Oncology 4 Flashcards
1
Q
- Harmful properties of chemotherapeutic drugs.
- Where can they been excreted/secreted in patients receiving chemotherapeutic treatment?
A
- Mutagenic, abortifacient, teratogenic, carcinogenic, irritant, vesicant.
- Faeces, urine, saliva.
2
Q
What is the individual prescribing the product responsible for?
A
Ensuring their own health and safety, as well as that of other staff, the patient, the client, other individuals in the patient’s household and the environment.
3
Q
Examples of safe handling.
A
- Protocols for spillages and readily prepared spill-kits.
- Pregnant women should NEVER handle cytotoxic drugs.
- Appropriate chemo-specific PPE.
- All employees and owners must be informed of risks.
- Provide owner guidance to limiting exposure w/ saliva, urine, vomit, faeces.
- Closed systems for drawing up and administering meds.
- Never re-cap needles (risk accidental inoculation).
- Purple flagged containers for disposal.
4
Q
- Toxicity relating to which area of the body are most common in patients receiving chemo?
- What other systems can be affected by chemotherapeutic drugs?
- What protocols help reduce the effects of chemo on body systems?
A
- GIT and bone marrow.
- Dermatological, urinary, cardiac, renal, hepatic.
- Recovery time gives tissues time to repair.
5
Q
- GIT toxicity as a result of chemo clinical signs.
- How is GIT toxicity a contributing factor of sepsis risk in chemo patients?
- Management of clinical signs associated w/ GIT?
- Examples of chemo drugs that can cause GIT toxicity.
A
- Vomiting, diarrhoea, nausea, stomatitis.
- Decreased gut integrity increases risk of bacterial translocation into the blood and sepsis.
- Depends on side effects encountered e.g. nausea managed w/ anti-emetics.
- Doxorubicin, cisplatin (stimulate chemoreceptor trigger zone).
6
Q
- Examples of drugs that can cause bone marrow toxicity.
- How do we check patients bone marrow condition before chemo?
- Examples of conditions caused by chemo relating to bone marrow toxicity.
A
- Doxorubicin, vinblastine, cyclophosphamide.
- Routine haematology.
- leukopenia, neutrophilia.
7
Q
- Dermatological effects of chemo drugs.
- Examples of chemo drugs that can cause dermatological problems.
A
- Many are irritants and vesicants.
Tissue inflammation/even necrosis if administered inappropriately e.g. if the drug extravasates during IV admin. - Vincristine, cisplatin, doxorubicin.
8
Q
- Clinical signs of urinary toxicity due to chemo drugs.
- Example of chemo drug that can cause urinary toxicity.
- How do we monitor patients on these drugs and ensure we cause as little damage as possible.
A
- Stranguria, dysuria, pollakiuria, haematuria.
- Cyclophosphamide.
- Provide dipsticks to owner to use daily to look for signs of haematuria, and at first sign of haematuria, that drug is stopped and different drug used.
9
Q
- Types of cardiac toxicity that chemo drugs can cause.
- Give example of chemo drug and its cardiac effect. – mitigation in place to help reduce risk.
A
- Acute and chronic.
- Doxorubicin can cause tachyarrhythmias (acute) and cardiomyopathies which may lead to congestive heart failure (chronic). – Doxorubicin given slowly to avoid development of arrhythmias.
10
Q
- Renal effects of chemo drugs.
- Examples of chemo drugs that have renal effect.
- Mitigations to help avoid renal effects.
A
- Some have potential to cause proximal tubular necrosis > irreversible loss of renal function > development of acute and/or chronic kidney disease.
- Cisplatin, methotrexate, doxorubicin (cats).
- Admin alongside IV fluids, monitoring urea and creatinine, avoid use of such drugs in patients w/ pre-existing renal disease.
11
Q
- Hepatic effects of chemo drugs.
- Example of drug that can cause hepatotoxicity.
- Mitigations to help avoid hepatotoxicity.
A
- Transient or irreversible loss of liver function.
- Lomustine.
- Monitor hepatocellular enzymes, concurrent admin of anti-oxidant (e.g. SAMe = s-adenosyl methionine).
