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
