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Oncology > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

What is a cycle?

A

repeating pattern of treatment & rest

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2
Q

What is a course?

A

complete pattern of cycles

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3
Q

What is a line?

A

order of treatments

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4
Q

What type of chemotherapy?

Patient with osteosarcoma, aim is to make tumour smaller before surgery

A

Neoadjuvant

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5
Q

What type of chemotherapy?

Patient with breast cancer undergoing chemo post-mastectomy

A

Adjuvant

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6
Q

What type of chemotherapy?

Patient with in-situ breast cancer given tamoxifen before invasive carcinoma is recognised

A

Prophylactive

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7
Q

Why is chemo usually given as a combo of drugs? (3 reasons)

A
  1. Synergism: different drug classes have different actions & may kill more cells together
  2. Less chance of drug-resistant cells
  3. Different sites of toxicity
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8
Q

What are two cell types commonly affected by chemo & the resulting SEs?

A

haematopoietic stem cells: myelosuppression

Lining GI tract: mucositis

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9
Q

What is intravesical chemo?

Pros

A

Drug directly into bladder

High dose at tumour site with minimal systemic toxicity

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10
Q

What is intraperitoneal chemo?

What cancer can it be used for?

A

Into peritoneum

Ovarian cancer

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11
Q

what is an indication for intra-arterial chemo

A

Tumour with a well-defined blood supply

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12
Q

How is chemo dose calculated?

A

Based on body surface area using the DuBois formula

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13
Q

What drug is commonly used for chemo-induced nausea & vomiting?
What are two common SE?

A

Ondansetron
5 HT antagonist

SE: constipation & headache

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14
Q

Define:

  1. Myelosuppression
  2. Leucopaenia
  3. Thrombocytopenia
A
  1. Decreased bone marrow activity
  2. Low WBCs
  3. Low platelets
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15
Q

How long does haematopoietic recovery take?

A

3-4 weeks

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16
Q

What is the low-point of myelosuppression called? and when does this occur?

A

Nadir

10-14 days after beginning a treatment cycle

17
Q

A patient receiving chemo has peripheral neuropathy & high tone hearing loss. What chemo agent are they on?

A

Cisplatin (an alkylating agent)

18
Q

Which agent can cause haemorrhagic cystitis?

A

ifosfamide

19
Q

What is extravasation?

A

leakage of intravenously (IV) infused, and potentially damaging, medications into the extravascular tissue around the site of infusion

20
Q

What is hand-foot syndrome? and its likely cause

How is it managed?

A

(plantar erythema)
5-FU
Withdrawal & emolients

21
Q

What are beau’s lines?

A

Grooved lines in the nails, recurring evenly spaced lines

22
Q

Give 3 long-term complications of chemo

A

Secondary malignancy (due to sub-lethal DNA damage). Alkylating agents are most carcinogenic
Fertility problems
Pulmonary (fibrosis - bleomycin & busulphan)

23
Q

What is it important to discuss with patients re: reduced fertility from chemo

A

Council prior to treatment & discuss sperm storage/ storage of fertilised ova if applicable

24
Q

What types of cancer are myelosuppression mos common in? (i.e. due to bone marrow infiltration)

A

Heamatological malignancies

Solid tumours: breast, lung & prostate

25
Q

What is the most common type of aneamia due to repeated chemo?

A

Macrocytic

think fewer blood cells

26
Q

When can anaemia impair QOL?

How should this be treated?

A

Hb <10

Transfusion or recombinant erythropoietin

27
Q

What are some clinical signs of thrombocytopaenia?

A

petechial haemorrhage, spontaneous nosebleeds, corneal haemorrhage, haematuria

28
Q

What is severe thrombocytopaenia & its management?

A

Platelet count <10 x 109/L

Significant risk of spontaneous bleed (e.g. intra-cerebral)

Urgent indication for platelet transfusion

29
Q

If a patient has WBC <1x10^9 with fever, what is the immediate management?

A

Broad spec antibiotics

30
Q

When examining a patient with suspected neutropenic sepsis, what two examinatios should you never do & why?

A

Rectal & vaginal exam

Risk of bacteraemia if mucosa is breached

31
Q

Why is adequate renal function important for chemo?

A

Many cytotoxics are renally excreted

Oncology (8 decks)

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