Cytotoxic safety and Chemo administration

Question 1

What are the routes for drugs in the CHOP protocol

Answer 1

Cyclophosphamide (C) - oral
Doxorubicin (H) - iv
Vincristine (O) - iv
Prednisolone (P) - oral

Question 2

How long does CHOP protocol last for

Answer 2

25 weeks or 19 weeks

Question 3

What are the routes for drugs in the COP protocol

Answer 3

Cyclophosphamide(C) - oral
Vincristine (O) - iv
Prednisolone (P) - oral

Question 4

Chemotherapy causes bone marrow supression. List 3 cell lines affected by this in order of speed of onset

Answer 4

1st Neutropenia (shortest half life)
2nd Thrombocytopenia
3rd Anaemia

Question 5

Drug dosing is based on…

Answer 5

Body surface area

Question 6

What to do if oral cytotoxics dose calculations are hard to give due to tables having a high amt of drugs

Answer 6

Increase dosing interval
For example, work out a dose over two weeks then give tablets equally spaced over 14 days
37mg x 7 = 259mg - Could give 5 x 50mg (250mg) over 15 days ie 1 every 3 days

Question 7

What is the Gold standard for injectable drug preparation

Answer 7

Laminar flow biological safety cabinet

Question 8

Why Use a Catheter when giving chemo

Answer 8

Ensures accurate dosage
Allows thorough flushing with NaCl (saline)
Allows you to keep the system closed when using a T-connector
Less likely to ‘slip’ and mis-inject
Prevents perivascular extravasation

Question 9

Extravasation - treatment

Answer 9

Stop injection
Suck back as much as possible
Cold compresses (hot for vinca alkaloids)
Talk to your owners
Standard wound management
Surgical debridement, skin grafts