Cytotoxin Side Effects Flashcards
Tumour lysis syndrome occurs due to the rapid destruction of what??? Risk is higher in non Hodgkin??? And what others higher risk in prexisiting what??? Tumour lysis can cause….. what can hypo calcaemia lead to???
- occurs due to rapid destruction of malignant cells
- risk is higher in non - Hodgkin’s lymphoma, burkitt’s lymphoma ,acute lymphoblastic leukaemia and acute myeloid leukaemia
- higher risk in pre existing hyperuricaemia,dehydration and renal impairment
- causes HYPER K, uricaemia and PH as well as HYPO Ca = renal damage and arrhythmias
Hyperuricaemia is more present in what kind of grade lymphoma and leukaemia?? What is started 24hrs before to treat these tumours?? Him hint gout?? What else do we need to do for the pt and what is al alternative and when would it be given???
- more present in high - grade Lymphoma and Leukaemia
- allopurinol started 24 hours before treating those tumours - hydrate patient
- alternative- febuxostat given 2 days before treatment
Bone marrow suppression is caused by all groups other than what? How many days does it take to occur after admin? What do we need to check before treatment? - reduce the dose if what happens?? Avoid treatment during what?
- neurogenic fever is cured using what kind of spectrum abx
- caused by all drugs other than vincristine and bleomycin
- occurs 7-10 days after administration
- check blood count before treatments - reduce dose if dose if bone marrow hasn’t recovered
- avoid treatment during acute infection - or seek medical attention if currently taking
- neurogenic fever immediate - broad spectrum antibiotics
Alopecia
Common
Thromboembolism
Chemo increases risk
Urotheial toxicity - can be treated using what- what does it do to the urinary tract specifically?
- causes haemorrhage in urinary tract
- common in cyclophosphamide and ifosfamide
- treated with Mensa
Myelosupression - is caused by what?? And what do we use to treat toxicity???
- Caused by methotrexate
- use folinic acid to treat toxicity
Reproductive system - what about the drugs, with regards to tetrogenicity, pregnancy, contraception and women of child bearing
- mostly teratogenic - not to be administered during pregnancy
- exclude pregnancy before cytotoxic treatment with drugs
- advise on contraception before therapy begins
- women of childbearing age to use contraception during and after treatment
Alkylating drug or procarbazine increases the risk of permanent male… it affects women less but what may it cause an early onset of?
- increased risk of permanent male sterility
- consider sperm storage
- affects women less - may cause onset of a premature menopause
Nausea and vomiting they may be what in terms of timing??? With delayed and anticipatory is more difficult than ??? Who is anxiety more common in with regards to patients
Symptoms can be acute, delayed or anticipatory
- delayed + anticipatory more difficult to control than acute
More common, patients <50 ,anxiety and repeated exposure
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Prevention of acute symptoms (with 24 hours of treatment) - what do we give to low risk patients? What do we give to high risk patients? Remember APRIPITANNNNNTTTTTTTTTT
- low risk patient - dexamethasone or lorazepam
- high risk patients - Ondansetron + dexamethasone +aprepitant
Prevention of symptoms (after 24 hours of treatment)- moderately emetogenic drugs?? And high emetogenic drugs?? Highly emetogenic?? APREPITAAAAAANT 2.0
- moderately emetogenic drugs:dexamethasone + ondasetron
- high emetogenic drugs - dexamethasone + aprepitant
Prevention of anticipatory symptoms
Occurs before treatment =, lorazepam
Alkylating agents - what can they cause and who does this affect the most?
Cyclophosphamide, ifosfsmide,mephalan:
- urothelial toxicity
- increased risk of permanent male sterility
