Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

therapeutics 2 drugs > Lec2 > Flashcards

Lec2 Flashcards

1
Q

Types of Chemotherapy induced Nausea and vomiting

A

1-Acute onset nausea and vomting(occurs within mins to hrs)
2-Delayed onset CINV (develops after more than 24 hrs)
3-Expected CINV (occurs before patient recieve their next treatment)
4-Breakthrough CINV(occurs despite prophylactic antiemesis treatment.
5-Refractory CINV (occurs despite rescue has benn intiated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Delayed on set chemotherapy happens usually with what type of drugs with examples

A

happens commonly with Highly emetogenic chemotherapy,
ex (cisplatin, carboplating, cyclophosphamide, anthracyclines)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Managment of general conitions tha occur in cancer patients

CNS involvement

A

Dexamethasone, 4–8 mg PO BID-TID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Managment of general conitions tha occur in cancer patients

Gastric outlet obstructions

A

1-Dexamethasone PO.
2-Metoclopramide,30 min before meals and at bedtime.
3- PPI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Managment of general conitions tha occur in cancer patients

Gastritis/GERD

A

PPI or H2 blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Managment of general conitions tha occur in cancer patients

Medication-induced gastropathy (gastritis)

A

PPI or metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Managment of general conitions tha occur in cancer patients

Nonspecific NV

A

Metoclopramide or
(Hoop):
1-Ondansetron,
2-Haloperidol
3-Prochlorperazine,
4-Olanzapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Managment of general conitions tha occur in cancer patients

Contributing anxiety

A

Lorazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Managment of general conitions tha occur in cancer patients

Vertiginous component

A

Anticholinergic AND/OR antihistamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pharmacologic consideration for antiemetic prescribing(prohylaxs mainly)

NK1 RAs

A

Largest benefit seen in a delayed CINV setting
ex(cisplatin, carboplatin, cyclophosphamide, and/or
anthracyclines)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pharmacologic consideration for antiemetic prescribing(prohylaxs mainly)

5-HT3 RAs

A

Schedule dependant
non sedating
causes Headache and constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pharmacologic consideration for antiemetic prescribing(prohylaxs mainly)

Corticosteroids

A

used mainly in extended delayed CINV
Ex(dexamethasone)
Consider AM dosing to minimize insomnia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pharmacologic consideration for antiemetic prescribing(prohylaxs mainly)

Olanzapine

A

bedtime administration is recommended when possible due to sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pharmacologic consideration for antiemetic prescribing(prohylaxs mainly)

Benzodiazepines

A

Consider for anticipatory CINV or when breakthrough CINV has an
anxiety component

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pharmacologic consideration for antiemetic prescribing(prohylaxs mainly)

Phenothiazines

A

Promethazine is more sedating than prochlorperazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pharmacologic consideration for antiemetic prescribing(prohylaxs mainly)

Metoclopramide

A

Metoclopramide increases gut motility and can be utilized
to manage gastroparesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pharmacologic consideration for antiemetic prescribing(prohylaxs mainly)

Haloperidol

A

lower doses of haloperidol are required to
produce an antiemetic effect than what is required for an
antipsychotic effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pharmacologic consideration for antiemetic prescribing(prohylaxs mainly)

Scopolamine

A

Consider using when positional changes, movement,
or excessive secretions are triggering episodes of
nausea/vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pharmacologic consideration for antiemetic prescribing(prohylaxs mainly)

Cannabinoid

A

May stimulate appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Emetogenecity risks of cancer agents

A

1-Minimal emetic risk(<10%)
2- Low emetic risk (10%-30%)
3-Moderate emetic risk (>30%–90%)
4-High emetic risk>90%

if it says <30% without spicifying means low to minimal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

anti emetic prevention agents for Low risk anticancer

A

D+PMS:
1- Dexamethasone
2- Metoclopramide
3-Prochlorperazine
4-5-HT3 RA:–GOD:(-Granisetron,-Ondansetron,-Dolasetron.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

anti emetic prevention agents for minimal risk anticancer

A

None needed ;)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

anti emetic prevention for Low to minimal risk

A

1-Metoclopramide
2- Prochlorperazine
3-5-HT3 RA:–GOD:(-Granisetron,-Ondansetron,-Dolasetron.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

anti emetic prevention for moderate emetic risk

A

takes two drugs on Day1:
1-5-HT3 RA:–GOD+P:(-Granisetron,-Ondansetron,-Dolasetron, Palonosetron)..
and 2-Dexamethasone
day 2-3 continue on only one of them

Granisetron is preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
anti emetic prevention for high emetic risk
takes 4 drugs on day 1: 1- Olanzapine 2-NK1 receptor antagonist( Aprepitant, Netupitant, Fosnetupitant ) 3-5-HT3 RA:--GOD+P:(-Granisetron,-Ondansetron,-Dolasetron, Palonosetron) 4- Dexamethasone 12mg Day2-4 takes 3 drugs: 1- Olanzapine 2-Aprepitant 3- Dexamethasone 8 mgs | if he didnt take aprepitant then on Days 2-4 only takes two drugs ## Footnote (Netupitant, Fosnetupitant) are the only ones that comes in combination.
26
Breakthrough treatment for anticancer therapy-induced nausea/vomiting
1-Olanzapine (preferred catagory) (1) 2- Lorazepam (only when patient has anxiety) 3-Cannabinoid (Dronabinol ,Nabilone) 4- Other:(HMS): Haloperidonl,Metoclopramide, Scopolamine 5-Phenothiazine: Prochlorperazine, Promethazine 6-5-HT3 RA:--GOD+P:(-Granisetron,-Ondansetron,-Dolasetron, Palonosetron) 7-Corticosteroid: Dexamethasone
27
treatment for Radiation-induced nausea/vomiting
1-Granisetron w/wo Dexamethasone 2-Ondansetron w/wo Dexamethasone ## Footnote Start before radiation therapy
28
treatment for Anticipatory nausea/vomiting
A/prevention mainly: 1-optimize antiemetic therapy 2-avoid strong smells B/Behavioral therapy. C/ Consider anxiolytic therapy (Lorazepam the night before)
29
Pain rating Scale
None(0) Mild(1-3) Moderate(4-6) Severe(7-10)
30
Mild pain treatment for naive and opioid tolerant patients
1-First consider non opioid adjuvant therapies 2-Re-evaluate need for opioids and reduce if appropriate
31
Moderate/Severe Pain - Opioid-naïve patients
Non-opioids and adjuvant therapies as appropriate with one short acting opioid as needed: 1-Oxycodone immediate release w/wo acetaminophen or 2-Hydrocodone with acetaminophen or 3-Hydromorphone or 4-Morphine or ## Footnote if patient takes opioid therapy more than 4 times a day consider long acting opioid
32
Moderate/Severe Pain - Opioid tolerant patients
Non-opioids and adjuvant therapies as appropriate with short-acting opioids as needed: Dose may require a 30%-50% increase compared to naive patient
33
Severe Pain/Pain Crisis or uncontrolled pain naive vs tolerant, IV vs Oral
IV:Opioid-naïve patients: 2-5mg IV morphine sulfate Opioid-tolerant patients: Administer IV opioid dose equivalent to 10%–20% of the total opioid taken in the previous 24 h reassess after 15min Oral:Opioid-naïve patients: 5–15 mg oral short-acting morphine sulfate Opioid-tolerant patients:Administer oral opioid dose equivalent to 10%–20% of total opioid taken in the previous 24 h reassess after 60min
34
Acetaminophen daily max dose
4G/day ## Footnote 3G/day in chronic use
35
Which NSAID to use
Use any NSAID but consider ibuprofen to maximal dose
36
Antidepressants used along side opioid for pain
the more efficacious: (amitriptyline, imipramine) the better tolerated: (nortriptyline, desipramine)
37
Drugs use in Chemotherapy induced peripheral neuropathy
1-Duloxetine 2-Venlafaxine
38
example of Anticonvulsants as Adjuvant analgesics for neuropathic pain
Gabapentin & Pregabalin ## Footnote 1-Pregabalin is more efficiently absorbed through the GI tract than gabapentin, 2-Dose adjustment is required for those with renal insufficiency
39
example of Topical Agents used with analgesics for neuropathic pain
Lidocaine patch ## Footnote causes cutaneous damage over time with use
40
example of Corticosteroids use as Adjuvant analgesics for neuropathic pain
(dexamethasone) Useful in the acute management of a pain crisis when neural structures or bones are involved. ## Footnote preferably in the morning,
41
example of drugs that are not recommended in pain mangement
1-Meperidine 2-Mixed agonist-antagonists (pentazocine, nalbuphine, butorphanol)
42
# Pallative care for Dyspnea for both dying and not dying patient general
opioid ## Footnote consider alternative in non dying patient if renal insuffiency
43
# Pallative care for Dyspnea for both dying and not dying patient Anxiety
Lorazepam
44
# Pallative care for Dyspnea for both dying and not dying patient Fluid overload
furosemide
45
# palliative care -Anorexia/Cachexia non dying patient Depression/anorexia
Mirtazapine
46
# palliative care -Anorexia/Cachexia non dying patient Gastroparesis
Metoclopramide ## Footnote before meals and at bed time
47
# palliative care -Anorexia/Cachexia non dying patient Low/no appetite
Olanzapine
48
# palliative care -Anorexia/Cachexia dying patient Low/no appetite
DOC:1-Dexamethasone 2- Olanzapine 3- cannabinoid
49
constipation prophylaxis
senna+ polyethylene glycol ## Footnote recommend starting with polyethylene glycol if the patient is not on opioids
50
General constipation treatment
bisacodyl oral with a goal of 1 non-forced bowel movement (BM) every 1–2 days
51
Persistent constipation treatment
(BPCSS) 1- Bisacodyl suppository 2-Polyethylene glycol 3- LaCtulose 4-Sorbitol 5-magneSium hydroxide
52
Opioid-induced constipation treatment
NLM: 1-Methylnaltrexone 2-Linaclotide 3-Naloxegol
53
# * palliative care Diarrhea non dying patient Grade 1 diarrhea treatment
if on opioid: Loperamide (preferred) If not on opioids: – Diphenoxylate/atropine
54
# * palliative care Diarrhea non dying patient Grade 2 diarrhea treatment
if on opioid Initiate/continue loperamide If not on opioids: Diphenoxylate/atropine or hyoscyamine or atropine
55
# * palliative care Diarrhea non dying patient C. diff-induced diarrhea treatment
1-Metronidazole 2-Vancomycin
56
# * palliative care Diarrhea non dying patient Immunotherapy-related diarrhea treatment
1-Dexamethasone 2-infliximab
57
# * palliative care Diarrhea non dying patient Grades 3/4 (Inpatient hospitalization w/ICU for Grade 4) diarrhea managment
if not on opioid: Initiate/continue loperamide If not on opioids: Diphenoxylate/atropine or hyoscyamine or atropine (Consider octreotide)
58
# * palliative care Diarrhea dying patient Dying patient diarrhea managment
Reevaluate ongoing antidiarrheal, anticholinergic agents Initiate or increase dose of around-the-clock opioid AGO: Atropine, or glycopyrrolate, or octreotide.
59
palliative care – Malignant Bowel Obstruction treatment
1- Reduce opioid dose or rotate opioid 2-Metoclopramide 3-Dexamethasone 4- Octreotide 5-anticholenergic:Scopolamine, hyoscyamine,glycopyrrolate ## Footnote avoid Metoclopramide in the setting of complete obstruction discontinue Dexamethasone if no improvement in 3–5 days if prognosis >8 weeks consider long acting injection
60
# palliative care for – Sleep/Wake Disturbance Insomnia treatment
(TOZ MLCQ) * Trazodone * Olanzapine * Zolpidem * Mirtazapine * Lorazepam * Chlorpromazine * Quetiapine
61
# palliative care for – Sleep/Wake Disturbance phase shift disorder treatment
1-ramelteon 2-melatonin
62
# palliative care for – Sleep/Wake Disturbance Daytime Sedation treatment
CDMM: 1-Caffeine 2- Dextroamphetamine 3-Methylphenidate 4-Modafinil
63
# palliative care for – Sleep/Wake Disturbance restless leg syndrome
1- Ropinirole 2-Pramipexole
64
# palliative care – Delirium non dying patient Mild/Moderate Delirium treatment
1- Haloperidol (preferred) 2-Risperidone 3- olanzapine 4-quetiapine
65
# palliative care – Delirium non dying patient Severe Delirium (agitation) treatment
1-Haloperidol 2-Olanzapine 3-chlorpromazine
66
# palliative care – Delirium non dying patient High-dose neuroleptic-refractory treatment
lorazepam
67
# palliative care – Delirium dying patient delirium for dying patient
Upward titrate haloperidol, risperidone, olanzapine
68
# palliative care – Delirium dying patient High-dose neuroleptic-refractory
Upward titrate lorazepam * Consider rectal or IV haloperidol
69
# Palliative Sedation Imminently dying patient pallative care
1-Benzodiazepines:Midazolam or lorazepam. 2- Phenobarbital or pentobarbital 3-propofol.

therapeutics 2 drugs (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions