Effects on the Nervous System
Central nervous system toxicity
can produce symptoms such as confusion, dizziness, and an unsteady gait. Toxicity
to the peripheral nervous system, which comprises the sensory and motor nerves,
causes abnormal sensations known as paresthesias, including numbness and tingling
of the hands and feet. Toxicity affecting the autonomic nervous system causes
constipation, paralytic ileus, urinary retention, and bladder and bowel incontinence.
Risk factors that increase
the possibility of neurotoxicity include intrathecal administration of drugs,
radiation to the head area, impaired renal function, concomitant use of aminoglycosides,
cumulative doses of vinca alkaloids such as vincristine and vinblastine, increasing
age, and previous neurotoxic sensitivity.
Management strategies for
a. Advising the patient to take a prophylactic stool softener and high-fiber foods to prevent constipation.
b. Providing bladder and bowel training for incontinence or urinary retention.
c. Assessing visual acuity, pupillary reaction to light, and visual fields.
d. Assessing the patients level of consciousness.
e. Instituting seizure precautions if indicated.
f. Instructing the patients family or significant other to supervise patient activity and institute safety precautions if needed.
Check with Cancersymptoms.org for information about pharmacologial interventions for cognitive dysfunction secondary to chemotherapyy.
Look for the answer to this question.
What are some of the drugs being used to manage cancer-related cognitive dysfunction?