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DF Heme/Onc > BMT Drug Side Effects > Flashcards

BMT Drug Side Effects Flashcards

1
Q

What is CBV (cyclophosphamide, BCNU, etoposide) used for?

A

Auto- SCT for lymphproliferative disorders.

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2
Q

What is Bu/Cy (BCNU, Etoposide, Ara-C, Melphalan) used for?

A
  • Allo SCT

- Auto SCT for AML

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3
Q

What is BEAM 868 used for?

A

Auto SCT for NHL and HL

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4
Q

What is Melphelan Regimen used for? What is LOS?

A

Only Myeloma.

LOS: leave after engraftment, generally 14d after infusion

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5
Q

What is Flu/Bu and what used for?

A

Allo SCT, both RIC and high-dose conditioning

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6
Q

Carmustine/BCNU hypersensitivity reaction:

A

due to EtOH:

  • HA
  • Facial tingling
  • Bronchospasm, dyspnea
  • Diaphoresis
  • Urticaria, rash
  • Tachycardia, HOTN
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7
Q

What to give for carmustine/BCNU hypersensitivity reaction?

A

Pepcid, Benedryl, +/- steroids

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8
Q

BCNU drug interactions

A

digoxin, ampho B

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9
Q

BCNU organ toxicities

A

pulm, renal, can have LFT abnormalities

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10
Q

Melphalan SE

A
  • mucositis (use cryotherapy!)
  • orthostasis, autonomic dysfunction (MWF ortho vitals)
  • highly emetogenic (day of admin, day after)
  • diarrhea
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11
Q

Etoposide acute SE

A
  • *Give w/ fluids**
  • orthostasis
  • hypersensitivity (inclu. angioedema)
  • metallic taste during infusion
  • radiation recall (severe sunburn-like effect)
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12
Q

Etoposide chronic SE

A
  • secondary AML
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13
Q

Cytarabine

A 
Allergic type, w/in 12 hours infusion:
- rash
- flu-like sx
- bone pain
- conjunctivitis 
- CP 
Also...
- noncardiogenic pulm edema
- neurotox (cerebellar, etc) but generally only w high dose
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14
Q

Cytarabine drug interaction

A

Digoxin

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15
Q

LOS for BEAM?

A

Leave after engraftment, generally 14d after infusion

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16
Q

What is 898 and who used for?

A

Thiotepa, Busulfan, Cytoxan
+Keppra and Mesna
Used for CNS lymphoma

17
Q

Thiotepa SE

A

PROFOUND RASH.
- urticaria, bronzing, flaking, desquamation
–> Nursing to do: showers/linen change twice daily, no moisturizers
NEUROTOX.
- confused, ST mem, motor function
MUCOSITIS.
- should get kepivance PTA, days 0-2

18
Q

Bulsulfan SE:

A
  • neurotoxicity (Keppra ppx til day -1)
  • N/V/D, mucositis
  • skin hyperpigmentation
  • busulfan lung = intersitital pneumonitis
19
Q

Busulfan drug interaction:

A

Tylenol (avoid 72h prior and after), will increase bu toxicity

20
Q

Cytoxan SE:

A
  • hemorrhagic cysititis (goal UOP 200cc/hr)

- URI-like sx

21
Q

Cytoxan late SE:

A
  • Secondary AML

- Secondary bladder cancer

22
Q

898 LOS

A

14d after engraftment techinically… but often longer. Patients will get sick (rash, high fevers, confusion)

23
Q

896 (Carboplatin, etoposide) what is it used for:

A

“Tandem autoSCT” Given for germ cell tumors and testicular Ca

24
Q

Carboplatin SE:

A
  • Hypersensitivity (typically rash, urticaria only)
  • peripheral neuropathy
  • renal tox
  • transient LFT abnormality (particularly alk phos)
25
Q

855 RIC (Flu/Bu with Tac/Rap/MTX) who gets it

A

alloSCT for lymphoma who failed autos

26
Q

Fludarabine SE:

A
  • mild N/V, fever, flu-like sx
  • maculopapular rash
  • transient transaminitis
27
Q

LOS for 855 RIC

A

~5 days, normal leave after day +1 MTX

28
Q

What med to add for 855 RIC (flu/bu, tac/rap/mtx) if hx liver issues?

A

Actigall

29
Q

886 (flu/mel with tac/rap/mtx) indication

A

moderate intensity conditioning for alloSCT in AML/MDS who can’t tolerate full intensity

30
Q

TBI SE

A
  • worsening nausea
  • worsening mucositis
  • hyperpigmentation
31
Q

Goal tac level

A

5-10

32
Q

Goal rap level

A

3-12

33
Q

General time to engraft PBSCT

A

14d

34
Q

General time to engraft BMT

A

21d

35
Q

Since marrow products have heparin, hold ___?

A

AC (lovenox etc)

36
Q

What info to always put in note for allo BMT patients

A
  • related/unrelated
  • ABO mismatch status
  • CMV and toxo status
  • Peripheral vs marrow cells
  • Include pre-BMT workup as resolved problem in all notes
37
Q

How to manage toxo positive patient

A

Toxo PCR 0,7,14

Bactrim (as opposed to Mepron) on discharge

DF Heme/Onc (6 decks)

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