View source for Antimetabolite, anthracycline, taxane, and vinca agents

{{Drugbox
| name = Antimetabolite, anthracycline, taxane, and vinca agents
| therapeutic = Antineoplastic
| pharmacologic = Antimetabolite (5-FU), anthracycline (doxorubicin), taxane (paclitaxel), vinca alkaloid (vincristine)
| onset = Per cycle.
| halflife = Variable; no routine level.
| routes = IV, Intrathecal
| highalert = No
| blackbox = <span style="color:#b00020;">'''Yes'''</span> (see Safety)
| antidote = Dexrazoxane for doxorubicin extravasation and cardioprotection; supportive care.
| pregnancy = Contraindicated.
}}

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''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''
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'''Antimetabolite, anthracycline, taxane, and vinca agents''' &mdash; Antineoplastic; Antimetabolite (5-FU), anthracycline (doxorubicin), taxane (paclitaxel), vinca alkaloid (vincristine).

== Identification ==
* '''Therapeutic class:''' Antineoplastic.
* '''Pharmacologic class:''' Antimetabolite (5-FU), anthracycline (doxorubicin), taxane (paclitaxel), vinca alkaloid (vincristine).

== Pharmacology ==
* '''Mechanism of action:''' Interfere with DNA, RNA, or cell division at various phases.
* '''Onset / peak / duration:''' Per cycle.
* '''Half-life / therapeutic level:''' Variable; no routine level.

== Clinical use ==
* '''Indications:''' Various solid tumors and hematologic cancers.
* '''Usual dose, route, frequency:''' IV per protocol.
* '''Maximum dose / adjustments:''' Doxorubicin has a lifetime cumulative dose limit (cardiotoxicity); paclitaxel requires premedication for hypersensitivity.

== Safety ==
* '''Contraindications:''' Severe myelosuppression, pregnancy; vincristine must never be given by the intrathecal route.
* '''Black box warning:''' Doxorubicin carries boxed warnings for cardiomyopathy and heart failure (cumulative dose related), severe tissue necrosis if extravasated (a vesicant), and secondary leukemia; vincristine carries a boxed warning that it is fatal if given intrathecally and must be given only intravenously.
* '''Interactions:''' Other cardiotoxic or myelosuppressive drugs, live vaccines (avoid).
* '''Pregnancy / lactation:''' Contraindicated.
* '''High-alert:''' No.

== Adverse effects ==
* '''Common side effects:''' Myelosuppression, nausea, alopecia, mucositis; 5-FU causes hand-foot syndrome; vincristine causes peripheral neuropathy.
* '''Serious effects to report:''' Doxorubicin heart failure, extravasation injury, vincristine neuropathy and constipation, paclitaxel hypersensitivity, severe myelosuppression.
* '''Antidote / reversal:''' Dexrazoxane for doxorubicin extravasation and cardioprotection; supportive care.

== Nursing process ==
* '''Assessment before administration:''' CBC, cardiac function and ejection fraction (doxorubicin), premedication (paclitaxel), neuro status (vincristine), IV access.
* '''Interventions during therapy:''' Verify central or reliable access for vesicants; monitor the IV site closely; premedicate for paclitaxel; vincristine labeled IV only and given via the correct route.
* '''Monitor:''' CBC and nadir, cardiac function (doxorubicin), neuropathy (vincristine), infusion reactions (paclitaxel).
* '''Evaluation / expected outcome:''' Tumor response with managed toxicity.

== Patient teaching ==
* '''Patient teaching:''' Doxorubicin harmlessly turns urine red; report swelling or breathlessness; report numbness or constipation (vincristine); infection precautions.
* '''Notify provider if:''' Shortness of breath or swelling, IV-site pain or burning, numbness, fever.
* '''Administration tips:''' Vesicant precautions; vincristine never intrathecal; hazardous-drug handling.

[[Category:Traditional Cytotoxic Agents]]