A 45-year-old woman has a primary brain tumor that has been refractory to treatment. Her health care providers have decided to prescribe thalidomide (Thalomid). What should the nurse teach the client about this drug?
Standard Text: Select all that apply.
1. A negative pregnancy test will be required before treatment is started.
2. There is a risk of clotting disorders with this drug.
3. The drug is available only in a limited number of pharmacies.
4. Irreversible graying of the skin may occur when taking this drug.
5. The drug must be handled only by the person taking it.
Correct Answer: 1,2,3
Rationale 1: Because this drug is pregnancy category X, a negative pregnancy test is required prior to administration.
Rationale 2: Adverse effects include thromboembolic diseases.
Rationale 3: This drug is highly regulated and is available only through a limited number of pharmacists and health care providers.
Rationale 4: Irreversible graying of the skin is not an adverse effect of Thalomid.
Rationale 5: There is no restriction on who can handle the drug.
Global Rationale: The drug is highly regulated and is available only through a limited number of pharmacists and physicians. Because the drug is pregnancy category X, a negative pregnancy test is required prior to administration in women with childbearing potential. Adverse effects include teratogenesis, thromboembolic disease, drowsiness, and peripheral neuropathy. Thalidomide carries a black box warning regarding its teratogenic effects, as well as a high risk of thromboembolic events occurring during therapy. It does not cause graying of the skin and there is no restriction on who can handle the drug.
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