Oncologic Support

Question 1

What the are the most highly emetic risk agents?

Answer 1

Cisplatin, cyclophosphamide > 1500 mg/m2, doxorubicin >60 mg/m2, ifosfamide > 2 g/m2/dose

Question 2

Which serotonin receptor antagonists come in non-PO administrations?

Answer 2

Ondansetron (ODT), granisetron (patch)

Question 3

What agents should be used to prevent acute and delayed emesis

Answer 3

NK-1 Inhibitors and steroids

Question 4

What agents should be used to prevent anticipatory emesis?

Answer 4

BZDs

Question 5

Patients with breast cancer who have evidence of bone metastases should receive which bisphosphonates?

Answer 5

Pamidronate or zoledronic acid every 3-4 weeks

Question 6

How do you calculate ANC?

Answer 6

WBC x (segmented + banded neutrophils)

Question 7

When is it appropriate to administer CSF in neutropenic fever?

Answer 7

Neutropenic, febrile AND prescence of risk factors for complications ANC < 100, PNA, hypotension, multiorgan dysfunction, invasive fungal infections

Question 8

What are normal folate and vitamin B12 levels?

Answer 8

Folate 1.6-1.8 ng/mL

Vit B12 100-900 pg/mL

Question 9

What does amifostine prevent in terms of chemotherapy related complications?

Answer 9

Nephrotoxicity from cisplatin

Question 10

What is the calcium cutoff requiring aggressive inpatient treatment?

Answer 10

corrected ca 14 mg/dL

Question 11

How would you treat hypercalcemia?

Answer 11

Hydration
Diuretics
Calcitonin

Question 12

At what uric acid cutoff, should you use rasburicase?

Answer 12

8 mg/dL

Question 13

How would you manage extravasation of anthracyclines and vinca alkaloid?

Answer 13

Anthracyclines: cold or dexrazocine

Vinca alkaloid: heat