Chemotherapy complications Flashcards
What are risk factors for tumor lysis syndrome?
- high tumor burden
- very treatment responsive tumor (tend to be hematologic, e.g., lymphoma)
- preexisting renal diseas
- dehydration
What are the clinical features of tumor lysis syndrome?
hours to days after chemotherapy - up to 5-7 days after
- hyperkalemia
- hyperphosphatemia
- metabolic acidosis
- AKI
- hypocalcemia secondary to high P
How soon after chemotherapy administration does neutropenia from myeolosuppression typically occur?
7-10 days
Which chemotherapy causes cardiotoxicity and what heart changes are seen?
Doxorubicin induced changes similar to DCM
How do you manage perivascular administration of doxorubicin
- stop infusion
- withdraw as much as possible from the catheter
- cold pack area
- infuse dexrazoxane IV
- check site every other day for at least 10 days
- treat local reactions symptomatically as appropriate
How do you manage accidental extravasation of Vincristine or Vinblastine?
- stop infusion
- withdraw as much as possible from catheter
- warm compress
- consider local infiltration of hyaluronidase or alternatively 0.9% NaCl
- treat local reactions symptomatically as appropriate
What are the 2 mechanisms by which chemotherapy causes GI signs?
nausea via the chemoreceptor trigger zone
diarrhea via intestinal crypt stem cell injury
Which chemotherapy is known to cause frequent hepatotoxicity?
CCNU
Why should 5-Flourouracil and Cisplastin never be administered in cats?
5-FU –> severe neurotoxicity - fatal reactions with excitability, blindness, tremors, dysmetria, death
Cisplastin –> fatal pulmonary edema
Which drug causes sterile hemorrhagic cystitis in dogs?
Cyclophosphamide
