Miscellaneous Flashcards
What are the side effects for IP chemotherapy?
Leukopenia, infection, fatigue, renal toxicity, abdominal discomfort, neurotoxicity. In the trial, only 42% of women were able to complete all six cycles of the IP treatment. Reasons for discontinuing were: nausea vomiting dehydration abdominal pain, catheter complications.
Is the dosing for IP chemotherapy?
Paclitaxel 135mg/m2 over three hours or 24 hrs IV
Cisplatin: 75 -100 mg/m² IP on day 2
Day 8: taxol 60 mg/m² IP
How effective is does Dense?
Progression free survival was 28 months vs 17 months. Overall survival was 100 months versus 62 months.
What is the dosing for dose dense? What is a common side effect?
Paclitaxel 80 mg/m² IV over one hour days one, eight, and 15.
Carboplatin AUC 6 day one over one hour. The side effect is anemia.
What is your patient experiences neuropathy from taxol?
You can substitute taxotere 60-75 mg/m². Combined with carboplatin patients will experience a higher degree of neutropenia
How do you does BEP in children?
Bleomysin is administered once per cycle versus once per week in adults
Cisplatin 33.3 mg/m² days 123
Etoposide 167 mg/m² on days 123
Bleomycin 15 units/m2 on day one
This regimen is from the children’s oncology group
What is the Taxol reaction due to? And when does it occur?
It is due to cremophor for an Paclitaxel and generally occurs during the first two cycles but can occur anytime
How do you treat allergic drug reaction in chemotherapy?
Give epinephrine intramuscular 0.3 ML of 1 mg /ML solution for anybody with hypertension with our without symptoms of an allergic reaction. Perform a CLS is necessary
What are the symptoms of an infusion reaction? Which chemo does it more likely to occur with?
Hot flashing, rash, fever, chest pain, mild blood pressure changes, back pain, chills.
More common with paclitaxel however they occur with Doxil or Carbo
What are the symptoms that are true allergic reaction chemotherapy? What agents are more likely to exhibit this?
Rash, Edema, shortness of breath, syncope, chest pain, tachycardia, highs, change in blood pressure, nausea, vomiting, chills, bronchospasm. Symptoms persist after stopping infusion. Carboplatinum
How do you treat severe allergic reaction?
Start the infusion, give oxygen, bronchodilators, H2 blockers, steroids; epinephrine if needed, saline bolus as needed
How do you does BEP in adults?
Bleomyosin, 30 units/week
Etoposide 100 mg/m2/d days1-5
Cisplatin 20mg/m2/d days 1-5
For 3-4 cycles
For patients receiving chemotherapy for germ cells BEP, myelosuppression is common and may extend into the beginning of the next cycle. Do you delay or does reduce?
Low white blood counts do not mandate does reduction or delay unless the patient had febrile neutropenia before
How do you dose reduce?
The first dose reduction is 25% below full dose, the second is 50% the third 75%
What is the dose of etoposide that is associated with risk of leukemia?
1500 – 3000 mg/m²
How do you perform carbo desensitization ?
Perform a carbo skin test for hypersensitivity after six cycles. Stepwise dilutions are given over shortened time intervals, give premeds to prevent anaphylaxis(prednisone albuterol dexamethasone Pepcid Benadryl)
What is the difference between giving taxol 24 hours versus three hours
Three hour has more neurotoxicity 24 hours has more mylesupression
What you give for doxorubicin extravasation
DMSO and cold compress
What do you give her cisplatin extravasation
Sodium thiosulfate cold compress
What you give for taxol extravasation
Hyaluronidase and cold compress
Vincristine extravasation
Hyaluronidase an warm compress
To top aside extravasation
Hyaluronidase and warm compress
Vesicant
Vesicants: adria, act-D, vincristine, vinblastine, mito-C, etoposide
Specific antidotes:
For adria—hydrocortisone and sodium bicarb, COLD compress
For act-D—sodium thiosulfate, COLD compress
For etoposide, vincristine—hyaluronidase, WARM compress
Mito-C no specific
