Anti cancer drugs Flashcards
Facts about most cytotoxic drugs
Teratogenicity and should not be administered during pregnancy especially during first trimester
Exclude pregnancy before treatment
Guidelines for handling cytotoxic drugs
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Safe system for cytoxic meds.
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Side effects of cytotoxics
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Extravasation of IV drugs
Oral mucositis
Tumors lysis syndrome
Hyperuricaemia
How to prevent oral mucositis( sore mouth) caused by cytotoxic ( FL-A ME)
Good oral hygiene ( rinse and brush mouth frequently)
Use saline , mouthwashes
How to prevent sore mouth caused by fluorouracil
Sucking ICE chips during short infusion
Patient group more susceptible to drug induced N and Vomiting
Women
Pt under 50yrs of age
Anxious patients
Patients experiencing Motion sickness
Pt with repeated exposure to the cytotoxic drug
List anticancer drugs that are mildly emetogenic
Flurouracil
Methotrexate
Etoposide
Vinca alkaloids
Abdominal Radiotherapy
Drugs that are moderately emetogenic
Taxanes( docetaxal, paclitaxel)
Doxorubicin
Intermediate and low doses of cyclophosphamide
High doses of Methotrexate, mitoxantrone
Anti cancer agents that are highly emetogenic
Cisplatin
High dose of cyclophosphamide
Dacarbazine
Drugs for prevention of acute symptom of N and V
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)
Prevention of delay symptoms of N and V
Moderately emtogenic therapy: 5HT +Dexamethasone
Highly emetogenic chemotherapy: Dexamethasone +aprepitant ,), Metoclopramide + Rolapitant
Prevention of anticipatory symptoms of N and V
Lorazepam
Examples of Anthracyclines antibiotics
Doxorubicin
Daunorubicin
Epirubicin
Idarubicin
Important side effect of Anthracyclines
Red urine and cardio toxicity
What is Mitoxantrone
An anthracycline deravative
What drug is used in methotrexate overdose
Folinic acid
Speeds recovery of Methotrexate induced mucositis or myelosuppression
Urothelical toxicity (haemorrhagic cystitis) caused by cyclophosphamide is treated with
MESNA
Important side effect of Doxorubicin
Extravasation can cause tissue necrosis
Cardiomyopathy associateed with higher dose ( lower dose to 450mg/m2
Many cytotoxic drug acts as radiomimetic, what should you avoid
Avoid simultaneous Radiotherapy Radiotherapy as may increase toxicity
What formulation of Doxorubicin may reduce cardio toxicity and local necrosis
Liposomal formulation
State how to treat hand foot syndrome ( painful reddening skin eruption) that occurs with liposomal formulation
By cooling hands and feet, avoiding socks, gloves or tight fitting footwear
MOA of alkylating drugs
They act by damaging DNA thus interfering with cell replication
Examples of alkylating drugs
Cyclophosphamide, ifosfamide, Melphalan, lomustine, carmustine, estramustine
