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 4

Side effects of cytotoxics

Answer 4

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

Question 4

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

Answer 4

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

Question 5

How to prevent sore mouth caused by fluorouracil

Answer 5

Sucking ICE chips during short infusion

Question 6

Patient group more susceptible to drug induced N and Vomiting

Answer 6

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

Question 7

List anticancer drugs that are mildly emetogenic

Answer 7

Flurouracil
Methotrexate
Etoposide
Vinca alkaloids
Abdominal Radiotherapy

Question 8

Drugs that are moderately emetogenic

Answer 8

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

Question 9

Anti cancer agents that are highly emetogenic

Answer 9

Cisplatin
High dose of cyclophosphamide
Dacarbazine

Question 10

Drugs for prevention of acute symptom of N and V

Answer 10

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 11

Prevention of delay symptoms of N and V

Answer 11

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

Question 12

Prevention of anticipatory symptoms of N and V

Answer 12

Lorazepam

Question 13

Examples of Anthracyclines antibiotics

Answer 13

Doxorubicin
Daunorubicin
Epirubicin
Idarubicin

Question 14

Important side effect of Anthracyclines

Answer 14

Red urine and cardio toxicity

Question 15

What is Mitoxantrone

Answer 15

An anthracycline deravative

Question 16

What drug is used in methotrexate overdose

Answer 16

Folinic acid
Speeds recovery of Methotrexate induced mucositis or myelosuppression

Question 17

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

Answer 17

MESNA

Question 18

Important side effect of Doxorubicin

Answer 18

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

Question 19

Many cytotoxic drug acts as radiomimetic, what should you avoid

Answer 19

Avoid simultaneous Radiotherapy Radiotherapy as may increase toxicity

Question 20

What formulation of Doxorubicin may reduce cardio toxicity and local necrosis

Answer 20

Liposomal formulation

Question 21

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

Answer 21

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

Question 22

MOA of alkylating drugs

Answer 22

They act by damaging DNA thus interfering with cell replication

Question 23

Examples of alkylating drugs

Answer 23

Cyclophosphamide, ifosfamide, Melphalan, lomustine, carmustine, estramustine