Fundamentals of Chemotherapy Immunotherapy
Administration (FCIA)_ Questions And Answers.
Hematologic cancer (blood cancer) - --cancer that begins in bone marrow or immune
system cells.
-Ex: leukemia, lymphoma, multiple myeloma
-Leukemia - -cancer starts in blood-forming tissues like bone marrow
-causes lots of abnormal blood cells to be produced and enter bloodstream
-Lymphoma - --cancer that begins in immune system (WBC=lymphocytes)
-hodgkin and non-hodgkins
-B lymphocytes (B cells) - make antibodies (bacteria and viruses, most common
lymphoma
-T lymphocytes (T cells) - boost/slow immune, destroy germs and abnormal cells
-Hodgkin lymphoma - -Reed-Sternberg cell (cancer cells in classic)
-typically starts in B cells
-Non-Hodgkin's Lymphoma - --large, diverse group of cancers in immune system cells
-indolent (slow growing) or aggressive (fast)
-Myeloma - -Cancer in plasma cells (WBC that produce antibodies)
-Chemotherapy - -All antineoplastic agents used to treat cancer, given through oral and
parenteral routes or other routes as specified in the standard, not including hormonal
therapies.
-Who can order chemotherapy? - -Written and signed by licensed independent
practitioners (MD/DO, PA, Oncology NP)
-Can you use verbal orders for chemotherapy? - -NO! Only when holding/stopping
admin.
-Who can mix Chemotherapy? - -Pharmacist, Pharmacy tech, MD/DO, qualified RN
-Who can administer chemotherapy? - -Registered Nurses with specialized education,
prep and training. See specific state laws and statutes
-How often is chemo competency reassessed> - -Annual continuing ed and competency
assessment is recommended
-What is the dose verification process? - --confirm plan with patient
-two practitioners verify: drug name, dose, volume, rate, route, expiration date,
appearance
-document verification in chart
-What PPE is required for IV Chemotherapy? - --Gloves: two pairs, HD tested
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, -Gown: disposable, back closed, long sleeved
-Respirator: NIOSH approved
-Eye & Face: face shield/mask
-Neoadjuvant therapy (tumor burden) - -Chemo BEFORE primary treatment (common
in breast and colon)
-Adjuvant therapy - -Chemo AFTER primary treatment (common in solid tumor)
-Bone Marrow - -soft, sponge-like tissue in center of most bones, produce WBC, RBC,
and platelets.
-Myelosuppression - -bone marrow activity is decreased, causing less RBC, WBC and
Platelets.
-Myeloablation - -severe myelosuppression
-Induction phase - -initial phase, typically in hospital, intended myelosuppression
-Consolidation phase (intensification/postremission therapy) - -after successful
induction, kills cancer cells left in body (ex radiation, stem cell transplant)
-Synergy - -when one chemo drug helps another work better at the same time
-Complete response - -no identifiable cancer present for at least one month or longer
-Partial response - -Measurable tumor reduced by 50% for at least one month with no
new tumors
-Stable disease - -Tumor size reduced by less than 50% or less than 25% increase in
growth
-Progressive disease - -tumor growth more than 25% or new cancer
-What are the phases of the cell cycle? - --G1 phase
-S phase
-G2 phase
-M phase
-What happens in G1 phase? - -The cell increases in size and prepares to replicate its
DNA.
-What do chemo drugs do to target S phase? - -Prevent cell from making DNA and/or
RNA (replicating)
(ex: antifolates (methotrexate), antipyrimidines (5-fu), antipurines (hydroxyurea))
-What do chemo drugs do to target G2 phase? - -Cells prepare to divide, chemo drugs
stop development of elements needed for cell division
(ex: topoisomerase I and II inhibitors, bleomycin)
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Administration (FCIA)_ Questions And Answers.
Hematologic cancer (blood cancer) - --cancer that begins in bone marrow or immune
system cells.
-Ex: leukemia, lymphoma, multiple myeloma
-Leukemia - -cancer starts in blood-forming tissues like bone marrow
-causes lots of abnormal blood cells to be produced and enter bloodstream
-Lymphoma - --cancer that begins in immune system (WBC=lymphocytes)
-hodgkin and non-hodgkins
-B lymphocytes (B cells) - make antibodies (bacteria and viruses, most common
lymphoma
-T lymphocytes (T cells) - boost/slow immune, destroy germs and abnormal cells
-Hodgkin lymphoma - -Reed-Sternberg cell (cancer cells in classic)
-typically starts in B cells
-Non-Hodgkin's Lymphoma - --large, diverse group of cancers in immune system cells
-indolent (slow growing) or aggressive (fast)
-Myeloma - -Cancer in plasma cells (WBC that produce antibodies)
-Chemotherapy - -All antineoplastic agents used to treat cancer, given through oral and
parenteral routes or other routes as specified in the standard, not including hormonal
therapies.
-Who can order chemotherapy? - -Written and signed by licensed independent
practitioners (MD/DO, PA, Oncology NP)
-Can you use verbal orders for chemotherapy? - -NO! Only when holding/stopping
admin.
-Who can mix Chemotherapy? - -Pharmacist, Pharmacy tech, MD/DO, qualified RN
-Who can administer chemotherapy? - -Registered Nurses with specialized education,
prep and training. See specific state laws and statutes
-How often is chemo competency reassessed> - -Annual continuing ed and competency
assessment is recommended
-What is the dose verification process? - --confirm plan with patient
-two practitioners verify: drug name, dose, volume, rate, route, expiration date,
appearance
-document verification in chart
-What PPE is required for IV Chemotherapy? - --Gloves: two pairs, HD tested
1|Page
, -Gown: disposable, back closed, long sleeved
-Respirator: NIOSH approved
-Eye & Face: face shield/mask
-Neoadjuvant therapy (tumor burden) - -Chemo BEFORE primary treatment (common
in breast and colon)
-Adjuvant therapy - -Chemo AFTER primary treatment (common in solid tumor)
-Bone Marrow - -soft, sponge-like tissue in center of most bones, produce WBC, RBC,
and platelets.
-Myelosuppression - -bone marrow activity is decreased, causing less RBC, WBC and
Platelets.
-Myeloablation - -severe myelosuppression
-Induction phase - -initial phase, typically in hospital, intended myelosuppression
-Consolidation phase (intensification/postremission therapy) - -after successful
induction, kills cancer cells left in body (ex radiation, stem cell transplant)
-Synergy - -when one chemo drug helps another work better at the same time
-Complete response - -no identifiable cancer present for at least one month or longer
-Partial response - -Measurable tumor reduced by 50% for at least one month with no
new tumors
-Stable disease - -Tumor size reduced by less than 50% or less than 25% increase in
growth
-Progressive disease - -tumor growth more than 25% or new cancer
-What are the phases of the cell cycle? - --G1 phase
-S phase
-G2 phase
-M phase
-What happens in G1 phase? - -The cell increases in size and prepares to replicate its
DNA.
-What do chemo drugs do to target S phase? - -Prevent cell from making DNA and/or
RNA (replicating)
(ex: antifolates (methotrexate), antipyrimidines (5-fu), antipurines (hydroxyurea))
-What do chemo drugs do to target G2 phase? - -Cells prepare to divide, chemo drugs
stop development of elements needed for cell division
(ex: topoisomerase I and II inhibitors, bleomycin)
2|Page
