Management of Chemotherapy ADEs Flashcards
What are the 5 phases of chemo-induced N/V (CINV)?
- Acute emesis
- Delayed emesis
- Anticipatory emesis
- Breakthrough
- Refractory
How do you treat acute emesis?
“setrons” (ondansetron) - 5HT antagonists
How do you treat delayed emesis?
Aprepitant, fosaprepitant, & rolapitant
How do you prevent anticipatory emesis?
Prophylactics - benzos (diazepam, lorazepam) the night before & morning of chemo
How do you treat breakthrough CINV?
Consider around-the-clock dosing w/:
Prochlorperazine, phenothiazine
How do you treat refractory CINV?
Glucocorticoids (dexamethasone)
How do you treat mucositis caused by Candida?
Clotrimazole troches or nystatin oral suspension
How do you treat more severe oral or esophageal fungal infections?
Oral fluconazole or IV antifungals
How do you treat reactivation of HSV?
Acyclovir
What is keratinocyte growth factory (KGF) approved for in pts to prevent Mucositis?
High dose chemo prior to hematopoietic stem cell transplantation
What are ADEs of keratinocyte growth factory (KGF)?
Increase in serum amylase & lipase
How do you treat mucositis of the GI tract?
Antispasmodics s/a lomotil (diphenoxylate & atropine) or loperamide
What are common cutaneous reactions?
Hand foot syndrome (acral erythema): Diffuse edema & redness of the palms/soles
How do you treat acral erythema?
Oral pyridoxine, 200mg daily & apply cold packs to extremities during chemo administration
How do you prevent hand foot skin reaction (HFSR) & hand foot syndrome?
Topical moisturizers:
Urea cream, topical steroids, & pain meds (s/a gabapentin or NSAID)
