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Oncology 1-V

Clinical Recap of Chemotherapy Side Effects

Which chemo therapeutic drugs have the min risk of inducing myelosuppression? - asparaginase - bleomycin - Vincristine - Monoclonal/ TKIs ( cristine with mycie - eat asparagly)
What are some lab parameters to monitor myelosuppression? - CBC - Temp ( febrile neutropenia) - SOB, fatigue ( anemia) - bleeding ( thrombocytobina)
Drug of choice to tx neutropenia? CSF
drug of choice to tx anemia? - transfusion - ESA
drug of choice is tx thrombocytopenia? platelet transfusion
Which chemo agents are highly emetogenic ? C2DEF - cisplatin - doxorubicin/epirubicin - cyclophosphamide - ifosfamide
drug of choice for CINV? - 5-HT-3 blocker - neurokinin-1 receptor blocker - dexamethasone - IV/PO fluid ( volume depletion)
Which chemo agents induce mucositis? Mouth irritated with fluorouracil and nib - mexthotrexate - fluorouracil, capecitabine - irinotecan - TKIs: 1- afatinib 2- ponatinib 3- sorafenib - sunitinib
drug of choice of chemo induced mucositis? - mucosal coating - anesthetics
what are some complications of mucositis ( monitor during therapy)? - herpes simplex virus - fungal ( candida species)
which chemo agents induce diarrhea? - fluorouracil, capecitabine - irinotecan - sorafenib - sunitinib
what are some complication associated with chemo induced diarrhea ( monitor during therapy? - volume depletion - potassium/ electrolyte level - bowel movement
drug of choice for chemo induced diarrhea? - anti motility drugs
drug of choice for acute onset diarrhea ? in particular with irinotecan use? - atropine ( acute ) IV/PO hydration
drug of choice for delayed onset diarrhea? - loperamide - IV/PO hydration
which chemo drug causes constipation? - vincristine - pomalidomide - thlidomide ( cristine domide)
drug of choice for chemo induced constipation? - PEG ( stimulant)
what chemo regimen causes xerostomia? - radiation therapy of head/neck
drug of choice for chemo induced xerostomia? pilocarpine
what are the two main types of chemo induced cardiotoxicity? - cardiomyopathy - QT prolongation
Which chemo drugs cause cardiomyopathy? - anthracyclines ( rubicin family) - fluorouracil - lapatinib - HERS (-) ( stuzumab family): 1- adotrastuzumab 2- trastuzumab 3- pertuzumab
what are the common anthracycline drugs ? RUBICIN FAMILY Daunorubicin. Doxorubicin. Epirubicin. Idarubicin. Mitoxantrone. Valrubicin
what are monitoring parameters for cardiomyopathy? - LVEF - cumulative dose of anthracyclines
what is the recommended cumulative dose of anthracyclines to prevent/min risk of chemo induced cardiomyopathy? - doxorubicin: 440-550 mg/m2 life time
drug of choice as prophylaxis for doxorubicin induced cardiomyopathy? - dexrazonxane
which drugs cause QT prolongation? 1- arsenic trioxide 2- TKI (inib & enib) 3- leuoprolide
What are monitoring parameters for QT prolongation? - heart electrolyte 1- Mg, 2- Ca 3- K 4- ECG
WHEN chemo therapy should be held? if QTc> 500 msec --- prolonged
which drugs causes pulmonary fibrosis? carlomu- mycne busu - bleomycine - busulfan - carmustine - lomustime
what are monitoring parameters for pulmonary fibrosis? - oxygen - ABGS ( atrial blood gas) - SOB
what is the management of chemo induced pulmonary fibrosis? - stop the drug - as prevention keep bleomycin max life dose of 400mg IU
which drugs cause pulmonary pneumonitis? mexthotrexate MC AB 1- atezolizumab 2- ipilimumab 3- nivolumab 4- pembrolizumab
which chemo drugs induce hepatotoxicity? - 4 main class of drugs: 1- anti-androgens 2- folate anti metabolites 3- pyrimidine analog antimetabolites ( cytarabine and gemcitabine) 4- TKI inhibitors
what are the common anti androgens chemo drugs that induce hepatotoxicity? amide 1- bicalutamide, 2- flutamide, 3- nilutamide)
what are the common folate anti metabolites chemo drugs that induce hepatotoxicity? trexate 1- methotrexate, 2- pemetrexed 3- prallatrexate
what are the common Pyrimidine analog antimetabolites that induce hepatotoxicity? abine 1- cytarabine 2- gemcitabine)
what are the common TKI induce hepatotoxicity? 1- ipilimumab 2- pembrolizumab 3- nivolumab 4- atezolizumab
what are some common monitoring parameters for hepatotoxicity? 1- LFT 2- Jaundice 3- Ascites
what is the recommended management of chemo induced hepatotoxicity ? - stop tx - steroid if the hepatotoxicity is induced by TKI that targets PD-1
which chemo drugs induce nephrotoxicity? - cisplatin and carbaplatin - methotrexate ( high dose), pemetrexed, pralatrexate - other: 1- carflizomib 2- bevacizumab 3- nivolumab 4- pembrolizumab 5- ipilimumab 6- atezolizumab -
what are some common monitoring parameters for nephrotoxicity? - BUN - SCr - urinalysis - urine output - CrCl
what is the recommendation to manage cisplatin induced nephrotoxicity? - hydration - max dose of cisplatin 100mg/m2 /cycle - amifostine ( Ethyol prophylactic)
which chemotherapeutic agents induce hemorrhagic cystitis? - ifosfamide ( all doses ) - cyclophosphamide ( high dose >1 gram/m2)
what is the recommendation to manage ifosamide induced hemorrhagic cystitis? - Mesna prophylactically - hydration
what are the two common forms of chemo induced neuropathy? - peripheral sensory neuropathy - autonomic neuropathy
which chemo drugs induce peripheral sensory neuropathy? - vinca alkaloids: vincrisine,vinblastine,vinorelbine - platinums:cisplatine,oxaliplatin - taxanes: paclitaxel, docetaxel, cabazitaxel
which chemo drugs induce peripheral sensory neuropathy? - proteasome inhibitors: : bortezomib, carflizomib - thalidomide, cytarabine high dose brentuximab - ado trastuzumab
which chemo drugs induce autonomic neuropathy? - vinca alkaloids
what are some management step to reduce the risk of vincristine induced peripheral neuropathy? - limit the dose of vincristine to 2 mg/week - cap at 2 mg /week
which drug causes acute cold mediated sensory neuropathy? oxaliplatin
which forms of administration of brotezomib associated with less peripheral neuropathy risk? - SC
which chemotherapy induce thromboembolic risk? - aromatase inhibitors: ( trazole) - serms ( tamoxifen) - immunomodulators ( thalidomide, lanalidomide, pomalidomide)
what are some common monitoring parameters for thromboembolic ? - dvt - pe - stroke - MI
Created by: Smoham38



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