Treatment of cytotoxic induced SE Flashcards
What can be given to speed recovery from MTX-induced mucositis or myelosuppression?
‘folinic acid rescue’ with folinic acid (given as calcium folinate)
it counteracts the folate-antagonist action of MTX and thus speeds recovery from the above
Folinic acid, given as ………. is used to counteract the folate-antagonist action of methotrexate and thus speed recovery from methotrexate-induced mucositis or myelosuppression (‘folinic acid rescue’).
given as calcium folinate
What is used in the management of MTX overdose
Folinic acid together with other measures to maintain fluid and electrolyte balance, and to manage possible renal failure.
Does folinic acid counteract the abx activity of folate antagonists e.g. trimethoprim
No
Using folinic acid + FU together in metastatic colorectal cancer vs using FU alone - what is the advantage?
When folinic acid and fluorouracil are used together in metastatic colorectal cancer the response-rate improves compared to that with fluorouracil alone.
When is the calcium salt of levofolinic acid (calcium levofolinate) used instead of calcium folinate
also used for rescue therapy following methotrexate administration, for cases of methotrexate overdose, and for use with fluorouracil for colorectal cancer
The dose of calcium levofolinate is generally ….. that of calcium folinate
half
What is a common manifestation of urothelial toxicity
Haemorrhagic cystitis
Haemorrhagic cystitis is a common manifestation of urothelial toxicity which occurs the following 2
oxazaphosphorines, cyclophosphamide and ifosfamide
Haemorrhagic cystitis/urothelial toxicity is caused by which metabolite?
acrolein
Haemorrhagic cystitis/urothelial toxicity is caused by the metbaolite acrolein. The following drug reacts specifically with this metabolite in the urinary tract, preventing toxicity
Mesna
Mesna is routinely used (preferably PO) in patients receiving the following 3 scenarios
mesna is a drug that reacts with the metabolite acrolein which causes urothelial toxicity*
ifosfamide, and in patients receiving cyclophosphamide by the IV route at a high dose (e.g. more than 2 g) or in those who experienced urothelial toxicity when given cyclophosphamide previously.
Why should simultaneous use of radiotherapy be avoided with many cytotoxic abx e.g. anthracyclines?
Many cytotoxic antibiotics act as radiomimetics and simultaneous use of radiotherapy should be avoided because it may markedly increased toxicity
Anthracycline abx examples (4)
Daunorubicin, doxorubicin hydrochloride, epirubicin hydrochloride and idarubicin hydrochloride
1x anthracycline derivative example
Mitoxantrone i
