Cancer Flashcards
____ may cause distal axonal degeneration, severe neuropathic pain, and rarely motor involvement which can lead to quadriparesis
Vincristine
What three chemotherapy medicines can cause autonomic neuropathies, resulting in fluctuating BP and HR.
- Cisplatin
- Bortezomib
- Vincristine
____ and ____ are two of the most common chemo agents that could cause hemorrhagic cystitis.
Ifosfamide
cyclophosphamide
risk increases with IV use
Which chemo agent?
Neurotoxicity:
Acute cerebellar toxicity, encephalopathy, seizures, peripheral neuropathy
Cystosine Arabinoside
Which chemo agent?
Neurotoxicity: Neuropsychiatric syndrome, CVA
L asparaginase
Which chemo agent?
Neurotoxicity: Acute encephalopathy, leukoencephalopathy (with XRT)
MTX
What is the neurotoxicity effect of ifosphamide?
encephalopathy, This drug also causes hemorrhagic cystitis.
Which chemo agent?
Neurotoxicity: acute cerebellar dysfunction
fluorouracil
Which chemo agent?
Neurotoxicity: Leukoencephalopathy
Fludarabine
Which chemo agent?
Neurotoxicity: Distal sensory polyneuropathy, cold intolerance
Oxaliplatinum – very common (74% mild, 2% severe)
Which chemo agent?
Neurotoxicity: Peripheral sensory polyneuropathy, ototoxicity (20%), optic neuropathy (Rare)
Cisplatinum - common, dose-dependent, large sensory nerves
Which chemo agent?
Neurotoxicity: Peripheral sensory polyneuropathy, Ototoxicity (5-10%)
carboplatinum - less common/severe than cis or oxaliplatinum
Cisplatinum affects which nerves in a peripheral poly
large sensory nerves
Which chemo agent?
Neurotoxicity: sensory/motor peripheral neuropathy (60% mild, 4% severe)
Paclitaxel (Taxol) - common, dose-dependent, dose-limiting.
Which chemo agent?
Neurotoxicity: sensory/motor peripheral neuropathy (49% mild, 3% severe)
Decetaxel (Taxotere) - less common and less severe than taxol (paclitaxel)
Which chemo agent?
Neurotoxicity: Peripheral sensory/motor polyneuropathy, autonomic neuropathy, cranial nerve palsy, encephalopathy
Vincristine - almost 100%, dose-dependent
Which chemo agent?
Neurotoxicity: sensory peripheral polyneuropathy
Vinorelbine - common (25% mild, 1% severe)
Which chemo agent?
Neurotoxicity: Sensory motor axonal polyneuropathy
Thalidomide - common, dose-dependent
Which chemo agent?
Neurotoxicity: sensory peripheral polyneuropathy (36%) and autonomic neuropathy (11%)
Bortezomib (Velcade) - very common, painful, dose dependent/limiting.
Which non-opioid is centrally acting with low affinity for mu-opioid receptors which also inhibits reuptake of NE and sertonin.
Max dose?
Tramadol
Max dose: 400mg/day
Name the step 2 opioids of the WHO analgesic ladder
“weak” - codeine, hydrocodone, oxycodone
+ tramadol
Name the step 3 opioids of the WHO analgesic ladder
morphine, oxycodone, methadone, levorphanol, fentanyl
Morphine is agent of choice
Of the NSAIDs used to treat cancer pain, which has the lease incidence of thrombocytopenia?
Ketoralac
Conversion of morphine from IV:PO
10 —> 30mg or 3