Cytotoxic drugs

Question 1

What are the main side effects of cytotoxic drugs

Answer 1

Alopecia

Thromboembolism

Tumour lysis syndrome- can lead to hyperkalaemia, hyperphosphataemia, hyperuricaemia, hypocalcaemia

Hyperuricaemia

Nausea and vomiting

Bone marrow suppression

Oral mucositis

Anthracycline induced cardiotoxicity

Question 2

Describe the treatment option for hyperuricemia

Answer 2

Allopurinol and Febuxostat can be used for prophylaxis

Reduce dose of mercaptopurine or azathioprine if allopurinol needs to be given (bone marrow suppression risk)

Question 3

What are the mild emetogenic cytotoxic drugs

Answer 3

Fluorouracil
Etoposide 
Methotrexate
Vinca alkaloids
Abdominal radiotherapy

Question 4

What are the moderate emetogenic cytotoxic drugs

Answer 4

Taxanes
Doxorubicin
Low doses of cyclophosphamide
High doses of methotrexate

Question 5

What are the highly emetogenic cytotoxic drugs

Answer 5

Cisplatin

High doses of cyclophosphamide

Question 6

What are the anti-emetics used for cytotoxic drugs

Answer 6

Dexamethasone
Lorazepam
Metoclopramide
Cyclizine

Question 7

What are the only two cytotoxic drugs that do not cause bone marrow suppression

Answer 7

VINCRISTINE

BLEOMYCIN

Question 8

What are the monitoring requirements needed for bone marrow suppression

Answer 8

Blood counts checked before each treatment

Doses reduced or therapy delayed if bone marrow not recovered

Question 9

What are the two main dose-limiting side effects vinca alkaloids

Answer 9

Myelosuppression

Neurotoxicity