Flashcards in 11 Oral Chemotherapy Kam Deck (22):
What is Hand-Foot syndrome most common with?
Capecitabine and TKIs
What are nonpharmacological management options for Hand-Foot syndrome?
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
What pharmacologic agent can be used for Hand-Foot syndrome?
Pyridoxine 50-100mg PO BID (may help with tingling/numbness)
What is Acneiform Rash most common with?
What is Grade 1 Acneiform Rash?
Macular or papular eruption or erythema. NO associated symptoms
What is Grade 2 Acneiform Rash?
Macular or papular eruption or erythema. Pruritus or other symptoms
What is Grade 3 Acneiform Rash?
Severe, generalized erythroderma or macular, papular or vesicular eruption
What is Grade 4 Acneiform Rash?
Generalized exfoliative, ulcerative or blistering skin toxicity
What is often used for Mild Acneiform Rash?
What is often used for severe Acneiform Rash?
What is Diarrhea most common with?
Capecitabine and TKIs
What is the management of Diarrhea like?
HOLD oral chemotherapy if increase of 4 or more stools per day over baseline until symptoms resolve and notify MD. Increase fluid intake
How is Loperamide dosed for cancer treatment-induced diarrhea?
4mg followed by 2mg Q4h or after each loose stool, max 16mg/day
Which medications must be taken WITH food?
(RIBCC). Cyclophosphamide. Capecitabine. Bosutinib. Imatinib. Regorafenib
Which medications must be taken WITHOUT food?
(SLERPN). Erlotinib. Lapatinib. Nilotinib. Pazopanib. Ruxolitinib. Sorafenib
What are the major drawbacks to oral chemotherapy?
Decrease in doctor visits. Responsibility of managing chemotherapy shifts more directly to the patient
What are the main CYP 3A4 Inhibitors to look out for with cancer drugs?
(G-PACMAN). Grapefruit. Protease inhibitor. Azoles. Cimetidine. Macrolides. Amiodarone. Non-DHPs CCBs (Verapamil, Diltiazem)
What are the main CYP 3A4 Inducers to look out for with cancer drugs?
(PS PORCS). Phenytoin. Smoking. Phenobarbital. Oxcarbazepine. Rifampin. Carbamazepine. St. Johns Wort
What are some Direct Measures that can be taken to assess medication adherence?
Biologic assays: measure plasma levels of drug or metabolites. This is an accurate method
What is the disadvantage of Biologic Assays?
Medications with short plasma half-lives (only identify the most recent doses). Costs. Time consuming
What does REMS stand for?
Risk Evaluation and Mitigation Strategy. From manufacturers to ensure that the benefits of a drug or biological product outweigh its risks