Oncology (Pt 1) Flashcards
Warning signs of cancer?
CAUTION C - change in bowel or bladder habits A - a sore that won't heal U - unusual bleeding or discharge T - thickening or lump in breast or elsewhere I - indigestion or difficulty swallowing O -obvious change in wart or mole N - nagging cough or hoarseness
Bleomycin has capped dosing due to _____ toxicity
pulmonary
Doxorubicin has capped dosing due to _____ toxicity
cardiotoxicity
Cisplatin has capped dosing due to _____ toxicity
nephrotoxicity
Vincristine has capped dosing due to _____ toxicity
neuropathy
Dose cap for bleomycin?
LIFETIME dose of 400 units
Dose cap for doxorubicin?
LIFETIME cumulative dose: 450 - 550 mg/m^2
Dose cap for cisplatin?
PER CYCLE do not exceed 100 mg/m^2
Dose cap for vincristine?
2 mg per single dose
Toxicities of Chemotherapy: MYLEOSUPPRESSION
— how to monitor?
CBC - complete blood count w/ differential
Temperature, bleeding, fatigue, shortness of breath
Most agents cause myleosuppression: except which ones?
- bleomycin
- vincristine
- TKIs
- monoclonal antibodies
what is the most emetogenic chemo agent?
cisplatin
what chemo agents very commonly cause mucositis?
- fluorouracil
- capecitabine (prodrug of 5-FU)
- irinotecan
- methotrexate
what cancer drugs cause cardiomyopathy?
- anthracyclines (doxorubicin)
- HER2 inhibitors (trastuzumab, pertuzumab)
what chemo agents very commonly cause diarrhea?
- fluorouracil
- capecitabine (prodrug of 5-FU)
- irinotecan
- many TKIs
what chemo agents very commonly cause constipation?
- vincristine
- pomalidomide
- thalidomide
what drug can be given to prophylactically prevent doxorubicin cardiomyopathy
dexrazoxane
what drugs cause QT prolongation?
mainly TKIs
what drugs commonly cause pulmonary fibrosis?
- bleomycin
- busulfan
- carmustine/lomustine
what drugs commonly cause nephrotoxicity?
- cisplatin
- methotrexate
what drugs cause hemorrhagic cystitis?
- ifosfamide (all doses)
- cyclophosphamide (high doses)
how to combat/prevent hemorrhagic cysitis?
give mesna and ensure adequate hydration
what drugs cause peripheral neuropathy?
- vinca alkaloids (vincristine, vinblastine)
- platinums (cisplatin, oxaliplatin)
- taxanes (paclitaxel, docetaxel)
what adjunctive medication should be given with cisplatin?
is is given to prevent ________
amifostine
prevent: nephrotoxicity
what adjunctive medication should be given with doxorubicin?
is is given to prevent ________
dexrazonxane
prevent: cardiomyopathy; treat extravasation
what adjunctive medication should be given with fluorouracil?
is is given to prevent ________
leucovorin
to enhance efficacy
what is the antidote for fluorouracil or capecitabine?
uridine triacetate
what adjunctive medication should be given with ifosfamide?
is is given to prevent ________
mesna
prevent hemorrhagic cystitis
what adjunctive medication should be given with irinotecan?
is is given to prevent ________
atropine or loperamide
prevent diarrhea
what adjunctive medication should be given with methotrexate?
is is given to prevent ________
leucovorin
to decrease myleosuppression, mucositis
what is the nadir?
lowest point of WBCs and platelets
usually about 7 - 14 days after chemo
examples of CSF? (colony stimulating factors)
filgrastim
pegfilgrastim (long acting)
sargramostim