Oncology Flashcards
when would you consider adding dexrazoxane to doxorubicin infusion?
when doxo >300mg/m2 and patient would benefit from more doxorubicin
ratio of dexrazoxane: doxorubicin dosing
10:1 dexrazoxane:doxo
amifostine is used as a protectant of what drug?
cisplatin nephrotoxicity
radiation w/head and neck cancer
why do you use mesna in oncology?
cyclophosphamide and ifosfamide - hemorrhagic cystitis
ALWAYS used with ifos and can be used in cytoxan >1500mg/m2
may be given w/ or before ifos but must end AFTER ifos
leucovorin uses in oncology
5Fu protection and methotrexate >500mg/m2
improves activity of 5FU
when to avoid emend?
R-CHOP - increases neuropathy
warfarin - decreases INR
if on oral dexamethasone, decrease emend by 40%
when to go to ER opioids
when 4 or more mild opioids are used in a day
e.g. Norco QID
preferred opioids in renal dysfunction
oxycodone and dilaudid
signs of low risk neutropenia
ANC >0.1
monocyte >0.1
normal chest xr, cx’s neg
normal renal and hepatic fxn
peak temps < 102
no abdominal pain or AMS
< 7 days duration and recovering
when to add bactrim or FQ’s
only if neutropenia is expected to last > 7 days
when to add vanc for neutropenia
PNA, + blood cx
SSI, MRSA, VRE, pen resistant strep pneumo
catheter related infection
filgrastim dose
5mcg/kg SC daily until adequate ANC attained, very patient specific
pegfilgrastim 6mg is equivalent to how many doses of filgrastim?
11
when to add GCSF in neutropenia
> 65, septic, ANC <0.1, PNA, fungal infection, hospitalized, long duration of neutropenia (>7days)
threshold to initiate treatment in hypercalcemia of malignancy
> 14 unless symptomatic at lower levels
hot to treat extravasation of vina alkaloids
hot compress or hyaluronidase
which med for extravasation of anthracyclines
topical DMSO and cold compress
could do dexrazoxane but must remove cold compress 15 mins before
