4th Year Chemotherapy Flashcards
when are bloods taken?
before each treatment
how do alkylating agents work?
bind via alkyl groups to DNA causing apoptosis
examples of alkylating agents
cyclophosphamide
chlorambucil
examples of angiogenesis inhibitors
bevacizumab
aflibercept
sunitinib
how do antimetabolites work?
interfere with metabolism
examples of antimetabolites
methotrexate
5-fluroruracil
adverse of 5-flurorouracil
DPD deficiency
coronary artery vasospasm
examples of antitumour antibiotics
doxorubicin
bleomycin
examples of antimicrobtubule agents
vinca alkaloids
taxanes
e.g. vincristine
adverse of vincristine
nerve toxicity
adverse of cisplatin
renal toxicity
adverse of oxaliplatin
cold-induced peripheral neuropathy
examples of fertility preservation techniques
semen cryopreservation cryopreservation of embyros, oocytes or ovarian tissue ovarian tranposition (oophoropexy)
examples of antiemetics
metoclopramide ondansetron cyclizine dexamethasone levomepromazine lorazepam
contraindications in metoclopramide
PD
gastric outlet obstruction
when is metoclopramide used?
N&V with constipation or reduced gastric turnover
when to avoid ondansetron?
avoid if constipated
when is cyclizine used?
N&V with diarrhoea or gastric outlet obstruction
when to avoid cyclizine?
constipation
chemo/radiotherapy if gastric turnover reduced
when to use dexamethasone?
delayed CINV
severe XRT
brain mets, liver mets
appetite
when to use levomepromazine?
chemotherapy
radiotherapy
when to avoid levomepromazine?
can cause drowsiness
prolong QT interval
when to use lorazepam?
anticipatory N&V
when to avoid lorazepam?
elderly and falls risk
what is a dose limiting factor?
bone marrow suppression
when increases the risk of N&V in chemotherapy?
<50
female
alcohol
prone to N&V
acute N&V timeframe
within 24 hours
delayed N&V timeframe
24hours- 7 days
most effective method for managing chemotherapy N&V
NK1 antagonist + 5HT3 antagonist + dexamethasone
aprepitant + ondansetron
if constipation present use metoclopramide (extrapyramidal SE)
management of alopecia
wigs
hair nets
cold caps
sun protection/ moisturiser
adverse of bone marrow suppression
neutropenia
anaemia
thrombocytopenia
side effects of chemotherapy
N&V alopecia bone marrow suppression nephrotoxicity neurotoxicity cardiac toxicity bladder toxicity
