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1
Q

What is Hand-Foot syndrome most common with?

A

Capecitabine and TKIs

2
Q

What are nonpharmacological management options for Hand-Foot syndrome?

A

Keep skin moist. Reduce friction and pressure. Wear sunscreen, avoid exposure to heat. Shower in lukewarm water. Use mild soap to bathe pat dry. War loose-fitting cotton gloves. Avoid walking barefoot. Put hands in cool water to relieve symptoms

3
Q

What pharmacologic agent can be used for Hand-Foot syndrome?

A

Pyridoxine 50-100mg PO BID (may help with tingling/numbness)

4
Q

What is Acneiform Rash most common with?

A

TKIs

5
Q

What is Grade 1 Acneiform Rash?

A

Macular or papular eruption or erythema. NO associated symptoms

6
Q

What is Grade 2 Acneiform Rash?

A

Macular or papular eruption or erythema. Pruritus or other symptoms

7
Q

What is Grade 3 Acneiform Rash?

A

Severe, generalized erythroderma or macular, papular or vesicular eruption

8
Q

What is Grade 4 Acneiform Rash?

A

Generalized exfoliative, ulcerative or blistering skin toxicity

9
Q

What is often used for Mild Acneiform Rash?

A

Topical antibiotics

10
Q

What is often used for severe Acneiform Rash?

A

Systemic antibiotics

11
Q

What is Diarrhea most common with?

A

Capecitabine and TKIs

12
Q

What is the management of Diarrhea like?

A

HOLD oral chemotherapy if increase of 4 or more stools per day over baseline until symptoms resolve and notify MD. Increase fluid intake

13
Q

How is Loperamide dosed for cancer treatment-induced diarrhea?

A

4mg followed by 2mg Q4h or after each loose stool, max 16mg/day

14
Q

Which medications must be taken WITH food?

A

(RIBCC). Cyclophosphamide. Capecitabine. Bosutinib. Imatinib. Regorafenib

15
Q

Which medications must be taken WITHOUT food?

A

(SLERPN). Erlotinib. Lapatinib. Nilotinib. Pazopanib. Ruxolitinib. Sorafenib

16
Q

What are the major drawbacks to oral chemotherapy?

A

Decrease in doctor visits. Responsibility of managing chemotherapy shifts more directly to the patient

17
Q

What are the main CYP 3A4 Inhibitors to look out for with cancer drugs?

A

(G-PACMAN). Grapefruit. Protease inhibitor. Azoles. Cimetidine. Macrolides. Amiodarone. Non-DHPs CCBs (Verapamil, Diltiazem)

18
Q

What are the main CYP 3A4 Inducers to look out for with cancer drugs?

A

(PS PORCS). Phenytoin. Smoking. Phenobarbital. Oxcarbazepine. Rifampin. Carbamazepine. St. Johns Wort

19
Q

What are some Direct Measures that can be taken to assess medication adherence?

A

Biologic assays: measure plasma levels of drug or metabolites. This is an accurate method

20
Q

What is the disadvantage of Biologic Assays?

A

Medications with short plasma half-lives (only identify the most recent doses). Costs. Time consuming

21
Q

What does REMS stand for?

A

Risk Evaluation and Mitigation Strategy. From manufacturers to ensure that the benefits of a drug or biological product outweigh its risks

22
Q

What are the 3 components to a REMS program?

A

A medication guide or patient PI. A communication plan for healthcare providers. Elements to assure safe use (ETASU)