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Oncology I-III

Oncology Side Effects & GI Complications

what are the three common chemo induced gastrointestinal complications? 1- damage to epithelium of the GI track --> diarrhea 2- damage to oral mucosal epithelium --> mucositis 3- damage to the salivary glands --> xerostomia
What are the common complications of chemo induced diarrhea CID? 1- dehydration 2- electrolyte imbalance
What are the drug(s) of choice to treat chemo induced diarrhea? 1- loperamide 2- diphenoxylate + atropin
what is the different in loperamide dosing in CID? - usual max dose of loperamide is 16 mg/day - in CID max is 24 mg/day
What are some COMMON chemo agents that cause DELAYED CID? - fluorouracil - capecitabine
What is the main factor that increases the risk of CID while using fluorouracil and capecitabine? - leucovorin - pt has DPD deficiencies
what is a common chemo agent that cause acute onset of CID? - irrinotecan - during the infusion combined with cholinergic sxs
what is the recommended treatment of irrinotecan induced diarrhea and cholinergic sxs? - anti cholinergic drug 1- benzoatropine 2- diphenhydramine
what are chemo class that commonly cause diarrhea? - VEGFR - EGFR 1- sorafenib 2- sunitinib
what is the common drug caues CID? - fluorouracil - capecitabine - irrinotecan - VEGFR - EGFR
what is the onset of oral mucositis ? - peaks after a week - resolves within 4-8 days
what is the recommended prevention of chemo induced mucositis? - NO RECOMMENDATION
what are some complications a patient with oral mucositis may experience ? - herpes simplex virus - candida spp
what is the recommendation for oral pain and discomfort in patient with chemo induced oral mucositis? - mucosal barrier - anesthetic
what are some mucosal barrier medications ? - mucosal barrier: 1- gel 2- spray 3- solution 4- wafer
what are some anesthetic drug to treat chemo induced mucositis pain ? - lidocaine 2% solution
what are some common side effects of mucosal barrier? - burning - stinging sensation
what is the recommended dose of lidocaine 2% solution in chemo induce mucositis oral pain? 15 ml wish/ spit every 3 hrs PRN
Why the use of lidocaine 2% solution is not recommended ( avoided BBW) in patients 3 years old or younger? - seizure risk - cardiopulmonary arrest - death
what are some serious side effects of high dose lidocaine 2% solution? - high plasma level--> seizure and cardiopulmonary arrest
what are some of the lidocaine 2% solution side effects? - dizziness - drowsiness - confusion - hypotension
what are some of the recommendation a patient should follow if taking lidocaine 2%? - avoid ingestion for 60 min 2/2 swallowing and aspiration impairment
what is the recommended treatment in chemo induced xerostomia? - artificial saliva substituent - pilocarpine
which xerostomia drug requires dose adjustment in patient with hepatic impairment? - Pilocarpine - 5-10 mg/3X --> 5mg/2X - Avoid in SEVERE impairment - AVOID GIVEN with HIGH FAT meal
what are some common side effect of pilocarpine ? - cholinergic 1- flushing 2- sweating 3- nausea 4- urinary frequency
which disease states require caution of using pilocarpine? - CV - Respiratory ( COPD and asthma) - GI-stones ( choleithiasis and nephrolithiasis )
Created by: Smoham38



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