Antineoplastic agents can be administered via various routes including:1
- peripheral venous access
- central venous access
- percutaneous lines
- peripherally inserted central catheters (PICC)
- implantable devices (Port-a-caths)
- tunnelled venous access devices (Hickman catheter).
- Enables shorter treatment time, greater independence of the individual, and improved tolerability.
- Disadvantages may be that the individual is not monitored as intensively, there is a risk of noncompliance, possibility of under- or over-dosing, and inconsistency of absorption from the gastrointestinal tract.
Intrathecal / intraventricular
- Agents are administered directly into the cerebrospinal fluid, usually as prophylaxis in leukaemia or lymphoma.
- Direct administration of agents into the peritoneal cavity.
- It allows ovarian or colorectal cancers to be 'bathed' in high concentrations of antineoplastic agents.
- Direct administration of agents into the pleural cavity.
- It allows treatment of malignant effusions, which may be associated with lung, breast, prostate, gastrointestinal and ovarian cancers.
- Administration of agents directly into the bladder to treat superficial cancer of the bladder.
- Commonly prepared as ointments, and usually used to treat sun cancers.
Subcutaneous and intramuscular
- Uncommonly, agents may be administered by these routes.
Access a current text and:
- Outline the risks and benefits for different methods of intravenous access.
- Discuss considerations in choosing the most appropriate intravenous access device for a person receiving antineoplastic agents.
- Summarise the principles of venipuncture for antineoplastic agent administration.
- Appraise current policy and procedures for intravenous antineoplastic agent administration in light of state and national guidelines.
- Define vesicant and irritant agents and outline implications for their administration.
Access the following documents and complete the activities below.
- Guidelines for the Safe Prescribing, Supply and Administration of Cancer Chemotherapy16
- Role of the nurse in patient education and follow-up of people receiving oral chemotherapy treatment: an International survey27
- Multinational Association for Supportive Care in Cancer MASCC Oral Agent Teaching Tool (MOATT)28
- Outline the common concerns associated with oral administration of antineoplastic agents.
- Develop an in-service (including PowerPoint or written resources) for nursing staff in non-specialist settings for the administration of oral antineoplastic agents.
- Discuss the information which would be provided to a person going home with oral antineoplastic agents.
Access a current text and local policy and procedures relevant to intrathecal (IT) administration of antineoplastic agents, and Guidelines for the Safe Prescribing, Supply and Administration of Cancer Chemotherapy16 and:
- outline the key steps in preparing of a person for IT administration of an antineoplastic agent
- outline the role of each member of the MDT in IT administration of an antineoplastic agent
- discuss common adverse effects which may occur during IT drug administration and strategies to prevent and manage these issues
- summarise the evidence based post-procedural care of the person following IT administration of an antineoplastic agent.
Access a current text and local policy and procedures relevant to intraventricular administration of antineoplastic agents, and:
- Outline the key steps in preparing a person for intraventricular administration of an antineoplastic agent.
- Outline the role of each member of the MDT in intraventricular administration of an antineoplastic agent.
- Discuss common adverse effects which may occur during intraventricular drug administration and strategies to prevent and manage these issues.
- Summarise the evidence based post procedural care of the person following intraventricular administration of an antineoplastic agent.
Outline the indications, adverse effects and nursing considerations associated with the following routes of administration for antineoplastic agents: