Chemotherapy Side Effects Flashcards
Name some common Chemotherapy side effects.
Nausea and vomiting, mucositis, hypersensitivity, hair loss, rash, fatigue, myelosuppression, extravasation, constipation, diarrhoea
What is Chemotherapy Induced Nausea and Vomiting (CINV) caused by?
It is caused by a serotonin release from enterochromaffin cells in the GI tract. This form of serotonin binds to 5-HT3 receptors causing nausea and vomiting, and also a release of Substance P from the Area postrema in the brain causes this also.
What are the types of CINV?
Acute (within 24 hours), Delayed (after 24 hours), Breakthrough (CINV despite prophylaxis), Anticipatory (prior to chemo), Refractory (CINV despite appropriate measures)
What are some complications of CINV?
Dehydration, nutritional deficiency, electrolyte disturbances, aspiration pneumonia, oesophageal tears, delayed chemotherapy, reduced quality of life
What is mucositis?
A sore or ulcerated mouth/throat caused by sensitive mucosal cells in mouth.
How does a patient prevent mucositis?
Maintaining good oral hygiene, rinse mouth regularly with salt water, avoid spicy/acidic food
What can be given to treat mucositis?
Pain: local anaesthetic mouthwash or analgesics (paracetamol)
Infections: fungal (fluconazole or nystatin) or viral (aciclovir)
What chemotherapy agents are most likely to cause diarrhoea?
5-FU, Capecitabine, Irinotecan
What can be used to treat Chemotherapy Induced Diarrhoea?
Non-pharmacological: Oral hydration, dietary changes
Pharmacological: Loperamide 2mg
What can potentially cause Chemotherapy Induced Constipation?
Cisplatin, Vinca alkaloids (Vincristine), Opioids for pain, Ondansetron for CINV, inactivity
What can be used to treat Chemotherapy Induced Constipation?
Prevention: Fluids, high fibre foods, exercise
Treatment: Laxatives
What is alopecia?
Loss of hair due to hair cells being affected by systemic chemotherapy
What is myelosuppression?
A condition where the bone marrow doesn’t make enough of the key components of blood. There is a lack of red blood cells, white blood cells and platelets.
What can occur as a result of myelosuppression?
Red blood cells: Anaemia, fatigue
White blood cells: Increased infection risk, neutropenia
Platelets: Thrombocytopenia, easy bruising, may bleed more easily
What is febrile neutropenia?
Fever in patient with neutropenia. It is defined by a patient having a temp >38 degrees and an absolute neutrophil count <0.5 x10-9/L.
What is used/done to prevent febrile neutropenia?
Good hygiene, avoiding sick people, consider prophylactic antibiotics, G-CSF prophylaxis, chemotherapy dose reductions
What is GCSF prophylaxis?
GCSF will promote the production of neutrophils, can be given as Figrastim or Lenograstim SC injections for 5-7 days after chemotherapy
What are the risk factors for febrile neutropenia?
Severe symptoms, hypotensive, COPD, Leukaemia treatment (Imatinib), dehydration, >60yrs old, inpatient
What is used to treat neutropenic sepsis?
Low risk: oral antibiotics (Ciprofloxacin, Co-amoxiclav)
High risk: IV antibiotics (Tazocin, Vancomycin, Gentamicin), with 48 hour review
What is a dermatological side effect of Capecitabine?
Hand-foot syndrome (Palmar-plantar erythema)
What can be used to treat EGFR inhibitor skin reactions?
Mild: Topical antibiotic cream (Clindamycin)
Moderate: Add topical steroid (Hydrocortisone), add oral antibiotics (Doxycycline)
Severe: Dermatology referral, reduced chemo dose
What is extravasation?
Where there are leakages from a vein into surrounding tissues causing inflammation, pain, necrosis and blistering of skin.
What can be given for a hypersensitivity reaction in chemotherapy?
Oral Dexamethasone 20mg, Oral Chlorphenamine 4mg
What are the toxicities associated with Methotrexate therapy?
Stomatitis (mouth ulcers)
What are the toxicities associated with Bleomycin therapy?
Pulmonary Fibrosis (scarring lung disease)
What are the toxicities associated with Doxorubicin?
Cardiac toxicity (left ventricular dysfunction due to free radicals from Doxorubicin metabolism affecting cardiomyocytes)
What are the toxicities associated with Cisplatin?
Ototoxicity (reactive oxygen species in ear tissue) and Nephrotoxicity (oxidative stress to renal tubular cells)
What are the toxicities associated with CyclophospHamide? (Think HC)
Haemorrhagic cystitis (inflamed bladder lining, starts bleeding)
What are the toxicities associated with Vincristine/Vinblastine? (Think SPINE)
Peripheral neuropathy
