cytotoxin side effects Flashcards
(11 cards)
oral mucositis and treatment
sore mouth associated with fluororacil, methotrexate and anthracyclines
advise good oral hygiene
sucking ice chips with fluororacil
treat with saline mouthwashes
if caused by methotrexate - use folinic acid (use levofolinic acid)
what is extravasation of IV drugs?
severe local tissue necrosis due to leakage of cytotoxin
tumour lysis syndrome
rapid destruction of malignant cells - causes metabolic waste build up
causes HYPER K, P, Ca and uricaemia - renal damage and arrhythmia
hyperuricaemia
LL
present in high-grade lymphoma and leukaemia
allopurinol started 24hrs before
febuxostat - 48hrs before
bone marrow suppression - imp points
caused by all drugs except vincristine and bleomycin
occurs 7-10 days after administration
FBC before treatment
avoid treatment during acute infection
alopecia and thromboembolism
alopecia - common
thromboembolism - chemo increases risk
urothelial toxicity - imp points
haemorrhage in urinary tract
common in cyclophosphamide and ifosfamide
treated with mesna
myelosuppression - imp points
caused by methotrexate
use folinic acid to treat toxicity
reproductive SEs
most teratogenic - not to be administered during pregnancy
exclude pregnancy before treatment
contraception during and after treatment
alkylating agents + procarbazine - increased risk of male sterility
N&V - imp points
more common in women, <50
mild - fluorouracil, methotrexate, vinca alkaloids
moderate - taxanes, doxorubicin, low cyclophosphamide doses
high - cisplatin, dacarbazine, high cyclophosphamide doses
N&V treatment
prevention of acute symptoms (within 24 hours of treatment):
- low risk pts - dexamethasone or lorazepam
- high risk - dexamethasone + ondansetron + aprepitant
prevention of delayed symptoms (within 48 hours):
- moderate emetogenic drugs - dexamethasone + ondansetron
- highly emetogenic drugs - dexamethasone + aprepitant
prevention of anticipatory symptoms (before treatment):
- lorazepam
