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PR4152 > IC5 > Flashcards

IC5 Flashcards

1
Q

what are the common GI symptoms that are chemo-induced

A

nausea vomiting, diarrhea, constipation, mucositis

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2
Q

patient and treatment risk factors for CINV

A

Patient:
young(<50)
female
anxiety
low alcohol intake
hist of motion sickness
hist of prev CINV
hist of prev emesis during past preg

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3
Q

patient and treatment risk factors for CID

A
  1. > 65 yo
  2. female
  3. ECOG PS >2
  4. bowel inflammation/malaaborptive
  5. bowel malignancy
  6. biliary obstruction
    7, 1st cycle of chemo
  7. cycle duration greater than 3 weeks
  8. concomitant neutropenia
    10: sx(anorexia, anemia, n/v, mucositis)
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4
Q

patient and treatment risk factors for constipation

A
  1. lowered fluid intake and dehydration
  2. loss of appetite
  3. lack of fiber or bulk forming food in the diet
  4. vitamin or mineral supplements (iron/calcium pills)
  5. overuse of laxatives
  6. low physical activity
  7. thyroid problems
  8. depression
  9. high levels of calcium or potassium in blood
  10. cancer growing into the large intestine pressing on the bowel
  11. drugs(opioid, antinuasea(ondansetron, granidetron), chemo)
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5
Q

patient and treatment risk factors for mucositis

A

Patient:
- autoimmune disorders
- female
- diabetes
- caucasians
- genetic
- folic acid or vit b12 deficiency

treatment:
- chemotherapy
- radiation
- smoking, alcohol
- presence of xerostomia/infection

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6
Q

pathophysiology of CINV

A
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7
Q

pathophysiology of CID

A
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8
Q

pathophysiology of constipation

A
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9
Q

pathophysiology of mucositis

A
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10
Q

MOA & PK of CINV drugs

A

NK1 nurokinin-1 antagonist:

5HT3 serotonin antagonist:

Dexamethasone:

Olanzapine(atypical antipsychotics):

Dopamine antagonist(metoclopramide):

Benzodiazepines:

Haloperidol:

Phenothiazides:

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11
Q

MOA & PK of CID drugs

A

uncomplicated:
- loperamide

complicated:
- octrotide
- antibiotics

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12
Q

MOA & PK of constipation drugs

A

stool softerner to hol dwater, keep it soft

laxatives to stimulate bowel actiivty - senna/mineral oil/ lactulose

laxative to increase fibre and produce bulk - psyllium

suppositories - glycerin, bisacodyl

enema - fleet, tap water

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13
Q

MOA & PK of mucositis drugs

A

Prevention:
1. IV palifermin 60mcg/kg/d x3 x2
2. benzydamine HCL mouth wash
3. LLLT therapy
4. oral cyrotherapy

Management:
1. Oracare suspension(nystatin, tetracyclin, hydrocortisone, diphenhydramine) - after food
2. mylocaine suspension (diphenhydramine, lignocaine) - b4 food
3. morphine sulphate solution - b4 food
4. oracort e
5. difflam mouthewash
6. soragel
7. medijel

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14
Q

ADR and DDI of CINV drugs

A

NK1 nurokinin-1 antagonist:

5HT3 serotonin antagonist:

Dexamethasone:

Olanzapine(atypical antipsychotics):

Dopamine antagonist(metoclopramide):

Benzodiazepines:

Haloperidol:

Phenothiazides:

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15
Q

ADR and DDI of CID drugs

A
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16
Q

ADR and DDI of Constipation drugs

A
17
Q

ADR and DDI of mucositis drugs

A
18
Q

Dosing of mucositis drugs

A
19
Q

Dosing of CINV drugs

A

NK1 nurokinin-1 antagonist:

5HT3 serotonin antagonist:

Dexamethasone:

Olanzapine(atypical antipsychotics):

Dopamine antagonist(metoclopramide):

Benzodiazepines:

Haloperidol:

Phenothiazides:

20
Q

Dosing of CID drugs

A
21
Q

Dosing of constipation drugs

A
  • fybrogel 1 sachet BD
  • lactulose 10ml TDS
  • senna 15mg ON
  • forlax 1 sachet BD
21
Q

severity grading of CID

A
22
Q

NPM for CINV

A
  1. take frequent small meals
  2. avoid spicy, greasy, very sweet or very salty food
  3. sip small amounts of fluid often
  4. avoid caffeinated beverages
  5. avoid lying flat for 2hrs after eating
23
Q

NPM for CID

A
  • probiotics with lactobacillus
  • diet modifications(avoid spicy, lactose containing, fatty)
  • small, freq meals
  • BRAT diet
  • more than 3L of clear fluid containing salt and sugar
24
Q

NPM for constipation

A

eat more fiber
eat natural laxatives - caffiene, prune, vege
increase physical activity

25
Q

NPM for mucositis

A

Oral7 mouthwash

26
Q

irinotecan associated diarrhea patho

A
27
Q

irinotecan associated diarrhea treatment

A
28
Q

what makes a grade 1/2 CID complicated?

A

At least one of the following:
-1. cramping
2. >grade 2 n/v(>6/d, WL)
3. dehydration
4. frank bleeding
5. fever
6. sepsis
7. neutropenia
8. decreased performance status

29
Q

what to avoid in patients with CID that have a high risk of infection/bleeding

A

suppositories and enemas

30
Q
A
31
Q
A

PR4152 (3 decks)

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