Oncology Flashcards
Bleomycin maximum dose and toxicity
LCD: 400 units; Pulmonary toxicity
Doxorubicin maximum dose and toxicity
LCD: 450-550 mg/m2; Cardiotoxicity
Cisplatin maximum dose and toxicity
Dose per cycle max 100 mg/m2; Nephrotoxicity
Vincristine maximum dose and toxicity
Single-dose “capped” at 2 mg; Nephrotoxicity
Neutropenia management
colony-stimulating factors (CSFs)
Thrombocytopenia management
platelet transfusion
Chemo-induced N/V management
NK-1 receptor antagonist, Serotonin-3 receptor antagonist, dexamethasone, metoclopramide, prochlorperazine; and IV/PO fluid hydration
Mucositis management
symptomatic management (mucosal coating agents, topical local anesthetics)
Diarrhea management
IV/PO fluid hydration, antimotility agent (eg. loperamide), irinotecan (atropine for early onset diarrhea)
Constipation management
Stimulant laxatives, Polyethylene glycol
Xerostomia management
artificial saliva substitues, pilocarpine
Cardiotoxicity management
{Cardiomyopathy: DNE LCD for doxorubicin. Dexrazoxane can be given prophylactically in some patients receiving doxorubicin.} [QT prolongation: Maintain K, Mg, Ca WNL. Hold therapy if QTc > 500msec}
Pulmonary toxicity management
Stop therapy. symptom management. Corticosteroid may be used if autoimmune mechanism is suspected
Hepatotoxicity management
Symptom management. Consider stopping. Corticosteroids if an autoimmune mechanism for PD-1 immunotherapy.
Nephrotoxicity management
Amifostine (Ethyol) for prophylaxis with cisplatin. Adequate hydration. DNE maximum cisplatin dose.
Hemorrhagic cystitis management
Mesna (Mesnex) is always given with IFOSFAMIDE (and sometimes with cyclophosphamide) prophylactically. Adequate hydration!