Miscellaneous Flashcards

0
Q

What are the side effects for IP chemotherapy?

A

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.

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1
Q

Is the dosing for IP chemotherapy?

A

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

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2
Q

How effective is does Dense?

A

Progression free survival was 28 months vs 17 months. Overall survival was 100 months versus 62 months.

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3
Q

What is the dosing for dose dense? What is a common side effect?

A

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.

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4
Q

What is your patient experiences neuropathy from taxol?

A

You can substitute taxotere 60-75 mg/m². Combined with carboplatin patients will experience a higher degree of neutropenia

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5
Q

How do you does BEP in children?

A

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

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6
Q

What is the Taxol reaction due to? And when does it occur?

A

It is due to cremophor for an Paclitaxel and generally occurs during the first two cycles but can occur anytime

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7
Q

How do you treat allergic drug reaction in chemotherapy?

A

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

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8
Q

What are the symptoms of an infusion reaction? Which chemo does it more likely to occur with?

A

Hot flashing, rash, fever, chest pain, mild blood pressure changes, back pain, chills.
More common with paclitaxel however they occur with Doxil or Carbo

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9
Q

What are the symptoms that are true allergic reaction chemotherapy? What agents are more likely to exhibit this?

A

Rash, Edema, shortness of breath, syncope, chest pain, tachycardia, highs, change in blood pressure, nausea, vomiting, chills, bronchospasm. Symptoms persist after stopping infusion. Carboplatinum

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10
Q

How do you treat severe allergic reaction?

A

Start the infusion, give oxygen, bronchodilators, H2 blockers, steroids; epinephrine if needed, saline bolus as needed

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11
Q

How do you does BEP in adults?

A

Bleomyosin, 30 units/week
Etoposide 100 mg/m2/d days1-5
Cisplatin 20mg/m2/d days 1-5

For 3-4 cycles

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12
Q

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?

A

Low white blood counts do not mandate does reduction or delay unless the patient had febrile neutropenia before

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13
Q

How do you dose reduce?

A

The first dose reduction is 25% below full dose, the second is 50% the third 75%

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14
Q

What is the dose of etoposide that is associated with risk of leukemia?

A

1500 – 3000 mg/m²

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15
Q

How do you perform carbo desensitization ?

A

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)

16
Q

What is the difference between giving taxol 24 hours versus three hours

A

Three hour has more neurotoxicity 24 hours has more mylesupression

17
Q

What you give for doxorubicin extravasation

A

DMSO and cold compress

18
Q

What do you give her cisplatin extravasation

A

Sodium thiosulfate cold compress

19
Q

What you give for taxol extravasation

A

Hyaluronidase and cold compress

20
Q

Vincristine extravasation

A

Hyaluronidase an warm compress

21
Q

To top aside extravasation

A

Hyaluronidase and warm compress

22
Q

Vesicant

A

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