Cytotoxics Flashcards
(27 cards)
What are common toxic effects of cytotoxic drugs?
Bone marrow suppression, nausea, vomiting, alopecia, mucositis, and reproductive toxicity.
What safety measures are essential when handling cytotoxic drugs?
Use trained staff, designated areas, protective clothing, eye protection, and protocols for spills and disposal.
What is tumour lysis syndrome and who is at risk?
A life-threatening condition from rapid tumor breakdown; common in leukemias and high-grade lymphomas.
What medication is used to manage hyperuricaemia from chemotherapy?
Allopurinol or rasburicase.
Which drugs are least likely to cause bone marrow suppression?
Vincristine sulfate and bleomycin.
How can chemotherapy-induced oral mucositis be prevented?
Through good oral hygiene and ice chips during fluorouracil infusions.
What drugs help prevent acute chemotherapy-induced nausea?
5HT3 antagonists, dexamethasone, and aprepitant.
What drug prevents urothelial toxicity from cyclophosphamide or ifosfamide?
Mesna.
What is the function of folinic acid in chemotherapy?
It rescues normal cells from methotrexate toxicity and enhances fluorouracil efficacy.
Which drugs are anthracycline antibiotics used in cancer treatment?
Doxorubicin, epirubicin, daunorubicin, idarubicin.
What are vinca alkaloids used to treat?
Leukaemias, lymphomas, and solid tumours.
What are some highly emetogenic chemotherapy drugs?
Cisplatin, dacarbazine, high-dose cyclophosphamide.
Why must vincristine be administered intravenously, and what safety measures are recommended for its administration?
Vincristine must be administered intravenously only, as inadvertent intrathecal administration can cause severe neurotoxicity and is usually fatal. To prevent errors, adult and adolescent patients should receive vincristine in a 50 mL minibag, while children in paediatric units may receive it in a syringe, per National Patient Safety Agency guidance.
Which chemotherapy agents are most commonly associated with sore mouth (mucositis)?
Fluorouracil, methotrexate, and the anthracyclines.
What is the treatment recommendation once a sore mouth develops during chemotherapy?
Use saline mouthwashes; antiseptic or anti-inflammatory mouthwashes lack strong evidence; mucositis is self-limiting but can lead to infection with poor oral hygiene.
What is tumour lysis syndrome and which patients are most at risk?
Tumour lysis syndrome is a metabolic complication from rapid malignant cell destruction; high risk in non-Hodgkin’s lymphoma (especially bulky), Burkitt’s lymphoma, ALL, AML, and occasionally solid tumours.
What metabolic abnormalities are seen in tumour lysis syndrome?
Hyperkalaemia, hyperuricaemia, hyperphosphataemia, hypocalcaemia; possible renal damage and arrhythmias.
How is hyperuricaemia managed in patients undergoing chemotherapy?
Allopurinol (started 24 hrs before treatment), hydration, dose reduction of mercaptopurine/azathioprine if co-administered; febuxostat or rasburicase may also be used.
When does bone marrow suppression typically occur after chemotherapy, and which drugs have delayed effects?
Typically 7–10 days post-treatment; delayed with carmustine, lomustine, and melphalan.
What is a common but reversible side effect of many cytotoxic drugs that affects hair?
Alopecia (hair loss), varying in severity between drugs and individuals.
What vascular complication is increased by both cancer and chemotherapy?
Venous thromboembolism.
What medications can be used to prevent emesis in low-risk chemotherapy patients?
Dexamethasone or lorazepam.
What is the recommended prophylaxis for high-risk emesis in chemotherapy patients?
A 5HT3-receptor antagonist combined with dexamethasone and aprepitant.
What combination is effective for preventing delayed symptoms with moderately emetogenic chemotherapy?
Dexamethasone and a 5HT3-receptor antagonist.
