Specific drug toxicity

Question 1

doxorubicin

Answer 1

Dysrhythmias 
Cardiomyopathy (DCM) - Give over 20-30 min, Monitor by echo., Care if pre-existing Dz, Risk increases at cumulative doses >180mg/m2 
Mast cell degranulation 
GI (colitis) 
Vesicant if perivascular 
Cats - ?nephrotoxic

Question 2

Cyclophosphamide

Answer 2

Haemorrhagic cystitis

Question 3

Cyclophosphamide - prevention of side effects

Answer 3

Monitor 
Free access to water 
Opportunity to urinate 
Furosemide with high doses 
Avoid prolonged courses

Question 4

Cyclophosphamide - treatment of side effects

Answer 4

Analgesia
Oxybutinin
DMSO

Question 5

vincristine

Answer 5

Peripheral neuropathies
Ileus (abdominal pain)
Constipation – Metoclopramide / ranitidine
Skin sloughs if perivascular injection

Question 6

lomustine

Answer 6

Hepatotoxic – monitor ALT, SAMe

Potentially nephrotoxic – monitor renal function (SG) and dipstick for glucosuria

Question 7

platinum drugs

Answer 7

Cisplatin is nephrotoxic
Carboplatin is preferable
Nausea via CTZ
cats - Cisplatin causes fatal pulmonary oedema, 5-FU causes neurotoxicity

Question 8

herding breeds

Answer 8

Collies, Shelties, Australian Shepherd, LH Whippets can have increased susceptibility to vincristine and doxorubicin due to mutated MDR1 gene
Poor drug excretion
PCR test

Question 9

prednisolone

Answer 9

PD, PU, PP, panting, muscle weakness,

slow healing, immunosuppression

Question 10

L-asparaginase

Answer 10

Possible anaphylactic reactions