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PHRM 864 Exam 2 > Supportive Care 1 > Flashcards

Supportive Care 1 Flashcards

1
Q

Side effects of 5-HT3 antagonists

A

headache
constipation
EKG changes (do not exceed 16 mg)

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2
Q

Side effects of dexamethasone

A

anxiety
euphoria
insomnia
hyperglycemia
increased appetite

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3
Q

Side effects of NK-1 antagonists

A

hiccups
drug interactions

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4
Q

Side effects of D2 antagonists

A

EPS
diarrhea
sedation

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5
Q

Side effects of atypical antiphsycotics

A

dystonia
sedation
weight gain

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6
Q

Side effects of Phenothiazines

A

sedation
EPS

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7
Q

Side effects of Cannabinoids

A

drowsiness
dizziness
euphoria
mood changes
hallucinations
increases appetite

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8
Q

Side effects of Benzodiazepines

A

sedation
urinary incontinence
hypotension
hallucinations

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9
Q

Filgrastim

A

CSF

Administration: daily subQ

Initiation: 3-4 days after completion of chemo and continue post-nadir ANC recovery til normal

Effects: regulates production, maturation, and function of neutrophil cell line

SE: Flu-like symptoms
Bone and joint pain: treat with Tylenol, NSAIDS, loratadine, DVT

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10
Q

Pegfilgrastim

A

Administration: 1-time SubQ

Initiation: 24 hours after chemo up to 2-4 days after chemo
At least 2 weeks should be spent before next cycle of chemo

Effects: regulation production, maturation, function of neutrophil cell line

SE: Flu-like symptoms, bone and joint pain, DVT

Pearls: Non-linear PK increase clearance with increased neutrophil count

Offered in an on-body injector that is injected 24 hours after chemo

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11
Q

Filgrastim biosimilars

A

Filgrastim-sndz
Filgrastim-aafi
Filgrastim-ayow
TBO-FILGRASTIM IS NOT A BIOSIMILAR

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12
Q

Epoetin alfa

A

ESA

Frequency: SubQ weekly

Dose adjustments: If Hb has increased by > 1g/dL in a 2-week period–>decrease dose by 25%

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13
Q

Darbepoetin

A

Frequency: SubQ weekly or every 3 weeks

Dose adjustments: If Hb increase by > 1g/dL in a 2-week period–>decrease dose by 40%

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14
Q

Neutropenia

A

Normal: 4.8-10.8 x103

Severely low: < 0.5 x 103
neutropenia, leukopenia, gransulocytopenia

Febrile: < 0.5 x 103 AND temperature > 101 or > 100.4 for an hour

Risks: serious infections
Fever is the only reliable factor

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15
Q

Thrombocytopenia

A

Normal 140-440 x 103

Severely low: < 100 x 103

Transfusion required: < 10 x 103

Risks: bleeding

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16
Q

Anemia

A

Normal: 4.6-6.2 x 1012

Workup: Hb < 11g/dL OR > 2g/dL drop from baseline

Risks: hypoxia and fatigue

17
Q

ESA’s do not use

A

Patients receiving myelosuppressive chemo with curative intent

Patients receiving non-myelosuppressive chemo

Patients with cancer not receiving chemo

18
Q

ESA’s consider use in

A

Cancer + CKD

Palliative chemo

Without identifiable cause

19
Q

Type 1 Chemotherapy-related Cardiac Dysfunction ACUTE

A

Immediate after a single dose
Uncommon, transient
Abnormal EKG changes, QTc prolongation, ST-T wave changes, arrhythmias

NOT RELATED TO CUMULATIVE DOSE

20
Q

Type 1 Chemotherapy-related cardiac dysfunction CHRONIC

A

Occurs within a year
Common, life-threatening
Rapid onset, progressive, irreversible

RELATED TO CUMULATIVE DOSE
DO NOT RECHALLENGE

21
Q

Type-2 Chemotherapy-Related Cardiac dysfunction

A

NOT RELATED TO CUMULATIVE DOSE
MAY RECHALLENGE
Not associated with cardiac damage–>reversible

22
Q

Myalgias/Arthralgia’s

A

Cause: Taxanes, Aromatase inhibitors
Solution: NSAIDS, Opioids

23
Q

Hemorrhagic cystitis

A

Cause: Cyclophosphamide, ifosfamide
Solution: MESNA, Hydration

24
Q

Heart failure

A

Cause: doxorubicin, cyclophosphamide, HER2 targeted therapies

Solution: monitor cumulative dose, risk factors, dexrazoxane

25
Q

Peripheral neuropathy

A

Cause: Vinca alkaloids, taxanes, platinum
Solution: change infusion rates, gabapentin, amitriptyline

26
Q

Pulmonary toxicities

A

Cause: Bleomycin
Solution: Corticosteroids

PHRM 864 Exam 2 (17 decks)

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