CSO exam Flashcards
velcade
bleomycin
Avastin
Erbitux
no green tea
xeloda
give B6 for hand/foot
tagretin
no grapefruit
exjade
contains lactose
sprycell
Tarceva
Affinitor
no St. John’s Wort, No grapefruit
5FU
give B6 for hand foot
methotrexate
no folic acid, no ETOH
Alimta
Add Folic Acid and B12
Mutulane
no tyramine foods
Zometa
Give 500mg Calcium and 400 IU Vit D
Mercaptopurine
avoid dairy at same time
Nexavar
No St. John Wort
Tasigna
no grapefruit, contains lactose
Metallic taste
cisplatin, etoposide, vinblastine
Antimetabolites
Cell cycle Specific
5FU, Methotrexate, ARA C, Gemzar, Xeloda
Gerson Therapy
Mostly juiced vegetables
Includes supplements and frequent enemas
Budwig Diet
flaxseed oil + cottage cheese (quark) 2 times a day
Avoid dairy and complete protein sources
No supplements rec
Essiac tea and red wine
Alkaline diet
Restricts red meat, sugar, flour coffee ETOH
May need Calcium and Vit D
Livingston Wheeler
Vegetarian but also get vaccine made from own blood or urine
Pts strongly advised to avoid
Gonzalez Regimen
Metabolic tx
varies according to individual
rec large dose of vitamins/minerals and animal glandular products
Macrobiotic Diet
Avoid all meat, dairy, eggs and processed sweeteners
Can meet requirements when carefully planned
Omega 3 fats
may reduce toxicity of irinotecan and paclitaxel
may enhance clinical benefit of Adriamycin, cisplatin and vincristine
may cause bleeding >4 grams a day
Quercetin
anti inflammatory effects
may decrease bioavailability of iron
melatonin
may improve response in women on tamoxifen w/ mets
Co Q 10
may reduce renal and cardiotoxicities of adriamycin but no dose identified
black cohosh
may interfere with tamoxifen
may be toxic to liver
SERM
selective estrogen receptor modulators
tamoxifen, fareston, evista
Aromatase Inhibitors
Arimidex, Femara, Aromasin
femara
high cholesterol
Progesterones
Megace
Anti estrogen effects
Can cause hyperglycemia
Antiandrogens
casodex, Eulexin
Lutenizing Hormone Releasing Hormone Agonists (LHRH)
Lupon, Zoladex
bone pain, gynecomastia
trismus
“lockjaw”
can be late side effect of Rad to H & N
bulking agents
Citrucel, Konsyl
Bran flaxseed, wheatgerm
stool surfactants
Colace, mineral oil
Osmotic laxatives
miralax, lactulose, MOM
Stimulant Laxatives
senocot, bisacodyl
selenium
may decrease prostate cancer growth in its aggressive form
calcium
may protect against colon cancer but >1500 mg can increase risk for prostate cancer
Progesterones
may cause hyperglycemia
used as anti estrogens and as appetite stimulants
Letrozole (AI)
may increase cholesterol
adiponectin
a protective hormone that decreases insulin resistance and inflammation and promotes apoptosis
Vitamin E
high doses may promote a modest increase in risk of prostate cancer (SELECT)
Protein requirements in cancer
1.0-1.5gm/kg
Protein requirements in cancer cachexia
1.5-2.5 gm/kg
dysgeusia
Altered sense of taste
oral candidiasis interventions
good oral hygiene soft, low acid foods avoid sugar and yeast derived foods 1 T. yogurt held in mouth x 5 minutes a day nystatin or Diflucan or chlorhexidine
dysphagia interventions
posture avoid distractions double swallow moist foods Avoid straws thicken liquids prn SLP eval
acute nausea and vomiting meds
Zofran, aloxi, anzemet, kytril
delayed nausea and vomiting meds
dopamine antagonists: Compazine OR Phenergan
Cannabinoids: marinol or cesamet
benzodiazapines: Ativan, valium
Corticosteroids: decadron, prednisone
to prevent CINV
decadron
Zofran
rezonic OR emend
reglan
ginger dosage for n/v
0.5-1.0 gram ginger extract
mucositis interventions
good oral care
sip honey in warm water
avoid carbonation, alcohol and tobacco
pancreatic enzyme dosage
30,000-40,000 lipase units per meal
10,000 units for snack
Do not exceed 2500 lipase units/kg body weight/meal
hyponatremia
fluid overload, may need to add sodium and restrict free water (SIADH)
hypernatremia
dehydration
when to hold enteral nutrition
if gastric residual volumes are >/= to 500 ml
Strontium 89(metastron) common nutrition side effect
Vomiting
Methadone side effects
Nausea and constipation
MST
PG-SGA
In OR Outpatient use
MUST
MSTC
Inpatient only
ECOG
O is perfect
5 is dead
Karnofskys
100 is perfect
0 is dead
Alkaline diet needs supplements of
Calcium and vitamin D
Feed (blank) to an anastomosis makes it more resistant to leaks
Proximal
Follow a low microbial diet for how long after autologoustransplant?
3 months
Long-term complications of HCT include
Chronic GVHD
Osteoporosis
Endocrine complications
Growth and development issues.
Tamoxifen increases your risk for developing this
Osteoporosis
If you take this in high doses it may increase your risk of developing long cancer
Beta carotene
Avoid folic acid when taking this
Methotrexate
What is the most common site for colorectal metastasis
Liver
Common Nutrition complications for NHL
Metabolic syndrome and hypothyroidism
Xofigo and Xgeva Are both used to treat ?
Relapsed NHL
What is one of the most disabling effects of chemotherapy used in lung cancer treatments?
Peripheral neuropathy
What is the long-term complication for an ovarian cancer patient
Osteoporosis and heart health
Which cancer patients experience the greatest weight loss
Pancreatic and gastric
Monoclonal antibody’s that include risk of cardiotoxicity
Pertuzumab(Perjeta)
Trastuzumab(herceptin)
Ado-trastuzumab( Kadcycla)
Which chemotherapy agents are most likely to cause SIADH?
Cisplatin cyclophosphamide and Vincristine
Which organ system is most negatively impacted by antitumor antibiotics and may need nutrition management?
Renal
Which pancreatic surgeries are not associated with dumping syndrome?
PPPD AND Distal Pancreatectomy
The most common presenting symptom of endometrial cancer?
Acute abdominal pain
Use these serotonin antagonist for acute N and V
Zofran
Kytril
Anzemet
Alicia
Probiotics rec for malabsorption
S boulardi
L rhamnosus
How much jejunum and ileum are needed for adequate GI absorption
100 cm jejunum
150 cm ileum with illeocecal valve
To avoid significant hyperglycemia and potential refeeding syndrome initiate parenteral nutrition with this much dextrose
25-50% of goal dextrose
indications for post pyloric feeding
Gastroparesis,
gastric outlet obstruction,
Duodenal obstruction
fistula proximal to the tube feeding location
What is the standard parenteral electrolyte requirement for calcium
10-15 Milliequivalents per day
Standard requirement for sodium and potassium per day in parenteral nutrition
1-2 mEq /day each
In PN The minimal daily requirement for lipids
250ML’s of 20% OR 500 ML’s of 10% twice per week
What is the hang time limit for IV FAT infusions
12 hours
Potential toxicities from PN Longterm
Manganese
chromium
aluminum and
Elevated triglycerides
Certain multi trace elements PN products do not contain what trace element
Selenium
What is incompatible with IV Fat infusions and should be administered separately?
Iron
Energy requirements for a Esophageal cancer
30-35 cal/kg
Protein requirements for esophageal cancer
- 0 to 1.2 kg if weight stable
1. 2 to 1.6 kg if stressed
