Flood Chapter 42

Question 1

Effectiveness of chemotherapy drugs requires

Answer 1

Complete destruction of all cancer cells , total killer cells .

Administered in an effort to eradicate even small residual tumor cell populations

Question 2

What is combination chemotherapy made of ?

Answer 2

Largest tolerated doses of each chemotherapy drug in the combination .
The drugs that work via different mechanism, and that do not share similar toxic effects are combined.

Question 3

What are the clinical manifestations of toxicity caused by chemo drugs ?

Answer 3

Myelosupression ( leukopenia , thrombocytopenia, or anemia )
Nausea/vomiting
Diarrhea
Mucosal ulceration
Dermatitis
Alopecia
* these represent activity at normal rapidly dividing cells

Question 4

Which is the dose limiting factor and the most common toxicity leading to withdrawal of therapy ?

Answer 4

Myelosupression

Question 5

Is Myelosupression reversible ?

Answer 5

Yes, by d/c the chemo

Question 6

What Lab tests are important when doing preop for chemo patients ?

Answer 6

Hgb
PLT count 
WBC
Coag 
ABG 
BGlucose 
Electrolytes
ECG
Chest X-ray

Question 7

Why are asepsis and prophylactic antibiotics critical in these patients ?

Answer 7

Because they have immunosupression

Question 8

chemo patients experience severe vomiting or diarrhea , what are those associated with ?

Answer 8

1) electrolytes disturbances and

2 decreased Intravascular fluid volume

Question 9

How is airway management in chemo patients?

Answer 9

If they have mucositis, that makes placement of pharyngeal airways, LMAs, and esophageal catheters questionable

Question 10

In THEORY , how is sux affected in pts receiving chemo?

Answer 10

Effects of sux are prolonged if plasma cholinesterase activity is decreased by chemo drugs

Question 11

Why do chemo drugs have a narrow therapeutic index ?

Answer 11

Because they typically target proteins or nuclei acids of BOTH malignant and non malignant cells.