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PHAM02 > adverse effects of cancer treatment > Flashcards

adverse effects of cancer treatment Flashcards

1
Q

potential factors for cancer related fatigue (CRC)

A

anaemia
wasting (cachexia)
tumour burden
sleep disturbance
pain
Tx - chemo, biologics, hormonal, radiotherapy
psychosocial factors

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2
Q

How to improve cancer related fatigue?

A

light exercise
resting
diet, maintaing carbs

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3
Q

What is myelosuppression?

A

reduced production of
- erythrocytes (RBCs)
- WBCs (incl neutrophils)
- platelets

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4
Q

When does myelosppression most commonly occur?

A

7-10 days after Tx

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5
Q

How long does it take to recover from myelosuppression?

A

20 days

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6
Q

Sx and Tx from low erythrocytes in myelosppression

A

anaemia

treat with blood transfusions dpeending on severity/associated Sx

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7
Q

What can reduced WBC cause in myelosppression?

A

neutropenia

risk of infection

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7
Q

Sx of low platalets in myelosppression

A

bruising and bleeding

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8
Q

management for myelosuppression

A

FBCs monitored before Tx initiated and before each chemo cycle

blood count low consider dose reducion in extreme cases or Tx delays

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9
Q

prophylaxis Tx for myelosppression

A

growth factors like granulocytes eg. filgrastim

given with some regimens to reduce incidence of neutropenia

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10
Q

What is filgrastim?

A

granulocyte G growth factor

reduces indidence of neutropenia

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11
Q

What is neutropenic sepsis?

A

neutropenia with elevated temperature with/wo Sx of infection

medical emergency

broad spectrum ABX

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12
Q

emperic broad spectrum ABX used in neutropenic sepsis

A

Tazocin

Meropenem

Ceftazidime

-> all for 48hrs

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13
Q

What can be given if anaerobic cover is needed in neutropenic sepsis?

A

metronidazole

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14
Q

How does chemotherapy cause N&V?

A

chemotherapy activates neurotransmitters

in chemoreceptor trigger zone AND GIT

vomiting centres in brain cause sickness

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15
Q

What patients are more susceptible to N&V in chemotherapy?

A

female
U50
non-drinkers
anxious
previous motion sickness/morning sickness

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16
Q

antiemetic used for anticipatory N&V

A

benzodiazepines

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17
Q

antiemetic that targets histamine

A

cyclizine

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18
Q

antiemetic that targets acetylcholine

A

hyoscine

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19
Q

antiemetic that targets serotonin

A

ondansetron

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20
Q

part of inner ear that can casue N&V in motion sickness or surgery

A

vestibular apparatus

21
Q

What is acute chemotherapy induced N&V (CINV)?

A

within 24hrs

22
Q

What is delayed CINV?

A

after more than 24hrs

23
Q

What does breakthrough N&V mean?

A

feeling sick despite being on antiemetics

24
Q

What does refractory N&V mean?

A

difficult to manage N&V

tried multiple antiemetics

25
Q

chemo drugs with high N&V

A

cisplatin

high dose cyclophosphamide

26
Q

chemo drugs with medium N&V

A

carboplatin

doxuribicin

low dose cyclophosphamide

27
Q

chemo drugs with low N&V

A

taxanes

5-FU

methotrexate

28
Q

chemo drugs with minimal N&V

A

vincristine

bleomycin

29
Q

How to prevent anorexia?

A

maintain healthy weight

eat healthy and drink plenty of fluids

make and freeze meals in advance

avoid diets

referral to dietitics

may need feeding - TPN/PEG/JEG

30
Q

What is mucositis?

A

inflammation of mouth leading to ulceration

because oral mucosa vulnerable to chemo due to rapid growth and cell turnover rate

31
Q

prevention of mucositis

A

good mouth care

mouthwashes

good nutrition

32
Q

Tx of established mucositis

A

topical analgesics or topical anaesthetics

syctemic pain control if topical ineffective

33
Q

Tx for constipation

A

docusate +- senna

macrogols (osmotic)

34
Q

What to look out for with constipation?

A

bowel obstruction or spinal cord compression

  • abdominal pain, really sick, vomit undigested food
  • consipation, unable to pass urine, incontinence, weakness in legs/arms, loss of use of legs
35
Q

complications of diarrhoea

A

dehydration
metabolic disturbance
malnutrition

36
Q

Tx for diarrhoea

A

loperamide PRN
fluids, diet
seek advice if >48hrs

37
Q

diarrhoea associated with irinotecan

A

within 24hrs likely to be chilineric reaction with asosciated Sx
- sweating
- hyper salivation
- visual disturbances
- abdominal cramps
- watery eyes
- hypotension

MUST REPORT

after 24hrs can Tx with loperamide

report if Sx >24hrs with loperamide

38
Q

Sx of peripeheral neuropathy

A

numbness, tingling of hands/feet
burning hands/feet
nymbness around mouth
loss of sensation to touch
loss of positional sense (where body part is)
weakness and leg cramping
difficulty picking things up

39
Q

name for hand and foot syndrome

A

palmar plantar erythrodysesthesia

40
Q

Sx of hand and food syndrome/palmar plantar erythrodysesthesia

A

redness
swelling
tingling/burning
tenderness/sensitive to touch
tightness of skin
thick calluses/blisters on palms/soles

41
Q

drugs that can cause hand and foot syndrome/palmar plantar erythrodysesthesia

A

capecitabine
5-FU
doxorubicin

42
Q

adivce for patients with palmar plantar erythrodysesthesia

A

avoid highly perfumed products

use moisturisers liberally

avoid sun exposure

keep nals short/clean (rub don’t itch)

43
Q

What Sx shuold be reported that could be palmar plantar erythrodysesthesia?

A

rashes

itchiness

44
Q

preventative measures for hair loss/alopecia

A

cold cap

-> reduces blood flow

45
Q

What is tumour lysis syndrome?

A

metabolic disturbances that occur as a result of rapid cell lysis

K and phosphate are released from dying cells

uric acid is produced from the breakdown of nucleic acid

hypocalcaemia occurs as a secondary response to hyperphosphataemia and renal failure

46
Q

In what patients is tumour lysis syndrome more common?

A

leukaemia and lymphoma

47
Q

tumour lysis Tx

A

IV hydration

management of hyperuricaemia - allopurinol

-> start both proir to Tx by at least 12hrs if possible

48
Q

LT effects of cancer Tx

A

infertility

teratogenicity

second cancer

CV/resiratory problems

psychosocial problems

49
Q

s/e of cetuximab (less serious)

A

rashes
dry skin
itching

50
Q

s/e of hormone therapy

A

women
- menopausal Sx
- hair thinning
- osteoporosis
- thrombosis

men
- muscle strength/tone reduced
- erectile dysfunction
- low libido
- hair thinning

PHAM02 (32 decks)

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