Lecture 5 - cancer pharmacy

Question 1

what is SACT?

Answer 1

systemic cancer therapy

Includes other non-cytotoxic agents such as:-Monoclonal Antibodies (MABs)-Immunotherapies

Extends to experimental treatments including:-Cancer Vaccines-Gene Therapy
Commonly IV but increasing range of SC and oral therapies

Question 2

what is the pharmacists role within SACT?

Answer 2

clinical verification of SACT prescriptions.

assessment of patient wellbeing - look for toxicities and side effects

check weights, renal, hepatic FBC, ureas and electrolytes

add/adjust supportive medicines such as anti-emetics

patient education and counselling, management of new days etc

Question 3

what are challenges of SACT prescribing?

Answer 3

increasing workload, high level of focus required, lots of new drugs, increasingly co-morbid apteitns

Question 4

what is involved in clinical verification of SACT?

Answer 4

check prescription details, check appropriate treatment plan, check patient details, check administration details, check calculations, check labs, critical tests and toxicities

Question 5

what are common toxicities of SACT?

Answer 5

cause, vomiting, diarrhoea (limited treated with loperamide), neuropathy, dry mouth, alopecia, fatigue, immunosuppression

Question 6

what are supporting anti-emetic medicines?

Answer 6

metoclopramide - baseline antiemetic

5HT3 antagonists - ondansetron/ granidetron

Steroids – Mostly dexamethasone

Antihistamines – Such as cyclizine

QT prolongation is a huge issue to consider here

Question 7

what are other supporting medicines ?

Answer 7

Diarrhoea – Loperamide, occasionally codeine

Neuropathies – Gabapentin/Pregabalin, lidocaine patches

Neutropaenia – Granulocyte colony stimulating factors (GCSF)

Electrolyte disturbances – standard replacements

Mucositis – Mouthwashes such as sodium bicarbonate (baking soda) or benzydamine