Drugs

Question 1

What is the difference between an infusion reaction and a hypersensitivity reaction?

Answer 1

Infusion reaction = milder symptoms

• eg. Hot flushing, rash, fever, chest tightness, mild BP changes, back pain, chills
• can be treated by decreasing infusion rate and resolve quickly after stopping the infusion

Hypersensitivity (allergic) Reaction = more severe symptoms
- SOB
- Generalized hives/itching
- changes in BP 
- bronchospasm
- syncope or pre-syncope
- chest pain
- nausea/vomiting
- changes in bowel function
- occ feeling of impending doom
Symptoms may persist after stopping infusion and/or after tx interventions

Question 2

What are the common oncological drugs that can cause adverse reactions?

Answer 2

Carboplatin 
Cisplatin
Docetaxel
Liposomal Doxorubicin
Oxaliplatin
Paclitaxel

Question 3

Explain the adverse reactions a/w Taxane drugs

Answer 3

Eg. Docetaxel, Paclitaxel
Also bio therapeutic agents

Tend to be infusion-related, often due to cremophor in Paclitaxel
Tend to occur during the first few cycles of treatment, but can be seen during any infusion regardless of how many previous cycles

Question 4

Explain the adverse reactions a/w platinum drugs

Answer 4

True allergy
Tend to occur following re-exposure to the inciting drug, or less commonly at the completion of initial chemotherapy
(Eg. #6 of planned 6 treatments)

Question 5

Who are at higher risk of developing a hypersensitivity reaction?

Answer 5

Re-introduction of the drug after a period of no exposure and following multiple cycles of the drug during the first and subsequent exposures

IV Admin of the drug rather than oral or IP

WIth allergies to other drugs

Previous reaction

Question 6

Name examples of H1, H2 blockers

Answer 6

H1: Diphenhydramine, hydroxyzine

H2: Cimetidine, Famotidine

Question 7

Who are at higher risk of developing a hypersensitivity reaction?

Answer 7

Re-introduction of the drug after a period of no exposure and following multiple cycles of the drug during the first and subsequent exposures

IV Admin of the drug rather than oral or IP

WIth allergies to other drugs

Previous reaction

Question 8

Name examples of H1, H2 blockers

Answer 8

H1: Diphenhydramine, hydroxyzine

H2: Cimetidine, Famotidine