Oncology Flashcards
Nitrosoureas cause what toxicity?
Neurotoxicity
Nitrosourea examples
lomustine, carmustine
Platinum-based chemo meds cause what toxicities?
nephrotoxicity, peripheral neuropathy, vomiting
Platinum-based med examples
Carboplatin, cisplatin
MTX, 5-FU, and capcitabine cause what toxicity?
Mucositis
Bleomycin, busulfan, carmustine, lomustine cause what toxicity?
Pulmonary fibrosis
Anthracyclines cause what toxicity?
Cardiotoxicity
Anthracycline examples
Doxorubicin, daunorubicin
Immunotherapy for cancer causes what toxicity?
Autoimmune syndromes
Examples of immunotherapy for cancer
ipilimumab, atezolizumab, pembrolizumab
Ifosfamide and cyclophosphamide cause what toxicity?
Hemorrhagic cystitis
Vinca alkaloids cause what toxicity?
peripheral neuropathy
Examples of vinca alkaloids
vincristine, vinblastine, vinorelbine
Taxanes cause what toxicity?
peripheral neuropathy
Examples of taxanes
paclitaxel, docetaxel
What chemo meds cause bone marrow suppression?
Most of them, EXCEPT bleomycin, pegaspargase, vincristine
Irinotecan causes what toxicity?
DIARRHEA
Chemo-adjunctive treatment: what to give with cisplatin
amifostine and hydration
What do amifostine and hydration do to help with cisplatin treatment?
Prevent neurotoxicity
Chemo-adjunctive treatment: what to give with doxorubicin
dexrazozane
Purpose of dexarzozane in doxorubicin treatment
Prevent cardiotoxicity
Chemo-adjunctive treatment: what to give with 5-FU
leucovorin, levoleucovorin
Purpose of leucovorin/levoleucovorin with 5-FU
enhance efficacy
Antidote for 5-FU
uridine triacetate- give within 96 hours
Chemo-adjunctive treatment: what to give with ifosfamide
mesna
Purpose of mesna with ifosfamide treatment
prevent hemorrhagic cystitis
Antidote for capecitabine
uridine triacetate
Chemo-adjunctive treatment: what to give with irinotecan
atropine, loperamide
Purpose of atropine and loperamide with irinotecan
Atropine for acute diarrheal episodes
loperamide for delayed diarrheal episodes
Chemo-adjunctive treatment: what to give with MTX
leucovorin, levoleucovorin
Purpose of leucovorin/levoleucovorin with MTX
protect the cells from toxicity after high-dose MTX
MTX antidote
glucarpidase, give within 48-60 hours
Extravasation treatment: anthracyclines
COLD compresses, give dexrazozane/dimethyl sulfoxide
Extravasation treatment: vinca alkaloids
WARM compresses, give hyaluronidase
Max doses: bleomycin
cumulative lifetime dose of 400 units
Max doses: doxorubicin
cumulative lifetime dose of 450-550mg/m2
Max doses: cisplatin
100mg/m2/cycle
Max doses: vincristine
single dose capped at 2mg
What route should you NOT give vincristine
Intrathecally (duh)
TLS management
Aggressive IV hydration
electrolyte correction as needed
urate lowering treatment: allopurinol, rasburicase
Hypercalcemia of malignancy treatment
hydration with NS
Calcitonin
IV bisphosphonates: Zometa (zoledronic acid)
Denosumab (Xgeva)
CINV treatment: high emetic risk
NK1-RA+5HT3 RA+olanzapine+dexamethasone
CINV treatment: moderate emetic risk
NK1-RA+5HT3 RA+ dexamethasone
CINV treatment: low emetic risk
One drug (as long as it’s not Emend): dexamethasone, prochlorperazine, metoclopramide
CINV treatment: minimal emetic risk
no routine prophylaxis needed