Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Oncology I-IV
Oncology Side Effects, Hand& Foot Syndrome, Hypercalcemia, and Extravasation
| Term | Definition |
|---|---|
| What is palmar-plantar erythrodysesthesia? | - hand- foot syndrome - Chemo induced |
| what are the common chemo agents that cause hand-foot syndrome? S2C2FL | - fluorouracil - capecitanine - cytarabine - liposomal doxorubicine - sorafenib - sunitinib |
| what are the common sxs of hand-foot syndrome? | - redness - swelling - tenderness - pain - blister - peeling of the palms and soles |
| what are some management approaches of hand- foot syndrome in patient showing no improvement ? | - delay the tx - reduce the chemo dose |
| how are the following sxs of chemo induced hand-foot syndrome managed? 1- temporary relief of pain and tenderness 2- moisturizing 3- alleviate inflammation and pain? | 1- cooling compresses 2- emollients 3- steroid |
| what are some important patient counseling as PREVENTION to chemo induced hand-foot syndrome? | - limit activity ( heat/ frication) 1 week after IV chemo ( fluorouracil) - limit activity ( heat/ friction) during the exposure ( capecitabine) |
| what are some important patient counseling as PREVENTION to chemo induced hand-foot syndrome? | 1- avoid hot water 2- shower with warm/luke water 3- avoid using washing gloves 4- avoid increasing pressure activity on soles of feet and palms of hands |
| what are the common cancer types that increase the risk of hypercalcemia? | - breast cancer - lung cancer - multiple myeloma |
| what are the common sxs of chemo induced hypercalcemia? | - nausea/vomiting - fatigue - dehydration --> volume depletion --> renal failure - altered mental status |
| what is the goal of treating patient with chemo induced hypercalcemia? | - hydration - chem ---> hypercalcemia --> intravascular volume depletion --> renal failure |
| What is the cutoff for mild, moderate and severe hypercalcemia? | - mild: corrected Ca <12 + no sxs - moderate/severe : corrected Ca> 12 OR sxs |
| What is the management plan for patient with mild vs. moderate/severe chemo induced hypercalcemia? | - mild: ORAL/IV normal saline - moderare/ severe: IV normal saline |
| what is the management steps in patient with chemo induced hypercalcemia? | - hydration with normal saline - after correction of volume depletion -->start pt on LOOP diuretics - if pt is moderate/severe --> start pt on IV bisphosohonates or denosumab ( if pt can't tolerate or no response) - start calcitonin in sxs pt |
| why loop diuretics such as furosemide is given to pt with chemo induced hypercalcemia? | - after correcting the patient hydration status using normal saline - loop diuretics helps with increasing the renal calcium excretion |
| When is the use of IV bisphosphonate is indicated? | in patient with moderate/severe chemo induced hypercalcemia - corrected Ca>12 and/or sxs |
| what is an alternative to IV bisphosphonate in patient with chemo induced hypercalcemia? | - denosumab --> for pt can't tolerate bisphosphonate OR no response to bisphosphonate therapy |
| when is the level of Ca expected to be lower after the use of IV bisphosphonate or Denosumab? | within 1-3 days |
| what is the drug of choice to add to the current chemo induced hypercalciemia regimen in SXS patient ? | - hydration + furosemide + denosumab or bisphosphonate - add Calcitonin ( as it lowers calcium within 2-6 hrs) |
| what is the important consideration in using calcitonin in chemo induced hypercalciemia patient? | - TACHYPHYLAXIS --> sudden drop of response to the drug - happens 2/2 repeated dosing - goal is to limiti the use to only 48 hrs |
| what is resorption of bone ? | - the break down the tissue in bones and release the minerals - resulting in a transfer of calcium from bone tissue to the blood. |
| what is the main MOA of loop diuretics & calcitonin in correcting Ca level in patient with chemo induced hypercalciuma? | - Loop diuretics: increases the renal calcium excretion - calcitonin: inhibit resorption + increases renal excretion |
| why the use of calcitonin is limited to only 48 hours? | because of tachyphylaxis risk |
| what is the recommended management in patient with moderate/severe chemo induced hypercalciemia? | - hydration - loop diuretics - bisphosphonate or denosumab - start calcitonin no more than 48 hrs ( MAX DURATION IS 2 DAYS ) |
| How the corrected calcium calculated? | - corrected calcium= calcium ( reported) + {{( 4- albumin) * 0.8 mg/dL ]} |
| What is the recommended dose of calcitonin in moderate/severe hypercalcium chemo induced? | - 4-8 units/Kg - IM/SC - Q 12hr |
| What are some example IV bisophosnates? (IV ROUTE) | - zoledronic acid - Pamidronate |
| Why Zoledronic acid should be INFUSED OVER >>> 15 min? | due to the risk of renal toxicity |
| what is the important consideration in using calcitonin in chemo induced hypercalciemia patient? | - TACHYPHYLAXIS --> sudden drop of response to the drug - happens 2/2 repeated dosing - goal is to limiti the use to only 48 hrs |
| what is resorption of bone ? | - the break down the tissue in bones and release the minerals - resulting in a transfer of calcium from bone tissue to the blood. |
| what is the main MOA of loop diuretics & calcitonin in correcting Ca level in patient with chemo induced hypercalciuma? | - Loop diuretics: increases the renal calcium excretion - calcitonin: inhibit resorption + increases renal excretion |
| why the use of calcitonin is limited to only 48 hours? | because of tachyphylaxis risk |
| what is the recommended management in patient with moderate/severe chemo induced hypercalciemia? | - hydration - loop diuretics - bisphosphonate or denosumab - start calcitonin no more than 48 hrs ( MAX DURATION IS 2 DAYS ) |
| How the corrected calcium calculated? | - corrected calcium= calcium ( reported) + {{( 4- albumin) * 0.8 mg/dL ]} |
| What is the recommended dose of calcitonin in moderate/severe hypercalcium chemo induced? | - 4-8 units/Kg - IM/SC - Q 12hr |
| What are some example IV bisophosnates? (IV ROUTE) | - zoledronic acid - Pamidronate |
| Why Zoledronic acid should be INFUSED OVER >>> 15 min? | due to the risk of renal toxicity |
| what makes zolderonic acid dosing in hypercalcemia ( zometa) different that zolderonic acid dosing in osteoporosis ( reclast)? | Zometa: 4mg IV once OVER 15 min infusion --> can repeat every week ( hypercalciuma) Reclast: 5 mg IV Q year ( osteoporposis) *** if zolderonic acid is used to tx pt for hypercalciuma --> no renal adjustment needed in mild- moderate pt |
| what is the dosing of pamidronate ( Aredia) in patient with hypercalciuma? | 60-90 mg IV over 2-24 hr may repeat in week |
| what is the recommended management in patient with mild chemo induced hypercalciemia? | - hydration - loop diuretics - IV bisphosphonate |
| What is the MOA of Denosumab ( Xgeva) in patient with hypercalciuma? | - blocks RANKL and RANK - inhibits the osteolcalst formation |
| what makes the dosing of denosumab ( Xgeva) in hypercalciuma different than osteoporosis ( prolia) dosing? | - hypercalciuma: 120 mg SC ( day 1,8, 15 of 1st month) --> every month - osteoporsis: 60 mg SC every 6 months |
| what are some consideration while handling chemo drugs in particular vesicants? | - vesicants induced extravasation - leakage of vesicants --> tissue necrosis ( extravasation) *** 1- deliver via central venous catheters *** 2- fresh started peripheral IV line |
| what are the two main vesicant drug classes? | - anthracyclines - vinca alkaloids |
| what are some management tips of vesicant leaked during the administration step? | - COLD compresses in all veiscants except 1- vinca alkaloids ( vincristine, vinblastine, vinorelbine) 2- etoposide |
| what is the antidotes of anthracyclines? | - dexrazoxane ( totect) |
| what is the antidotes of vinca alkaloids? | hyaluronidase |
| what is the IT administration? | - intrathecally - inject drug into cerebrospinal fluid |
| what are some common drugs of IT administration? | - cytarabine - methotreaxte - hydrocortisone - thiotepa |
| Which chemo drug should NEVER been given as IT? | Vincristine - can cause ascending radiculo myeloencephalopathy ( damage to the brain's blood vessels and BBB), --> death |
| what are some recommendation to avoid accident vincristine IT injection ? | - NEVER prepare vincristine in a syringe - ALWAYE prepare vincristine in IVPB solution ( 50-100ml) |
| what is the recommended vaccination schedule for patient receiving chemotherapy? | - 2 weeks prior to chemo - inactivated flu vaccine between chemo cycle - AVOID live vaccine 2/2 pt is immunocompromised - live vaccine can be given after D/C chemo for at least 3 MONTHS |
Created by:
Smoham38
Popular Pharmacology sets