11 - Chemo Flashcards
Indications for chemotherapy
Most effective single therapy for some malignancies, delay or prevent metastatic tumors after surgery, palliative for non resectable tumors, shrink large tumor
What type of tumor is chemotherapy most effectie single therapy for some malignancy
Lymphoma
Most cells are in what phase
G0 resting
Normal cells constantly dividing
Bone marrow precursors, GI crypt cels, hair cells
Chemo wil kill
Rapidly dividing cells
Is chemo targeted
No
Chemo side effects
Bone marrow supression, alopecia, and GI upset
Cytotoxic chemo
Directly killing diving tumor cells
Cytotoxic therapy
Giving the highest dose of chemo as you can
In between doses of cytotoxic chemotherapy
Tumor cells grow between doses
Metronomic Chemo
Lose dose chemotherapy
Does metronomic chemotherapy kill tumor cells
No
Metronomic chemotherapy works by
Inhibiting angiogenesis and activating immune system
Goal of metronomic chemotherapy
Tumor stabilization
Chemo dosing
Body surface area
With weight to BSA conversion charts always
Round down
Neutrophils are apart of teh
innate immune system
What is the first line of defense against infection
Neutrophils
What cell has the shortest half life of all white blood cells
Neutrophils
Neutropenia
most common dose liming toxicity of chemotherapy
Chemo effects on neutrophil
Stops neutrophils in bone marrow from going to the peripheral blood
Which pool of neutrophils is effected by chemo
Proliferating pool
Prior to chemo evaluation
HCT, neutrophils, PLT
Want neutrophils to be
Grater than 2500
Platelets want to be
Greater than 150,000
Danger zone of neutrophils
Less than 1,000
If neutrophils are less than 1000
Oral antibiotics , sepsis, ab, decrease dose
Usual chronic side effect of chemo
Thrombocytopenia
Most common anemia
Non regenerative anemia - anemia of inflammatory disease
Chemo affects hair in
Anagen phase
What types of cells are in teh crypts of GI
Rapidly dividing
GI side effects occur how may days post chemo
3 - 5 days
GI signs of chemo
Vomiting, diarrhea, anorexia a
MDR1
Drug efflux pump
Mutation in MDR1 s/e
Increased intracellular drug concentrations - increase side effects and death
What examples of drugs that can cause local tissue reaction if given SQ
Vincristine and doxorubicin
In event of possible extravasating
SLAP
NonDNA binding vesicants
Vincristine and vinblastine
Vincristine and vinblastine cause
Burn , swelling, edema, and ulcer
DNA binding vesicants
Doxorubicin
Doxorubicin causes
Progressive tissue destruction
Administer with doxorubicin
Dexrazoxane
Drug residues may present in urine and feces up to how many hours after administration
72 hours
