Special Considerations

Question 1

How should Extravasation for anthracyclines be treated

Answer 1

Apply COLD COMPRESS and administer DEXRAZOXANE or topical dimethyl sulfoxide (DMSO)*

note: anthracyclines are DNA binding vesicants and not easily metabolized that can cause more tissue injury than non-DNA binding vesicants; cold compresses are used to constrict blood vessels and limit drug spread and cellular uptake

Question 2

How should Extravasation be treated for Vinca Alkaloids

Answer 2

apply WARM COMPRESSES and administer HYALURONIDASE*

note: vinca alkaloids are non-DNA binding vesicants and are more easily metabolized; warm compresses are used to increase local blood flow (vasodilation) which helps facilitate the extravasated drug from the tissues

Question 3

Intrathecally administered chemo should be free of…

Answer 3

preservative free

Question 4

what vaccinations should be avoided during chemotherapy

Answer 4

ALL VACCINATIONS (both inactivated and live)

Question 5

When chemo is planned, how many weeks ahead of time should vaccinations be given

Answer 5

≥ 2 weeks

Question 6

when should the inactivated seasonal influenza vaccine be given to patients receiving chemo

Answer 6

between chemotherapy cycles

Question 7

Live vaccines should not be administered to immunocompromised patients; but they can be administered:

Q: how many weeks prior
Q: how many months after discontinuation of chemo

Answer 7

1. ≥ 4 weeks before
2. at least 3 months after discontinuation