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HANA Part 4 – PM4B > (SYNOPTIC) Complications of Chemotherapy > Flashcards

(SYNOPTIC) Complications of Chemotherapy Flashcards

1
Q

What are the two main routes of administration for chemotherapy drugs?

A

Orally or IV

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2
Q

Briefly, what is the rationale of chemotherapy with multiple drugs?

A
  • Use drugs with synergistic effects
    ø e.g. 5-fluorouracil + oxaliplatin
  • Combination of drugs that kill cancer cells at different stages of the cell cycle
  • Alternating cycles of different combinations
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3
Q

What do conventional chemotherapy treatments target?

A

Rapidly dividing cells

Not cancer cell specific

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4
Q

What are the effects of chemotherapy on the bone marrow?

A
  • Immunosuppression
  • Bleeding
  • Anaemia
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5
Q

What are the effects of chemotherapy on the chemoreceptor trigger zone?

A

N+V

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6
Q

What are the effects of chemotherapy on the GIT?

A
  • Ulceration
  • Diarrhoea
  • Mucositis
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7
Q

What are the effects of chemotherapy on the NS?

A

Neuropathy

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8
Q

What are the effects of chemotherapy on the heart?

A

Cardiomyopathy

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9
Q

What are the effects of chemotherapy on the liver?

A

Cirrhosis + fibrosis

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10
Q

What are the effects of chemotherapy on the kidney?

A

Nephrotoxicity

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11
Q

What are the effects of chemotherapy on the bladder?

A

Haemorrhagic cystitis

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12
Q

What are the effects of chemotherapy on the lungs?

A

Pulmonary fibrosis

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13
Q

What are the effects of chemotherapy on the hair follicles?

A

Alopecia

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14
Q

Which organs/ systems do most chemotherapy drugs affect?

A

(1) Bone marrow

(2) GIT

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15
Q

Which monitoring is most important when trying to minimise side effects of chemotherapy?

A

FBCs

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16
Q

Why is pre and post-hydration so important in chemotherapy?

A

To reduce contact time + urine concentration

High urine output required for 24hrs post-treatment

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17
Q

What is myelosuppression?

A

Fewer red/ white blood cells + platelets

As a result of decreased bone marrow activity

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18
Q

How can myelosuppression, as a side effect of chemotherapy, be minimised?

A
  • Transfusions
  • Growth factors
  • Timing of doses + careful monitoring
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19
Q

What is Filgrastim?

A

Type of growth factor

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20
Q

What is acute N+V?

A

Experienced in 24hr window after chemotherapy treatment

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21
Q

What duration is delayed N+V?

A

24hrs-> 6-7 days

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22
Q

What is anticipatory N+V?

A

Occurs prior to the beginning of a new cycle

Learned behaviour from anxiety

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23
Q

What is breakthrough N+V?

A

Development of symptoms despite standard anti-emetic therapy

Requires additional pharmacological management

24
Q

What is refractory N+V?

A

Patients who are still experiencing symptoms despite being on both standard and rescue medication

25
Q

What are some low N+V risk chemotherapy regimens?

A
  • Single agent fluorouracil regimens

- Dopamine antagonist alone

26
Q

What medicine is given TTA for diarrhoea prophylaxis, following chemotherapy treatments?

A

Loperamide

27
Q

How can mucositis be prevented in chemotherapy patients?

A

Difflam/ chlorhexidine mouthwash

28
Q

What are the performance status categories of chemotherapy patients?

A

(0) No symptoms
(1) Symptomatic but normal daily activities
(2) Symptomatic, in bed less than 1/2 the day
(3) Symptomatic, in bed >1/2 the day
(4) Bedridden

29
Q

What is the term for bone marrow suppression?

A

Myelosuppression

30
Q

When are FBCs taken in chemotherapy treatment?

A

Prior to administration of every cycle

31
Q

Where do most infections that chemotherapy patients get originate from?

A

Endogenous gut/ skin organisms

32
Q

What is tumour lysis syndrome?

A

Chemotherapy causes mass cell lysis

Uric acid + electrolytes released as they breakdown

33
Q

What is the pharmacological treatment of tumour lysis syndrome?

A

Allopurinol or rasburicase

Helps to promote excretion of uric acid

34
Q

Name 3 platinum chemotherapy drugs.

A

(1) Cisplatin
(2) Carboplatin
(3) Oxaliplatin

35
Q

What types of toxicity do platinum drugs cause?

A

Ototoxicity and nephrotoxicity

36
Q

What is aprepitant?

A

Anti-emetic used in chemotherapy N+V treatment

NK1 inhibitor

37
Q

What is an aprepitant licensed for use with?

A

Conjunction with dexamethasone and 5HT-3 antagonist

  • Ondansetron/ granisetron
38
Q

Name some examples of 5HT3 antagonists.

A

(1) Ondansetron

(2) Granisetron

39
Q

What is methotrexate?

A

Anti-folate

40
Q

What type of toxicity does methotrexate cause?

A

Nephrotoxicity

41
Q

What supplement is required, in chemotherapy, in conjunction with methotrexate treatment?

A

Folinic acid

NOT folic acid

42
Q

Name some examples of anti-metabolites.

A

(1) 5-fluorouracil

(2) Capecitabine

43
Q

What is the most common side effect of anti-metabolite use as a chemotherapy agent?

A

Diarrhoea

Palmar-plantar erythema (PPE) with capecitabine

44
Q

How do vinca alkaloids function?

A

Inhibit spindle formation

45
Q

What type of toxicity do vinca alkaloids tend to cause?

A

Neurotoxicity

46
Q

What is the most common side effect of vinca alkaloid use as a chemotherapy agent?

A

Constipation

47
Q

What are some examples of nitrogen mustards?

A

(1) Cyclophosphamide

(2) Ifosfamide

48
Q

What is the most common side effect of nitrogen mustard use as a chemotherapy agent?

A

Haemorrhagic cystitis

49
Q

What receptor does trastuzumab target?

A

HER2 receptor

Thought to selectively target cancer cells

50
Q

What is a potential side effect of trastuzumab?

A

Selectively targets HER2 receptors

HER2 receptors also present in myocardium

51
Q

What is extravasation?

A

Complication of IV injection therapy

Tissue damage/ irritation

52
Q

What is a drug classified as if it causes direct damage to vasculature?

A

Vesicant

53
Q

What is a vesicant?

A

A drug that causes damage directly to vasculature

54
Q

What is a side effect of a vesicant?

A

Extensive necrosis

55
Q

How can the risk of extravasation be minimised?

A

(1) Correct reconstitution to avoid damaging concentrations
(2) Optimal location is usually forearm
(3) Limb should be elevated w/ gentle pressure as needle is withdrawn

56
Q

If multiple vesicant drugs are required, how should they be administered?

A

3-5mL saline flush between each drug

HANA Part 4 – PM4B (28 decks)

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