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301 > Cytotoxic > Flashcards

Cytotoxic Flashcards

1
Q

Which mediations are used to in N&V ?

A

• 5-TH3 antagonist
• Substance P antagonist (acts on vomiting centre and CTZ)
• dexomethasone
• dopamine antagonist

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2
Q

High emetogenic risk (90%) meds?

A

• carmustine
• carboplatin (> AMU)
• cisplatin
• cyclophosphamide (>1500)
• busulfan - oral

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3
Q

Moderate Emetogenic Risk (30-90%) meds?

A

• carboplatin (<AUC)
• cyclophophamide ( <1500)
• cyclophophamide - oral
• imatinib oral
• datinomycin
• methotrexate

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4
Q

Low emtogentic risk (10-30%) meds?

A

• docetaxel
• methotrexate
• axitinib - oral

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5
Q

How to manage high risk emetogenic - acute and delayed ?

A

Acute
• 5-HT3 antagonist +
• substance P antagonist +
• dethomethasone

Delayed
• continue dethomethasone - omit if corticosteroids are being used

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6
Q

How to manage mod risk emetogenic - acute and delayed

A

Acute
• 5-HT3 +
• dexomethasone

Delayed
• 5-HT3 OR Dexomesthasone

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7
Q

How to manage low risk emetogenic - acute and delayed

A

Acute
• dopamine antagonist OR
• domperidone

Delayed
• antiemetics are not required

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8
Q

What is breakthrough Emesis?

A

When patient experience N/V after after antiemetic prophylaxis treatment

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9
Q

How to treat breakthrough Emesis?

A

• lorazepam
• 5-HT3 antagonist
• dexamethasone
• dopamine antagonist
- prochloperazine
- domperidone

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10
Q

Anticipatory Emesis treatment

A

BZD
• lorazepam
• can also help relieve anxiety
• give orally

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11
Q

Radiation infused nausea & vomiting?

A

• GI tract is most sensitive to radiation
• uncontrolled can lead to delay or refusal of treatment.

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12
Q

Assessments for patient with N+V?

A

• intensity, duration and frequency of vomiting
• dehydration?
• nutritional status
• serum electrolyte imbalance

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13
Q

RINV - risk factors?

A

• area of treatment
• size of treatment area
• dose of radiation

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14
Q

How to manage high risk RINV?

A

5-HT3 antagonist + dexomethasone

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15
Q

How to manage medium risk of RINV ?

A

5-HT3 antagonist + optional - dexomethasone

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16
Q

How to manage low risk of RINV ?

A

5-HT3 antagonist

17
Q

How to manage minimal RINV?

A

Rescue therapy with either:
• 5-HT3 antagonist
• dexomethasone
• dopamine antagonist

18
Q

How to minimise symptoms of nausea?

A

• eat small frequent meals
• avoid strong smelling foods
• eat warm/cold foods
• eat ginger contain foods
• avoid drink before a meal

19
Q

Which part of the body does Mucosistis affect ?

A

Oral mucosa and GI tract

  • all cytotoxic drugs can cause this*
20
Q

Signs and symptoms of mucosistis?

A

• oral bleeding
• change in taste and saliva
• burning sensation in mouth
• discomfort in swallowing

21
Q

Treatment of mucositis

A

• alcohol free mouth wash (benzylamine)
• soft foods. Avoid citrus
• analgesics
• lip moisturiser

22
Q

What are the common side effects/conditions of chemotherapy?

A

• n+v
• infertility
• alopeica
• diarrhoea
• hand food syndrome
• tumour lysis syndrome
• mylosupression

23
Q

Diarrhoea

A

Agents which can cause this:
• irinotecan, fluorourcil

• oral rehydration
• loperamide

24
Q

Alopecia

A

Agents which can cause this:
• taxens
• anthracyclines

Management:
• minoxidil
• sun protection
• wigs, hats

Do not do scalp cooling

25
Q

Mylosupression - anemia/thrombopenia/neutropenia

A

Anemia
• low rbc
• low heamoblogin
• low O2 supply to tissue
• management - blood transfusion

Thrombopenia
• low platelets
• higher bruising
• management- platelet transfusion

Neuropenia
• low level of neutrophils - risks of infections
• management - antibiotics
• infection prevention

26
Q

Advise for infection prevention?

A

• hand hygiene
• avoid sexual intercourse when severe
• wash hands before touching food
• avoid large crowds
• clean and cook food throughly

27
Q

Tumour Lysis Syndrome?

A

? Due to break down products of malignant cells

Effects: hyperkalaemia, hyperurincaemia, sezuires, renal failure

Management
• hydration
• maintenance of urine acid output
• allopurinol
• rasburicase (allows Uric acid to become more soluble to be excreted)

28
Q

Infertility

A

Men:
• poor sperm production & motility

Women:
• poor egg quality

Management
• sperm banking
• egg preservation
* barrier method during intercourse*

29
Q

Hand-food syndrome

A

S/S: redness and swelling of palms and soles

Management: emollient urea 10% cream

301 (27 decks)

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