 courses | Leukemia Breast, lung cancer | Interferes with folic acid metabolism, resulting in inhibition of DNA synthesis and cell reproduction | Pulmonary fibrosis; hepatotoxicity; stomatitis, signs and symptoms of chemotherapy side effects |
| NURSING IMPLICATIONS: Monitor: liver function; assess respiratory status; see nursing care of clients receiving chemotherapy, Physiological Integrity | |||
| Mitotane (Lysodren)—PO 9–10 gm/day in 3–4 divided doses initially; decrease for maintenance | Adrenocortical carcinoma | Affects pituitary disorders | GI complaints; lethargy, somnolence |
| NURSING IMPLICATIONS: Monitor: signs of disease progression, GI abnormalities, abdominal pain | |||