Malignancy Flashcards
When is neutropenia seen after starting chemo?
Day 8-16
How does this relate to infections?
The patient is more susceptible
What is the temp definition of fever?
Oral Temp >101 or 100.4 sustained for >1 hour
What is always the right answer?
H&P
Questions to ask patients presenting with fever
H&P, sources of infection, resp, GU, GI, CBC, LFTs, UA, CXR, draw cultures from 2 different sites (urine C/S)
What ANC count do you want before administering chemo?
Ideally 1500 but at least 1000
What defines high-risk fever and neutropenia?
ANC
High-risk RX
Inpatient IV antibx
Anemia
Blood transfusion and erythropoietin
Wet purpura. What risk do they have?
Seen on mucus membranes. High risk of intracranial bleeds
Dry purpura
Seen on skin
Types of nausea
Acute- 24 hrs of chemo
Delayed
Stimulation of nausea and vomiting
Stimulation of vomiting center in medulla by chemodrugs
Nausea drugs?
Zofran, dexamethasone, apepritant and lorazepam
General advise on nutrition?
Eat small meals, no alcohol, relaxation techniques and no spicy food
Drugs which casue infusional reactions
MABs: Rituximab
Rx for infusion reactions
Benadryl, steroids and Epi
mucositis
dsgs
Diarrhea
Usually self-limiting
Diarrhea RFs
GI tumors, old age, hx of colitis
Diarrhea Rx
Hydration, diet (BRAT), Loperamide and Octreotide
BRAT
Bananas, apples, rice and toast
Drugs which casue neuropathy
Vincristine, Vinblastine, Oxaliplatin and Taxanes
Key Oxaliplatin toxiticity
Acute cold electric shock-like neuropathy
What drugs are rashes common with?
MABs
Fever+Nausea
Send patient to ED and possibly start Rx with broad-spec antibx
Rx for hot flashes
Venlafaxine (Also an anti-depression)
