Supportive Therapies and Palliative care Flashcards
Name class of antiemetic: cyclizine
Histamine receptor antagonist
Name class of antiemetic: ondansetron
Serotonin (5HT) antagonist
Name class of antiemetic: metoclopramide
Dopamide (D2) receptor antagonist
Name class of antiemetic: Levomepromazine
Broad spectrum histamine, dopamine and serotonin antagonist
Name class of antiemetic: aprepitant
Neurokinin (NK1) antagonism, predominantly responsible for the central mechanism of emesis
What are recognised risk factors for chemotherapy induced nausea and vomiting
Female, age <50 years, previous chemo induced nausea and vomiting, hyperemesis, history of anxiety, expectancy of nausea and vomiting, low alcohol intake.
Do you need to dose reduce zometa for hypercalcaemia?
Not unless cr >400
What would be the first line mangement of itching associated with biliary obstruction?
Colestyramine then ursedeoxycholic acid. Second line options include sertraline, paroxetine and rifampicin.
What medication may be helpful in the use of uraemic pruritis?
Gabapentin
What electrolyte disturbance is expected in TLS?
High phosphate, high urate, high potassium, high LDH low calcium and often renal impairment.
What pharmacological treatments can be used to prevent chemotherapy induced neuropathy?
No proven pharmacological treatments, some evidence for cryotherapy with taxanes.
What transferrin saturation level suggests functional iron deficiency?
<20%
What pain block is useful for pelvic pain
Superior hypogastric block
What pain block is useful for visceral perineal pain
Ganglion impar block
What pain block is useful for tumour invasion of peripheral nerve plexus?
Spinal neurolytic block
What SAAG is indicative of ascites secondary to peritoneal disease
SAAG <11
Which chemotherapy drugs are most likely to cause hair loss?
Taxanes, etoposide, epirubicin, irinotecan, cyclophosphamide
When would you choose ganglion impar block over saddle block?
Where continence is preserved as saddle block will lead to incontinence.
Name 2 highly emetic chemotherapy regimes?
Anthracycline/cyclophosphamide and Cisplatin
Name 3 moderately emetic chemotherapy drugs?
Ifosfamide, irinotecan, carboplatin, doxorubicin/epirubicin, oxaliplatin
Naloxone should be administered at what RR?
If less than 8 breaths/min
Treatment option for tenesmus in locally advanced rectal cancer?
Consider smooth muscle relaxant such as nifedipine, neuropathic agents or nerve block
