Oncology

Question 1

These chemotherapy agents all don’t commonly cause what issues often seen in other chemotherapy treatments?

5-Flurouracil
Capecitabine
Gemcitabine
Vinorelbine

Answer 1

They don’t often cause nausea, vomiting, or alopecia.

Question 2

What are the specific chemotherapy toxicities of these drugs?

Doxorubicin
Bleomycin
Cisplatin
Taxanes
Vinca alkaloids
Capecitabine

Answer 2

Doxorubicin = cardiac toxicity
Bleomycin = lung toxicity
Cisplatin = renal and ototoxicity
Taxanes = neuropathy
Vinca alkaloids = neuropathy
Capecitabine = hand-foot syndrome

Question 3

What are the features of febrile neutropaenia?

Answer 3

Fever > 38 degrees
PMN < 1.0 x 10^9/litre

Treat these patients immediately with broad spectrum antibiotics
High doses in transplant patients.

Question 4

Antiemetics

Answer 4

Gastric stasis or irritation = Prokinetic antiemetics
metoclopramide or domperidone (D2 antagonists)
– Reduce acid secretion
proton pump inhibitor or ranitidine

Chemically induced nausea/vomiting – AKA ‘central’ nausea = Anti-emetic acting principally in chemoreceptor trigger zone
haloperidol or prochlorperazine

Chemotherapy induced nausea/vomiting =
– Anti-emetic acting principally in chemoreceptor trigger zone
dexamethasone
AND
palonosetron or ondansetron (5HT3 antagonist)
+/-
aprepitant (NK1 antagonist)
– Can also use:
haloperidol or olanzapine (D2 antagonists)
+/-
cyclizine (H2 antagonist)

Raised intracranial pressure = dexamethasone

Movement associated nausea/vomiting =
Antiemetic acting principally in the vomiting centre and on vestibular inputs
cyclizine (H 2 antagonist)
+/-
hyoscine (scopolamine) (muscarinic antagonist)