Anti cancer drugs

Question 1

Facts about most cytotoxic drugs

Answer 1

Teratogenicity and should not be administered during pregnancy especially during first trimester
Exclude pregnancy before treatment

Question 2

Guidelines for handling cytotoxic drugs

Answer 2

See photo

Question 3

Safe system for cytoxic meds.

Answer 3

See photo

Question 6

Side effects of cytotoxics

Answer 6

See photo
Extravasation of IV drugs
Oral mucositis
Tumors lysis syndrome
Hyperuricaemia

Question 6

How to prevent oral mucositis( sore mouth) caused by cytotoxic ( FL-A ME)

Answer 6

Good oral hygiene ( rinse abd brush mouth frequently)
Use saline , mouthwashes

Question 7

How to prevent sore mouth caused by fluorouracil

Answer 7

Sucking ICE chips during short infusion

Question 8

Patient group mote susceptible to drug induced N and Vomiting

Answer 8

Women
Pt under 50yrs of age
Anxious patients
Patients experiencing Motion sickness
Pt with repeated exposure to the cytotoxic drug

Question 9

List anticancer drugs that are mildly emetogenic

Answer 9

Flurouracil
Methotrexate
Etoposide
Vinca alkaloids
Abdominal Radiotherapy

Question 10

Drugs that are moderately emetogenic

Answer 10

Taxanes( docetaxal, paclitaxel)
Doxorubicin
Intermediate and low doses of cyclophosphamide
High doses of Methotrexate, mitoxantrone

Question 11

Anti cancer agents that are highly emetogenic

Answer 11

Cisplatin
High dose of cyclophosphamide
Dacarbazine

Question 12

Drugs for prevention of acute symptom of N and V

Answer 12

Patient at low risk of emesis give Dexamethasone or lorazepam
High risk pt give 5HT antagonist in combination with Dexamethasone and aprepitant (neurokinin receptor antagonist)

Question 13

Prevention of delay symptoms of N and V

Answer 13

Moderately emtogenic therapy: 5HT +Dexamethasone
Highly emetogenic chemotherapy: Dexamethasone +aprepitant ,), Metoclopramide + Rolapitant

Question 14

Prevention of anticipatory symptoms of N and V

Answer 14

Lorazepam

Question 15

Examples of Anthracyclines antibiotics

Answer 15

Doxorubicin
Daunorubicin
Epirubicin
Idarubicin

Question 16

Important side effect of Anthracyclines

Answer 16

Red urine and cardio toxicity

Question 17

What is Mitoxantrone

Answer 17

An anthracycline deravative

Question 18

What drug is used in methotrexate overdose

Answer 18

Folinic acid
Speeds recovery of Methotrexate induced mucositis or myelosuppression

Question 19

Urothelical toxicity (haemorrhagic cystitis) caused by cyclophosphamide is treated with

Answer 19

MESNA

Question 20

Important side effect of Doxorubicin

Answer 20

Extravasation cab cause tissue necrosis
Cardiomyopathy associateed with higher dose ( lower dose to 450mg/m2

Question 21

Many cytotoxic drug acts as radiomimetic, what should you avoid

Answer 21

Avoid simultaneous Radiotherapy Radiotherapy as may increase toxicity

Question 22

What formulation of Doxorubicin may reduce cardio toxicity and local necrosis

Answer 22

Liposomal formulation

Question 23

State how to treat hand foot syndrome ( painful reddening skin eruption) that occurs with liposomal formulation

Answer 23

By cooling hands and feet, avoiding socks, gloves or tight fitting footwear

Question 24

MOA of alkylating drugs

Answer 24

They act by damaging DNA thus interfering with cell replication

Question 25

Examples of alkylating drugs

Answer 25

Cyclophosphamide, ifosfamide, Melphalan, lomustine, carmustine, estramustine