Miscellaneous Flashcards
Stage 1 pressure ulcer
heralding lesion, non-blanchable erythema
Stage 2 pressure ulcer
partial thickness skin loss with epidermis, dermis or both involved. Typically with abrasion or shallow crater/blister.
Stage 3 pressure ulcer
full thickness involving subcutaneous, may exten down to (but not through) underlying fascia
Stage 4 pressure ulcer
necrosis and damage to underlying muscle, bone, and/or other supporting structures
Chemotherapy induced nausea and vomiting: high emetic risk
> 90%: Cisplatin, Dacarbazine, dose dense AC, AIM, cyclophosphamide
Treat:
Schedule (3-4) antiemetics prior to chemotherapy and continue ppx dosing for 3 days after
-dexamethasone + ondansetron (5HT3)+ fosaprepitant NK1)
Chemotherapy induced nausea and vomiting: moderate emetic risk
30-90%: Irinotecan, carboplatin, doxorubicin
Treat:
Schedule 2+ antiemetics prior to chemotherapy and continue ppx dosing for 3 days after
Chemotherapy induced nausea and vomiting: low emetic risk
10-30%: paclitaxel, docetaxel, 5-FU, etoposide, gemcitabine
Treat:
Schedule 1 antiemetic prior to chemotherapy
Chemotherapy induced nausea and vomiting: minimal emetic risk
<10%: vincristine, bleomycin
Treat:
no routine ppx
Chemotherapy side effects: neuropathy
most common with antimicrotubule agents (paclitaxel, vincristine) and platinum agents (cisplatin, carboplatin)
-generally progressive
-no proven preventative therapies
treatment:
-modifications of regimen, chemo holiday
-duloxetine (60gm/d)
-exercise
-acupuncture
-other meds (gabapentin, pregabalin, amitriptyline, cpasaicin, glutamine)
Chemotherapy side effects: diarrhea
Most common with antimetabolites (5-FU, capecitabine)
Treatment:
-loperamide 4mg x1 then 2mg after each loose stool (up to 24mg/day)
-octreotide
-etcChemotherapy side effects:
Palliative prognostic index (PPI)
Predicts 30 day mortality in advance cancers, at 6 wks.
PPS+ 4 additional factors (oral intake, edema, dyspnea at rest, delirium)
Palliative prognostic score (PaP)
stratifies risk for 30 day mortality (groups A, B, C)
KPS+5 additional factors (dyspnea, anorexia, clinical prediction, total WBC, lymphocyte percentage
ECOG and PPS associated with prognosis of <6 months?
ECOG 2, PPS<70%
Tumor markers in breast cancer
CA 15-3, CA 27.29
CA 19-9 is associated with what types of cancer?
Colon, pancreatic
CA 125 is associated with what types of cancer?
Ovarian, endometrial, lung, GI
CEA is associated with what types of cancer?
GI, cervical, lung
CD 117 is associated with what types of cancer?
GI stromal tumor, seminomaS
Secondary TCAs vs Tertiary TCAs
(2) Nortriptyline, desipramine: less anticholinergic side effects (urinary retention, dry mouth, confusion, hypotension, hallucinations)
(3) Amitryptiline, imipramine
