Managing Chemo Complications - Fitz Flashcards
CHOP regimen
NHL
ABVD regimen
HL
2 main ways to cause N/V from chemo
- Direct activation of medullary CTZ
- 5-HT3 release via damaged enterochromaffin cells (GI)
-setron
Use?
5-HT3 receptor antagonists
Acute CINV - PRIMARY THERAPY FOR THIS
Metoclopramide
Use?
D2 (central) receptor antagonist
Acute CINV
-pitant
Use?
Neurokinin-1 receptor antagonists
Acute or delayed CINV
Dronabinol
Use?
Cannabinoid CB1 receptor agonist
Refractory CINV
Side effect of -setron
QT prolongation (EKG changes)
Aprepitant blocks the binding of what substance?
Substance P (to the NK1 receptor)
Delayed emesis is most common after what?
Treatment?
Cisplatin
Aprepitant
Receptors in the CTZ
5HT-3, D2, NK1
Receptors in the vagal afferent (associated w/ N/V)
5HT-3, NK1
Which of the 3 receptor blockers does NOT act on vagal afferents?
Metoclopramide (D2 receptor antagonist)
Treatment regimen for high CINV risk
-setron, Aprepitant, Dexamethasone
Treatment regimen for moderate CINV risk
-setron, Dexamethasone
Treatment regimen for low CINV risk
Dexamethasone
Treatment for anticipatory emesis
MoA
Benzo (Lorazepam)
GABA-A receptor (Cl- channel) agonist/potentiator = hyperpolarization, relaxation
Treatment for Cyclophosphamide-induced hemorrhagic cystitis
MoA and when?
MESNA
PROPHYLACTIC anti-toxin for acrolein
Side effects of MESNA
Hypersensitivity, bad sulfur smell (GI distress)
Dexrasoxane
MoA
Blunting agent for Doxorubicin cardiotoxicity
Chelates iron-induced free radicals
Amifostine
MoA
Requires what?
Blunting agent for Cisplatin nephrotoxicity
Chelates toxic metabolites and ROS
Activation by alkaline phosphatase
