4th Year Chemotherapy

Question 1

when are bloods taken?

Answer 1

before each treatment

Question 2

how do alkylating agents work?

Answer 2

bind via alkyl groups to DNA causing apoptosis

Question 3

examples of alkylating agents

Answer 3

cyclophosphamide

chlorambucil

Question 4

examples of angiogenesis inhibitors

Answer 4

bevacizumab
aflibercept
sunitinib

Question 5

how do antimetabolites work?

Answer 5

interfere with metabolism

Question 6

examples of antimetabolites

Answer 6

methotrexate

5-fluroruracil

Question 7

adverse of 5-flurorouracil

Answer 7

DPD deficiency

coronary artery vasospasm

Question 8

examples of antitumour antibiotics

Answer 8

doxorubicin

bleomycin

Question 9

examples of antimicrobtubule agents

Answer 9

vinca alkaloids
taxanes

e.g. vincristine

Question 10

adverse of vincristine

Answer 10

nerve toxicity

Question 11

adverse of cisplatin

Answer 11

renal toxicity

Question 12

adverse of oxaliplatin

Answer 12

cold-induced peripheral neuropathy

Question 13

examples of fertility preservation techniques

Answer 13

semen cryopreservation
cryopreservation of embyros, oocytes or ovarian tissue
ovarian tranposition (oophoropexy)

Question 14

examples of antiemetics

Answer 14

metoclopramide
ondansetron
cyclizine
dexamethasone
levomepromazine
lorazepam

Question 15

contraindications in metoclopramide

Answer 15

PD

gastric outlet obstruction

Question 16

when is metoclopramide used?

Answer 16

N&V with constipation or reduced gastric turnover

Question 17

when to avoid ondansetron?

Answer 17

avoid if constipated

Question 18

when is cyclizine used?

Answer 18

N&V with diarrhoea or gastric outlet obstruction

Question 19

when to avoid cyclizine?

Answer 19

constipation

chemo/radiotherapy if gastric turnover reduced

Question 20

when to use dexamethasone?

Answer 20

delayed CINV
severe XRT
brain mets, liver mets
appetite

Question 21

when to use levomepromazine?

Answer 21

chemotherapy

radiotherapy

Question 22

when to avoid levomepromazine?

Answer 22

can cause drowsiness

prolong QT interval

Question 23

when to use lorazepam?

Answer 23

anticipatory N&V

Question 24

when to avoid lorazepam?

Answer 24

elderly and falls risk

Question 25

what is a dose limiting factor?

Answer 25

bone marrow suppression

Question 26

when increases the risk of N&V in chemotherapy?

Answer 26

<50 female alcohol prone to N&V

Question 27

acute N&V timeframe

Answer 27

within 24 hours

Question 28

delayed N&V timeframe

Answer 28

24hours- 7 days

Question 29

most effective method for managing chemotherapy N&V

Answer 29

NK1 antagonist + 5HT3 antagonist + dexamethasone aprepitant + ondansetron if constipation present use metoclopramide (extrapyramidal SE)

Question 30

management of alopecia

Answer 30

wigs hair nets cold caps sun protection/ moisturiser

Question 31

adverse of bone marrow suppression

Answer 31

neutropenia anaemia thrombocytopenia

Question 32

side effects of chemotherapy

Answer 32

``` N&V alopecia bone marrow suppression nephrotoxicity neurotoxicity cardiac toxicity bladder toxicity ```