Side effects of chemotherapy

Question 1

Side effects of chemotherapy

Answer 1

Toxicity is dose-related, and primarily effects rapidly dividing cells (blood-forming cells in the bone marrow, hair follicles & cells in the mouth, digestive tract, and reproductive system).

Question 2

Chemotherapy-induced-nausea-and-vomiting (CINV)

Answer 2

are common side-effects of many cytotoxic drugs. CINV may cause considerable distress, leading in some cases to refusal to undergo further treatment, and can also result in serious metabolic disturbances.

Question 3

Anticipatory (occurring prior to treatment)

Answer 3

Lorazepam (BDZ) relieves anxiety associated with treatment

Question 4

Acute (occurring within 24 hours of treatment)

Answer 4

o	Granisetron (5HT3 antagonist)
o	Metoclopramide (D antagonist

Question 5

Delayed (between 24-72 hours post chemotherapy)

Answer 5

o	Dexamethasone (corticosteroid)
o	Metoclopramide (D antagonist)
o	Netupitant (NK1 antagonist) – very expensive so only given in cases of high emetogenic potential

Or just
Refractory - over 72 hours following chemotherapy

Question 6

Myelosuppression

Answer 6

Causative agent:
Epirubicin 
Cyclophosphamide
Docetaxel
5-FU

Question 7

Cardiotoxicity

Answer 7

Epirubicin
Cyclophosphamide
5-FU
Trastuzumab

Question 8

Nausea & Vomiting

Answer 8

Epirubicin (H)
Cyclophosphamide (M)
Docetaxel/5-FU/Tras (L)

Question 9

Alopecia

Answer 9

Epirubicin 69-95%
Cyclophosphamide 40-60%
Docetaxel 80%
5FU

Question 10

Peripheral Neuropathy

Answer 10

Docetaxel 42-70%

Question 11

Vesicant (causes blistering)

Answer 11

Epirubicin ++

Question 12

Hypersensitivity

Answer 12

Docetaxel

Trastuzumab

Question 13

Other side effects include:

Answer 13

• Fatigue
• Hair loss
• Easy bruising and bleeding
• Infection
• Anaemia (low red blood cell counts)
• Nausea and vomiting
• Appetite changes
• Constipation
• Diarrhoea
• Mouth, tongue, and throat problems such as sores and pain with swallowing
• Nerve and muscle problems such as numbness, tingling, and pain
• Skin and nail changes such as dry skin and colour change
• Urine and bladder changes and kidney problems
• Weight changes
• Chemo brain, which can affect concentration and focus
• Mood changes
• Changes in libido and sexual function
• Fertility problems