ONC210 Toxicities of Systemic Therapies Flashcards
Name cells that have high turnover and are normally subject to toxicities of chemotherapy
1) hair follicles
2) GI tract
3) Oral mucosa
4) Germ cells
5) Bone marrow
How are toxicities graded ?
national cancer institute common toxicity criteria for adverse events
What is the major side effect of cisplatin?
vomitting
How do you prevent nausea and vomiting side effects of chemotherapy?
- depending on the emesis risk, combine with highest therapeutic index drugs that reduce side effect. Ex. Lorazepam. Prevention is key
- also important to exclude other disease and medication-related causes for emesis
What is mucositis?
when chemotherapy effects the oral mucosa. painful inflammation and ulceration of the mucous membranes.
How do you treat or prevent mucositis?
Can’t 100% prevent but supportive care is possible. Give pink lady mouth wash or topical lidocaine etc.
At what platelet count do we transfuse patients?
What is the drug that most commonly causes blood in the urine?
high dose cyclophosphamide or ifosfamide due to the metabolite acrolien
What is a protective agent against blood in the urine?
MESNA; an organosulfur compound used as an adjuvant in cancer chemotherapy involving cyclophosphamide and ifosfamide. It reduces the incidence of haemorrhagic cystitis and haematuria when a patient receives ifosfamide or cyclophosphamide for cancer chemotherapy. These two anticancer agents, in vivo, may be converted to urotoxic metabolites, such as acrolein.
What is the most commonest drug that causes acute renal failure?
Cisplatin
Which chemotherapy drug is most likely to cause heart failure?
Doxorubicin
How do we prevent the cardiac side effects of doxorubicin?
use dexrazoxane (cardioprotective agent) with increasing cumulative dose
What is the chemotherapy drug that is most likely to cause diarrhea?
Irinotecan
How do we treat diarrhea caused by irinotecan?
if cholinergic effect, treat w/ atropine
if >24 hours –> mucosal toxicity treat w/ loperamide or octerotide
What drug is most likely to cause x-ray changes?
Bleomycin
