Oncology Flashcards
Bleomycin risk and max dose
Pulmonary
400 unit lifetime dose
Doxorubicin risk and max dose
Cardio toxicity
450-550 mg/m2 lifetime dose
Cisplatin risk and max dose
Nephrotoxicity
100 mg/m2 per cycle
Vincristine risk and max dose
Neuropathy
2 mg max single dose
Myelosupression
All except: asparginase, bleomycin, vincristine, monoclonals and TKIs
N/V most common
Cisplatin, cyclophosphamide, ifosfamide
Mucositis
5-FU, MTX
Diarrhea
Irinotecan, capecitabine, 5-FU, MTX
Constipation
Vincristine
QTC
Droperidol, arsenic, TKIs
Pulmonary toxicity
Bleomycin, busulfan, carmustine, lomustine
Hepatotoxicity
Antiandrogens (bicalutamide, flutamide, nilutamide )
MTX
Nephrotoxic
Cisplatin, MTX
Hemorrhagic cystitis
Ifosfamide, cyclophosphamide
Peripheral neuropathy
Vinca alkaloids, platinums, taxanes
Totect
Dexrazoxane
Extravasation from doxorubicin
Zinecard
Dexrazoxane
Cardio protection from doxorubicin
Ethyol
Amifostine
Give with cisplatin to prevent nephrotoxicity
Uridine triacetate
5-FU and capecitabine antidote
Mesnex
Mesna
Give with ifosfamide to prevent hemorrhagic cystitis
What to give with MTX to reduce toxicity
Leucovorin (fusilev)
Glucarpidase (voraxaze)
When does nadir occur
7-14 days after chemo
High emetic risk regimen
Dex + 5HT3 + NK-1RA
*can add or substitute with olanzapine
Aprepitant alone?
No, always add on
Can 5HT3 antagonists cause seratonin syndrome
Yes
Does cesamet require refrigeration?
No
*drinabinol does
TLS
Allopurinol (400-800 mg/d)
Or rasburicase
Start both IV
Hypercalcemia of malignancy tx
Mild: hydration w/ NS and loop diuretics
Mod-severe;
- calcitonin (miacalcin) - iv bisphosphonates (zometa, pamidronate) * zometa is 4 mg while reclast is 5 mg iv yearly - xgeva 120 mg sc (prolia is 60 mg Q6 months)
Dimethyl sulfoxide
For anthracycline extravasation
Can also use dexrazoxane (Toltect)
Hyaluronidase
Vinca alkaloid or etoposide extravasation
How to prepare vincristine
Don’t make in syringe! To avoid accidental intrathecal administration
Vaccine and chemo timing
Vaccines should precede chemo by 2+ weeks
-live at least 3 months after chemo
Who gets aromatase inhibitors for breast CA?
Only post menopausal! (Or no uterus)
*doesn’t affect ovarian estrogen production
Who gets tamoxifen for breast cancer?
Premenopausal!
Can give in post menopausal if did not tolerate AI
Herceptin
Traztuzumab
Her-2 positive breast CA
Tamoxifen
SERM