From Quizlet Flashcards
Limit MCT oil to __ mL/day
100 mL/day (6.5 tbsp or 760 kcal)
macrobiotic diet does not include
mango pineapple and papaya
zoledronic acid (zometa) is used for what
bone mets
zoledronic acid should be given with what vitamins
500 mg calcium, 400 IU vit D
St Johns Wort increases/decreases activity of vinblastine (velban) and vincristine (oncovin)
decreases by inducing cyt P4503A4 (CYP3a4): found in liver and intestine oxidizes xenobiotics like toxins or drugs to they can be removed from the body
grapefruit juice can increase a drugs activity by inhibiting enzyme responsible for drugs metabolism. what is one example of this
grapefruit juice and docetaxel resulted in reduced clearance by 15%
3-4 foods that can alter CYP3a4 (and thus alters drugs efficacy/toxicity)
pomegranate, grapefruit, star fruit, seville oranges citrus juicecs
5 supplements that affect Cyp3a enzymes
St Johns Wort, Black cohosh, ginseng, gingo bilboa, goldenseal
which drug causes pharyngolaryngeal dysesthesia
(cold feeling) oxaliplatin (eloxatin)
high vomiting chemos
cyclophosphamide H, doxorubicin M, cisplatin H, ifosfamide M, mechlorethamine H, carmustine H dacarbazine H
streptozotocin (zanosar) can alter what metabolism
glucose- hypoglycemia
what should women not take within 2 hrs of tamoxifin
antacids
on EN hyponatremia may be caused by overhydration, GI sodium losses and what
SIADH
2 types of targeted therapy
monoclonal antibodies, small-molucule drugs (end in mab)
- these work by targeting proteins or genes the help stop cancer from growing or spreading
leucovorin (reduced form of folic acid) is given to decrease side effects of methotrexate but is also given with fluorouracil which does what
makes side effects more severe
what drug is used as an antidote for chemotherapy
uridine triacetate (vistogard)
cytokines
protein mediators produced by inflammatory cells which signal metabolic changes
- those related to cancer cachexia = cachectic, TNF, interleukin 1,6, interferon
tumor necrosis factor
hormone like protein that releases fat from fat stores reduces the concentration of enzymes required for the production and storage of fat and induces stage of anorexia
veno-occlusive disease
is sinusoidal obstruction system
macrobiotic diet
no nightshade veggies (avoid animal products and dairy -processed food)
to decrease acute vomiting (within 24 hours of chemo) these 3 drugs are often given before chemo
ondansetron (serotonin receptor agonist), dexamethasone (steroid), aprepitant (NK1 receptor agonost)
5ht3 receptor agonist
ondansetron
anticipatory n/v can be helped with
ativan
T/F mucositis is just inflammation of mouth and esophagus
F inflammation of mucous membrane lining of GI tract (mouth to butthole)
which chemo causes damage to GI tract
5-FU and methotrexate
steroid side effects
osteoporosis, fluid retention, adrenal suppression, glucose intolerance, lyte imbalance, muscle wasting
when boney mets for breast lung and pancreases occur hypercalemia can also occur, should you reduce calcium in diet?
no
energy needs for children HCT
initial: 1.6-1.8 x BMR and maintenance 1.4-1.6 x BMR
how many mL of MCT should someone start with
15mL (no more than 20 mL at a time)
Physical activity most proven in which cancers
Breast colon endometrial and lung
Serum magnesium can drop with which chemos
Cyclosporine, oxaliplatin, cetuximab, panitumab
Pet scan
Radioactive glucose
Indirect calorimetry measures what
RMR
HCT kcal needs for adults
30-35
Pro for cancer , hct , short bowel , IBD
1.0-1.5, 1.5, 1.5-2.0, 1.0-1.5
SIADH can cause what nutrition related
Over hydration
RDa for vit
Calc 1000-1200 - 2500 Iron 8, 18 - 45 Phos 700 - 4000 Zinc 11 and 8 - 40 Vit A 900-700 -2800 Folate 400 -1000 B12 2.4 - Vit C 90 and 75 - 2000 Vit D 15 and 20 - 100 Vit E 15 - 1000
Mnt for thrombocytopenia
Overly rough or course foods to avoid cut bleeding
Anemia
Many reasons but some could be iron folate and b12 deficiency
Anemia labs what do they mean
Hgb
Serum ferritin Serum iron tibc Transferrin sat RDW MCV
Hgb says if there is anemia < 8 very high
Iron deficiency Low serum ferritin Low serum iron High TIBC Low transferrin High RDW Low MCV
B12 deficiency High MCV Low serum b12 High serum mma High hcy (also b6)
Folate deficiency
High MCV
Low B12
Low rbc and serum folate (fluctuate with oral intake)
What could potentially help with PN in HCT
Glutamine .2-.5 g/kg/day
HCT how much fat
25-30% of kcal
Potentially beneficial supplements for peripheral neuropathy
Vit E, calcium, mg, glutamine, glutathione, acetyl L carnitine
EPA is useful for malnutrition how much
.26-6.0 g per day no pancreas
Head and neck cancer which vitamin could increase cancer risk again
Vit e more than 400 iu
Improve taste with what vit
50 mg elemental zinc less than 60 days
What nectar can help with thickened saliva
Papaya
