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Flashcards in Clinical Workshops Deck (17)
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If somebodies tumour is T2 N1 they have metastatic cancer?

No as M=0


They do have one lymph node that is involved however


What is the FEC-T regime?


And what it is used to treat?

5-FU (TS inhibitor)

Epirubicin (anthracycline)

Chyclophosphomide (Mustard)

- All for 3 weeks, with 3-4 cycles


Docetaxol (anti-microtubule)

- Given for 3 weeks after FEC, with 3-4 cycles



Used to treat breast cancer


What is the MHRA advice on giving IV Ondansetron?

Can get potential QT prolongation


Under 75 --> Not exceed 16mg


Over 75 --> Not exceed 8mg


Over 65 and diluted --> All doses should be diluted in 50-100mL of saline


Why can dexamethasome be problemactic in diabetics?

Will increase glucose levels


Define the following....


Acute CINV

Delayed CINV

Anticipatory CINV

Acute --> Occurs quickly (less than 24hrs) after chemo is given


Delayed --> Occurs more than 24 hours after chemo


Anticipatory --> Occurs before the next cycle of chemo after already having a cycle (as they know what to expect)


What are the common visible effects of a low platelet count (eg, 38)?

Bleeding from the gums


More bleeding in general


More bruising


Why is Folinic Acid included in the FOLFOX chemotherapy regime?


And what is this used to treat?

To improve the clinical outcome by proloning the inhibition of TS (for 5-FU)


Treats colorectal cancer


What is a common syndrome that occurs as a result of capecitabine (5-FU pro-drug)?


And what OTC drug would interact with this

Hand-foot syndrome


Often results in delays of treatments



Interacts with folic acid --> Possibly increasing its toxicity


Name 4 pre-medications that should be given when a patient is given the pemetrexed (antimetabolite), pembrolizumab and carboplatin regimen?

Folic acid --> 5 doses per week


Hydroxycobalabin injection (1000mg) before first pemetrexed dose


Dexamethasone 4mg BD for 3 days --> For N+V


Steroids --> to prevent pemetrexed rashes


At what GFR is Pemetrexed not allowed to be given?



In patients starting of Afatinib (an EGFR inhibitor), what advice should be given to prevent rashes/acne?

Moisturise with urea/aqueous based moisturisers (not alcohol based)


Avoid sunlight --> Use SPF 30 if subjected to it


Use soap substitutes


How does Palbociclib function?

A selective inhibitor of cyclin-dependent kinases (CDK4/6)


Prevents the phosphorylation of Rb, meaning that mitosis cannot occur


Why is there a maximum lifetime dose of anthracyclins (like doxorubicin/epirubicin)

To prevent cardiac side effects


What 3 types of pre-meds would be given to prevent hypersenstivity reactions in people taking paclitaxol?

Corticosteroid --> Dexamethasone


Antihistamine --> Chloramphenamine


H2 Antagonist --> Ranitidine


Why is bicalutamide taken with/after the single dose of goserlin?

To cover the period of time where the tumour may flare and symptoms worsen after taking goserlin


This is because goserlin is an LHRH agonist, and so will stimulate LH/androgen production....however after a few weeks the receptors become desensitised, so LH isn't stimulated and we dont need to give bicalutamide anymore 


Why must prednisolone always be given with Abiraterone?

As abiraterone is a CYP17A1 inhibitor, which is vital for the production of cortisol


So we need prednisolone to compensate


What are some of the side effects of enzalutamide?


Memory impairment


Restless legs


Risk of seziures (1%)