Supportive care

Question 1

Indications for prmiary prophylaxis of GCSF

Answer 1

Expected neutropenia of > 20%

pateient > 65 years with agressive lymphoma and curative intent

Question 2

Indications for secondary prophylaxis of GCSF

Answer 2

Previous episode of neutropenic fever if reduced dose intensity might compromise treatment outcome

Question 3

GCSF for neutropenic fever

Answer 3

Prolonged (>10 days) or profound (<100 cells/microL) neutropenia, age >65, pneumonia or other clinically documented infections, sepsis syndrome, invasive fungal infection, prior episode of febrile neutropenia, or being hospitalized at the time of the development of fever.

Question 4

GCSF for neutropenic fever

Answer 4

Prolonged (>10 days) or profound (<100 cells/microL) neutropenia, age >65, pneumonia or other clinically documented infections, sepsis syndrome, invasive fungal infection, prior episode of febrile neutropenia, or being hospitalized at the time of the development of fever.

Question 5

Paloxi dosage

Answer 5

IV 0.25 mg- 30 min prior to chemo

There is no oral drug in Israel

Question 5

Paloxi dosage

Answer 5

IV 0.25 mg- 30 min prior to chemo

There is no oral drug in Israel

Question 6

Paloxi side effect

Answer 6

CV- Bradycardia, 1st degree AVB, QT prolongation- risk is minimal even with X9 dosage.
Hypersnsitivity
Serotonin syndrome- combination with SSRI, SNRI, Miro

Question 7

Paloxi half life

Answer 7

~40 hours

Question 8

Akynzeo dosage

Answer 8

1 capsule-
Netupitant 300 mg and
Palonosetron 0.5 mg

1 hour prior to chemo

Question 8

Akynzeo dosage

Answer 8

1 capsule-
Netupitant 300 mg and
Palonosetron 0.5 mg

1 hour prior to chemo

Question 9

Akynzeo half life

Answer 9

80 hours

Question 10

Akynzeo bioavailavbilty

Answer 10

97%

Question 11

Akynzeo Time to peak

Answer 11

~4-5 hours

Question 12

Pramin side effects

Answer 12

Anxiety
Depression
Restlessness 
Akathisia
Dystonia
Tardive dyskinesia

Question 13

5-HT3 blockers

Answer 13

Ondansetron
Granisetron
Dolasetron
Palonosetron

Question 14

5-HT3 side effects

Answer 14

Headache

Question 15

NK1 receptor antagonists

Answer 15

Oral aprepitant
IV fosaprepitant
Oral netupitant (combined with palonosteron in Akynzeo)
Oral rolapitant

Question 16

Metabolism of NK1 antagonists

Answer 16

CYP3A4

resulting in a need for many dose reductions of medications

Question 17

Dosage of GCSF

Answer 17

Filgrastim (Neupogen, Tevagrastim)- 5 mcg/kg/day for up to 14 days
Pegfilgrastim- (Fulphila)- 6 mg once- 24 hours after end of chemo

Question 18

GCSF side effects

Answer 18

Osteoalgia
Capillary leak syndrome
ARDS
Aortitis
Cutaneous vasuculitis
Gleumerolunephritis
Splenic rupture
MDS

Question 19

Filgrastim time of onset

Answer 19

1-2 days

Question 20

Evusheld machanism fo action

Answer 20

Tixagevimab and cilgavimab

Human IgG1κ monoclonal antibodies

Question 21

Evusheld dosage

Answer 21

300 mg /300 mg

every 6 months