ONCOLOGY - common adverse effects of anticancer therapy Flashcards
EXAM 2 content
what can happen in bone marrow suppression aka myelosuppression?
suppressing neutrophils, platelets, & erythrocytes –>
- neutropenia –> risk for infection
- thrombocytopenia –> risk for bleeding
- anemia –> fatigue
pancytopenia = all three are low
how can we treat neutropenia?
FILGRASTIM: colony stimulating factors
how can we treat thrombocytopenia?
- avoid drugs that promote bleeding: aspirin & anticoagulants
- platelet transfusion
- NEUMEGA: stimulates platelet production
how can we treat anemia?
- PRBC transfusion
- erythropoietin (EPOETIN ALFA or DARBEPOETIN ALFA)
with anticancer therapies, we see problems with the GI tract, what are they?
- stomatitis: inflammation of oral mucosa, can be so severe that chemotherapy needs to be stopped
- diarrhea: bc of thinning of lining
- n/v: from radiation or chemotherapy esp if in the brain
how do we treat stomatitis?
- oral hygiene & bland diet
- if Candida albicans –> topical antifungal drugs (NYSTATIN)
- managed with mouthwash w topical anesthetic (LIDOCAINE) + antihistamine (DIPHENHYDRAMINE)
- if severe –> systemic opioids
how do we treat diarrhea?
- rule out C diff
- treat with oral LOPERAMIDE: nonabsorbable opioid that slows gut motility by activating local opioid receptors
how do we treat n/v?
- premedication with antiemetics + more than 1 type of antiemetics
- ONDANSETRON: serotonin antagonist
why is alopecia so common when it comes to chemotherapy?
due to hair follicles being a place in body with a lot of proliferation (chemotherapy kills normal cells with lots of proliferation)
how can we prevent alopecia? when does it grow again when therapy is done?
cooling scalp –> vasoconstriction –> reduce drug delivery to follicles –> BUT uncomfortable + increase risk of cancer recurrence bc drug is reduced in that area
- regeneration of hair starts 1-2 months AFTER last course of treatment
why would men & women consider banking their sperm & eggs before cancer treatments?
reproductive toxicity
- fetal malformation
- risk highest during first trimester
- risk lowers after 18 weeks of gestation
- irreversible sterility in males
- affects ovaries –> amenorrhea, menopausal symptoms, & atrophy of vag epithelium
what is hyperuricemia? why would this occur during cancer treatments? which cancers does this usually happen to? what organ can it damage & why?
excessive level of uric acid in blood
- uric acid – formed by BREAKDOWN of DNA, after cell death
- common for treatment for leukemias & lymphomas
- can damage kidneys: deposition of uric acid crystals in renal tubules
how do we treat & prevent hyperuricemia?
- hydration: prevents uric acid in renal tubules
- ALLOPURINOL: inhibits xanthine oxidase (enzyme that converts nucleic acids to uric acid)
what is extravasation injury? what should you do if this happens? how do we prevent? how to treat?
when IV medication goes into nearby tissues –> tissue damage –> tissue necrosis
- STOP INFUSION RIGHT AWAY
- prevent: assessing site prior to administering
- treat: cooling ice pack, dry heat, antidotes
- don’t remove catheter right away, might want to attempt to aspirate medication from IV site
how can carcinogenesis result from cancer therapy? which drug class increases this risk? what are the different types of drug specific toxicities?
ANOTHER cancer – results from drug induced damage to DNA
- alkylating agents increase risk
- DAUNORUBICIN = heart
- CISPLATIN = kidneys
- VINCRISTINE = peripheral nerves
