Misc Chemo Trivia Likely on Test Flashcards
Explain the mechanism of Methotextrate and how to address toxicity
Methotextrate is a antifolate chemotherapy agent, meaning it targets the metabolic process by inhibiting folate-mediated DNA synthesis and stopping cancer growth.
Folate, usually in the form of Leucovorin calcium, is used as an antidote if the levels are too high (“rescue” the patient)
Bonus: PT’s should NOT take multivitamin when on it
Recommendation for Capecitabine/Xeloda
Take after food (within 30 minutes of a meal) with water
Concerns for Dexamethasone/Decadron
It’s a glucocorticosteriod (steroid), so hyperglycemia is a large concern. Can also cause muscle weakness, fluid retention and weight gain.
Recommendation for Imatinib/Gleevec
Must be taken with a large glass of water after a meal
Concerns for Irinotecan/Campostar
(or any treatment with –IRI– in it, examples: FOLFIRI, FOLFIRINOX)
Tends to cause abd cramping, N/D, hair loss
Recommendation for Pemetrexed/Alimta
Usually requires folic acid and vitamin B12 supplementation to reduce side effects
Recommendation for Procarbazine/Matulane
Needs to be on a low-tyramine Diet to prevent interaction
Foods high in Tyramine include aged/cured/fermented/smoked/unpasteurized foods.
Examples: sourdough, sauerkraut, pickles/olives, kimchi, overripe fruit, aged cheese, cultured dairy like yogurt/buttermilk/kefir, pepperoni/chorizo/salami, liver, pickled or cured fish(lox), canned sardines, large amount of nuts, wines/beer, miso/teriyaki sauce, chocolate
What’s the major concern with Cisplatin/Platinol?
Very toxic to kidneys — this is why labs will always be taken and they will always get IVF with infusion
What’s a unique side effect(s) for Doxil/Doxorubicin liposomal?
Hand/foot syndrome and red/orange urine color change
What’s a side effect or Opdivo/Nivolumab that’s potentially severe?
Colitis
Concern for Oxaliplatin?
(Or any treatment with –OX in it — example FOLFOX, CAPEOX, FOLFIRINOX)
Neurotoxicity — peripheral neuropathy, sensitivity to cold, and laryngopharyngeal dysesthesia
Can also cause hepatic toxicity or have an allergic reaction
AC (Adriamycin + Cytoxan) is a Common regimen for what cancer? What is a common side effect concern?
N/V can be severe with Cytoxan, particularly in larger doses – and usually within 6-10 hours of infusion. Should have premeds for nausea. Also commonly has poor appetite.
What are the instructions for taking Temozolomide/Tremodar?
What are the common side effects?
Must be taken on an empty stomach – 1 hour before or 2 hours after any food – an with at least 8 oz of water
N/V and constipation
What are the common side effect of 5-FU/fluorouracil?
Taste changes, particularly metallic during the actual infusion. N/V, D, poor appetite, and mouth sores.
