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NAPLEX 2022 > ONCOLOGY SE MENAGEMENT > Flashcards

ONCOLOGY SE MENAGEMENT Flashcards

1
Q

WHAT IS NADIR AND WHEN DOES IT OCCUR DURING CHEMOTHERAPY

A

THE LOWEST POINT THAT WBC AND PLATELETS REACH
OCCURS ABOUT 7-14 DAYS AFTER CHEMO

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2
Q

HOW LONG DOES IT TAKE FOR WBC AND PLATELETS TO RECOVER

A

3-4 WEEKS POST TREATMENT

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3
Q

NEUTROPENIA AT WHAT ANC?

A

< 1000 CELLS/MM3

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4
Q

SEVERE NEUTROPENIA AT WHAT ANC

A

< 500 CELLS/MM3

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5
Q

WHAT ARE G-CSFs AND THEIR NAMES?

A

GROWTH COLONY STIMULATING FACTORS STIMULATE WBC PRODUCTION
FILGRASTIM AND PEGFILGRASTIM

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6
Q

WHEN ARE CSFs GIVEN AND WHY?

A

GIVEN PROPHYLACTICALLY AFTER CHEMO TO SHORTEN TIME A PT IS AT RISK FOR INFECTION AND REDUCE MORTALITY FROM INFECTION.
PREVENT NEUTROPENIA

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7
Q

G-CSF SIDE EFFECTS

A

BONE PAIN, FEVER, ARTHRALGIAS, MYALGIAS, RASH

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8
Q

WHAT IS FEBRILE NEUTROPENIA

A

WHEN A FEVER IS PRESENT IN A NEUTROPENIC PATIENT.
AT RISK OF DEATH FROM SEPSIS

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9
Q

FEBRILE NEUTROPENIA DIAGNOSIS REQUIREMENTS

A

ORAL TEMP > 38.3 C
ANC < 500

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10
Q

FEBRILE NEUTROPENIA EMPIRIC ANTIBIOTICS STARTED WHEN AND COVER WHAT?

A

IMMEDIATELY AFTER FEVER OCCURS
SHOULD HAVE ADEQUATED GN COVERAGE, INCLUDING PSEUDOMONAS

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11
Q

FEBRILE NEUTROPENIA ABX FOR LOW RISK

A

LOW RISK = ANC < 500 FOR ≤ 7 DAYS AND NO COMORBIDITIES
ORAL ANTI-PSUDOMONAL: (CIPRO OR LEVO) + (AUGMENTIN OR CLINDAMYCIN)

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12
Q

FEBRILE NEUTROPENIA ABX FOR HIGH RISK

A

HIGH RISK = ANC < 100 FOR ≥10 DAYS AND COMORBIDITIES OR RENAL OR HEPATIC IMPAIRMENT
IV ANTI-PSEUDOMONA BETA-LACTAM (CEFEPIME, CEFTAZIDIME, MEROPENEM, IMI/CILASTATIN, PIP/TAZO)

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13
Q

WHAT ARE ESAs

A

ERYTHROPOIESIS-STIMULATING AGENTS
EPOETIN-ALFA (EPOGEN, PROCRIT) AND DARBEPOETIN ALFA (ARANESP)
STIMULATE RBC

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14
Q

WHEN TO GIVE ESAs

A

FOR PALLIATIVE ONLY
WHEN HGB < 10

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15
Q

RISK FACTORS FOR N&V

A

FEMALE
<50 YEARS
ANXIETY/DEPRESSION
DEHYDRATION
HX OF N&V (MOTION, PRIOR CHEMOS)

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16
Q

FOR CINV, WHEN DOES ONE ADMINISTER ANTIEMETICS

A

AT LEAST 30 MINUTES PRIOR TO CHEMOTHERAPY
PROVIDE TAKE-HOME ANTIEMETICS FOR BREAKTHROUGH

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17
Q

ACUTE CINV MANAGEMENT

A

ONSET WITHIN 24 HOURS AFTER CHEMO
5HT3-RA
NK1-RA
DEXAMETHASONE
OLANZAPINE

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18
Q

DELAYED CINV MANAGEMENT

A

ONSET > 24 HOURS AFTER CHEMO
NK1-RA
CORTICOSTEROIDS
PALONOSETRON
OLANZAPINE

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19
Q

WHICH CHEMO AGENT HAS THE HIGHEST EMETIC RISK POTENTIAL

A

CISPLATIN

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20
Q

WHAT IS THE PROPHYLACTIC REGIMEN IF THERE IS A HIGH-EMETIC RISK

A

3 OR 4 DRUGS
1) NK1-RA + 5HT3-RA + OLANZAPINE + DEXAMETHASONE
2) PALONOSETRON + OLANZAPINE + DEXAMETHASONE
3) NK1-RA + 5HT3-RA + DEXAMETHASONE

21
Q

WHICH CLASSES CAN BE USED FOR BREAKTHROUGH CINV

A

5HT3-RA
DA-R ANTAGONISTS
CANNABINOIDS
OLANZAPINE

22
Q

NK1-RA - WHAT ARE THEY?

A

SUBSTANCE P/NEUROKININ 1 RECEPTOR ANTAGONISTS
AUGMENTS THE ACTIVITY OF 5HT3-RA AND CORTICOSTEROIDS
APREPITANT AND FOSAPREPITANT (EMEND)

23
Q

NK1-RA DDI NOTE

A

NK1-RAs ARE CYP3A4 INHIBITORS
NEED TO DECREASE DEXAMETHASONE DOSE (CYP3A4 SUBSTRATE) IF USED CONCURRENTLY

24
Q

WHICH 5HT3-RA IS AVAILABLE AS A PATCH?

A

GRANISETRON

25
Q

5HT3-RA CONTRAINDICATION

A

DO NOT USE WITH APOMORPHINE

26
Q

5HT3-RA WARNINGS

A

QT PROLONGATION
SEROTONIN SYNDROME WITH OTHER SEROTONERGIC AGENTS

27
Q

WHICH 5HT3-RA IS AVAILABLE AS COMBO AGENTS?

A

PALONOSETRON WITH NETUPITANT

28
Q

WHICH DA RECEPTOR ANTAGONISTS ARE USED FOR CINV

A

PROCHLORPERAZINE
PROMETHAZINE
METOCLOPRAMIDE
OLANZAPINE

29
Q

PROMETHAZINE BOXED WARNING

A

DO NOT USE IN CHILDREN < 2 YO (RESPIRATORY DEPRESSION)
DO NOT GIVE INTRA-ARTERIAL OR SC DUE TO SERIOUS TISSUE INJURY. DEEP IM PREFERRED

30
Q

METOCLOPRAMIDE BOXED WARNING

A

TD THAT CAN BE IRREVERSIBLE. DC AT FIRST SIGNS

31
Q

CHEMOTHERAPY INDUCED DIARRHEA MANAGEMENT

A

LOPERAMIDE (MAX 16 MG/DAY)
DIPHENOXYLATE + ATROPINE

32
Q

WHICH AGENTS COMMONLY CAUSE DELAYED ONSET CHEMO INDUCED DIARRHEA

A

FLUOROURACIL
CAPECITABINE
IRINOTECAN

33
Q

WHICH CHEMO AGENT CAUSES EARLY ONSET DIARRHEA? WHAT OTHER SYMPTOMS ACCOMPANY THIS?

A

IRINOTECAN
CHOLINERGIC EXCESS (CRAMPING, RHINITIS, LACRIMATION, SALIVATION)
TREAT W/ ANTICHOLINERGIC ATROPINE

34
Q

WHICH CHEMO AGENTS ARE LIKELY TO CAUSE HAND-FOOT SYNDROME

A

CAPECITABINE, FLUOROURACIL

35
Q

TUMOR LYSIS SYNDROME ELECTROLYTE ABNORMALITY

A

HYPERKALEMIA
HYPERPHOSPHATEMIA
HYPOCALCEMIA
HYPERURICEMIA

36
Q

WHAT AGENT IS USED TO PREVENT HYPERURICEMIA CAUSED BY TLS

A

ALLOPURINOL - XANTHINE OXIDASE INHIBITOR TO PREVENT PURINES (FROM THE LYSED CELLS) FROM BEING CONVERTED TO URIC ACID AND DAMAGING THE KIDNEYS
RASBURICASE CAN BE USED WHEN ALLOPURINOL IS NOT ADEQUATE OR ALLUPURINOL-INDUCED RASH HAS OCCURRED

37
Q

WHY DOES HYPERCALCEMIA OCCUR IN CANCER?

A

CERTAIN CANCERS CAUSE CA TO LEACH FROM THE BONE CAUSING HYPERURICEMIA AND BONES THAT ARE WEAK

38
Q

MILD HYPERCALCEMIA MANAGEMENT

A

ASYMPTOMATIC
HYDRATION AND LOOP DIURETICS

39
Q

MOD-SEV HYPERCALCEMIA MANAGEMENT

A

N/V, FATIGUE, DEHYDRATION, CONFUSION
CA > 12
IV HYDRATION WITH NS, CALCITONIN
IV BISPHOSPHONATES OR DENOSUMAB

40
Q

WHICH BISPHOSPHONATES ARE IV

A

PAMIFRONATE
ZOLEDRONIC ACID

41
Q

PREMEDICATIONS FOR MONOCLONAL ANTIBODY TREATMENTS

A

APAP AND DIPHENHYDRAMINE

42
Q

MOST CHEMO AGENTS ARE MAJOR VESICANTS, NAME THE 2 BIG GROUPS

A

ANTHRACYCLINES
VINCA ALKALOIDS

43
Q

IF EXTRAVASATION OCCURS WHAT SHOULD BE DONE? WHAT IS THE EXCEPTION?

A

COLD COMPRESSES
EXCEPT VINCA ALKALOIDS AND ETOPOSIDE, USE WARM COMPRESS

44
Q

WHAT IS THE ANTIDOTE IN THE EVENT OF ANTHRACYCLINE EXTRAVASATION

A

DEXRAZOXANE
DIMETHYL SULFOXIDE

45
Q

WHAT IS THE ANTIDOTE IN THE EVENT OF VINCA ALKALOID OR ETOPOSIDE EXTRAVASATION

A

HYALURONIDASE

46
Q

WHICH CHEMO DRUGS CAN BE GIVEN INTRATHECALLY

A

CYTARABINE
METHOTREXATE
HYDROCORTISONE
THIOPTA

47
Q

ALL MEDICATIONS THAT ARE GIVEN INTRATHECALLY SHOULD NOT HAVE WHAT?

A

PRESERVATIVES

48
Q

WHICH CHEMO AGENT IF GIVEN INTRATHECALLY IS FATAL

A

VINCRISTINE

NAPLEX 2022 (37 decks)

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