cytotoxic induced side effects Flashcards
what are some cytotoxic side effects?
-extravasation of IV drugs
-thromboembolism
-hyperuricaemia
-alopecia
-Nausea and vomiting
-bone marrow suppression
-urothelial toxicity
-oral mucositis
-pregnancy and reproductive function
what should happen when using cyctoxoic drugs when pregnant or reproducing?
for cyctotoxic drugs they are teratogenic
-exclude pregnancy before treatment
-offer contraception advice to men and female
alkylating drug and procarazine
-permanent male sterility. Counsel patient on sperm storage
-women are less affected; early menopause may occur
what is tumour lysis syndrome? how does it happen?
-caused by rapid destruction of malignant cells (high risk in lyphomas or leukaemias)
what are the clinical features of tumour lysis syndrome?
-hypERkalaemia, hypER urea, HypER PO4 and
hypO Ca2+
-this is followed by renal failure and arrhythmias
-at risk patients: renal impairment, dehydration and hyperuricaemia
is thromboembolism is malignant disease a risk factor for VTE? WHAT OTHER DRUGS DO THIS TOO?
YES
-TAMOXIFEN
-THALIDOMIDE/LINADAMIDE
what can good oral hygiene prevent? what to do?
sore mouth
-rinse mouth
-use a soft toothbrush 2-3 times a day. Suck on ice cubes
-saline mouthwashes
-folinic acid in MTX-induced adverse effects
what are some oral mucositis?
-anthracyclines
-antimetabolites
what is the treatment for urothelial toxicity?
also equal to hemorrhagic cystitis
-mesna
cyclophosphamide
what should be done before starting any cytotoxic drugs except vincristine & bleomycin due to bone marrow suppression?
-take a full blood count before each treatment
what are some contra-indications for cytotoxic drugs that can cause bone marrow suppression?
-infection avoid live vaccines
what is the treatment for bone marrow suppression?
-withdraw or reduce dose until the bone marrow recovers
what can be used for fever with neutropoenia due to bone marrow suppression?
-broad-spec rum antibiotics= filgrastim, avoid paracetamol delay starting an antibiotic
what can be used for symptomatic iron-deficiency anaemia due to bone marrow suppression?
-erythropoietin or red blood cell transfusions
when does hyperuricaemia occur the worst?
present in high-grade lymphoma and leukaemia. Can be worsened by chemotherapy and associated with renal failure
what is the treatment for hyperuricaemia?
-allopurinol 24 hrs before treating such tumours
-febuxostat 2 days before if allopurinol contraindicated
-rasuricase for hyperuricaemia associated with blood cancer
