Live vaccines Antineoplastics

X in renal/hepatic impair Caution [D, -] Contra IT administration Disp Caps, inj SE NA (emesis in 10-30%), X BM, alopecia, X BP w/ rapid IV, anorexia, anemia, leukopenia, T risk secondary leukemias Interactions T Bleeding W/ ASA, NSAIDs, warfarin T BM suppression W/ antineoplastics radiation T effects OF cisplatin X effects OF live vaccines EMS Pt has T risk of bleeding when combined w/ ASA, NSAIDs, anticoagulants/anti-plts OD May cause N/V symptomatic and supportive... 

The immune response of the body is suppressed by cytotoxic antineoplastics. The effectiveness of vaccines may be poor and generalised infection may occur in patients immunised with live vaccines. 

Vaccinations containing live organisms are not administered within 3 months of immune globulin administration because antibodies in the globulin preparation may interfere with the immune response to the vaccination. Corticosteroids, antineoplastic dru, and radiation therapy depress the immune system to such a degree that insufficient numbers of antibodies are produced to prevent the disease. When the salicylates are administered with the varicella vaccination, there is an increased risk of Reye s syndrome developing. 

Plasma digoxin levels may decrease when the drug is administered with bleomycin. When bleomycin is used witii cisplatin, there is an increased risk of bleomycin toxicity Pulmonary toxicity may occur when bleomycin is administered with other antineoplastic drugs. Plicamycin, mitomycin, mitoxantrone, and dactino-mycin have an additive bone marrow depressant effect when administered with other antineoplastic drugs. In addition, mitomycin, mitoxantrone, and dactinomycin decrease antibody response to live virus vaccines. Dactinomycin potentiates or reactivates skin or gastrointestinal reactions of radiation therapy There is an increased risk of bleeding when plicamycin is administered witii aspirin, warfarin, heparin, and the NSAIDs. 

Gallium Nitrate (Ganite) [Hormone] Uses t Ca of malignancy bladdCT CA Action -1- bone resorption of Ca Dose t Ca 200 mg/mVd X 5 d CA 350 mg/m cont inf X 5 d to 700 mg/m rapid IV inf q2wk in antineoplastic settings (pCT protocols) Caution [C, ] Do not give w/ live or rotavirus vaccine Contra SCr >2.5 mg/dL Disp Inj SE Renal insuff, -1- Ca, hypophosphatemia, -1- bicarb, <1% acute optic neuritis Interactions t Risks of nephrotox amphotCTicin B,... 

Uses Pancreatic CA, brain mets, NSCLC, gastric CA Action Antimetabolite -1-ribonucleotide reductase produces false nucleotide base-inhibiting DNA synth Dose 1000 mg/m over 30 min-1 h IV inf/wk x 3-4 wk or 6-8 wk modify dose based on hematologic Fxn (per protocol) Caution [D, /-] Contra PRG Disp Inj SE X BM, N/V/D, drug fever, skin rash Interactions t BM depression W/ radiation therapy, antineoplastic drugs -1- live virus vaccines EMS Monitor for S/Sxs of Infxn OD May cause N/V, p iphOTal tingling, fever and chills symptomatic and supportive... 

WARNING Administer only under sup vision of a healthcare provider experienced in leukemia and in an institution w/ resources to maintain a pt compromised by drug tox Uses Acute leukemias CML in blast crisis, breast CA Action DNA intercalating agent i DNA topoisom ases I II Dose (Per protocol) 10-12 mg/mVd for 3-4 d 4- in renal/hepatic impairment Caution [D, -] Contra Bilirubin >5 mg/dL, PRO Disp Inj 1 mg/mL (5, 10, 20 mg vials) SE X BM, cardiotox, N/V, mucositis, alopecia, IV site Rxns, rarely -1- renal/hepatic Fxn Interactions Myelo-suppression W/ antineoplastic drugs and radiation therapy -1- effects OF live virus vaccines EMS Monitor for S/Sxs of Infxn OD May cause N/V, t Infxn risk and cardio/GI tox symptomatic and supportive... 

Antineoplastic drugs,narcotic antagonists, steroid hormones,luteinizing hormone releasing hormone analogs,elastase, and other macromolecules have been incorporated into microspheres. In addition, vaccines, living cells, and tissues have been encapsulated. 

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