Medications Flashcards

1
Q

What 3 things do you need to know about the administration of anthracyclines?

A

1) They’re vesicants.
2) Cumulative lifetime maximum dose
3) Reduce dose if pt gets radiation

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2
Q

What do you monitor for with anthracyclines?

A
  • EKG/Echo

* Changes in urine/tears color

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3
Q

Side effects of anthracyclines?

A
  • GI; mucositis
  • Cardiac
  • Early/low nadir
  • Alopecia
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4
Q

Emetic potential of anthracyclines?

A

High

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5
Q

What is the cardiac protectant drug for anthracyclines and how soon do you administer it prior to giving the anthracycline?

A

Dexrozoxane (30 minutes prior)

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6
Q

What are 2 things to know about the administration of Cisplatin?

A

2) IV fluids with magnesium and mannitol

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7
Q

What 4 things do you monitor with Cisplatin?

A
  1. Check UOP q1-2 hours.
  2. Hearing tests
  3. Creatinine
  4. Creatinine clearance or iothalamate tests (iothalamate coming out of favor)
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8
Q

What organs are affected most by Cisplatin?

A

Kidneys and ears (high-pitched hearing loss)

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9
Q

What is the emetic potential of Cisplatin?

A

VERY HIGH!!!

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10
Q

What PRN medications might you give with Cisplatin?

A

Mannitol and Lasix PRN if UOP falls

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11
Q

What are 2 administration things to know about cyclophosphamide (cytoxan)?

A
  1. Always given with IVF

2. Mesna for higher doses

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12
Q

What do you monitor for with cytox?

A

Dip urine q void

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13
Q

What are side effects of cytox?

A
  • Hemorrhagic cystitis
  • Cardiac if high dose
  • Kidneys
  • SIADH
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14
Q

What is the emetic potential of cytox?

A

Moderate

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15
Q

What is hemorrhagic cystitis?

A

A biproduct of cytox (acrolein) irritates the bladder wall

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16
Q

What secondary cancer does cyclophosphamide put you at risk for?

A

Bladder cancer

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17
Q

What do you need to know about the administration of cytarabine (ARA-C)?

A

It has variable doses and variable forms.

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18
Q

What other medication is given with ARA-C?

A

Eye drops:
• Prophylactic NS with high dose
• Tx steroid drops if conjunctivitis

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19
Q

What are the side effects of cytarabine?

A
  • Chemical conjunctivitis
  • High fevers/flu symptoms
  • Hand/foot syndrome
  • Neuro toxicities (seizures, fine motor)
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20
Q

What is the emetic potential of ARA-C?

A
  • Low to moderate

* High if given IT (give zofran)

21
Q

Patients that get ARA-C are at increased risk for getting ___, because ____. Therefore AML patients get ____ when they spike a fever.

A
  1. Strep viridins
  2. strep V lives in the gut wall and ARA-C messes with the gut wall
  3. Cefepime
22
Q

What do you need to know about the administration/preparation of etoposide?

A
  • It needs minimal dilution for stability.

* Undiluted it’s very unstable.

23
Q

What do you need to monitor for with etoposide?

A

Hypotension: check BP before and mid-dose and slow the infusion if low BP.

24
Q

What is the emetic potential of etoposide?

A

Low to moderate

25
What secondary malignancy can result from etoposide treatment?
AML
26
What are 2 things to know about the administration of ifosfamide?
* IVF | * Always with mesna
27
What do you monitor for with ifosfamide?
Dip urine Q void.
28
What are side effects of ifosfamide?
* Hemorrhagic cystitis * Cardiac if high dose * Kidneys
29
What is the emetic potential of ifosfamide?
Moderate
30
What other kidney thing can ifosfamide cause?
Fanconi Renal Syndrome (pee a lot, electrolytes off)
31
What chemotherapies are given intra-thecally?
ARA-C, HCT, and MTX
32
How is IT chemo dosed?
By age
33
What are the platelet thresholds for IT chemo?
PLTs>10 (ommaya) | PLTs>20 (LP)
34
What administration thing do you need to know regarding IT chemo?
Need to lie flat to avoid headache
35
What are side effects of IT chemo?
* Headache * Neurotoxicity * Cognitive development * Seizure
36
What is the emetic potential of IT chemo?
* MTX/HCT: low | * ARA-C: high
37
What 3 things do you need to know about methotrexate?
1. Many routes and doses | 2. IV give with bicarbonate fluids
38
What 4 things do you monitor with methotrexate?
1. Urine pH | 2. MTX level must be
39
What are the side effects of MTX?
Liver, kidneys, GI/mucositis, rash, neuro toxicity/seizure
40
What is the emetic potential of MTX?
Moderate to high depending on the dose
41
What med is held while receiving MTX?
Bactrim
42
What supportive med do you receive while on MTX?
Leucovorin
43
What is one administration consideration for oral steroids?
They taste bad!
44
What do you need to monitor with steroids? (Name 3)
1. BPs 2. Glucose 3. Appetite/moods
45
What are three side effects of steroids?
Bone density, cushingd syndrome, infection/healing
46
What is the emetic potential for steroids?
None
47
What are steroids' affect on counts?
None
48
What do you need to know about administering thiotepa?
Bath/shower and linen change QID, care with skin, no lotion/ careful with adhesives
49
What are the side effects of thiotepa?
Skin, GI