oncologic emergencies and GI toxicity

Question 1

4 types of cancer induced nausea and vomiting

Answer 1

anticipatory
acute
delayed
breakthrough/refractory

Question 2

risk factors for CINV

Answer 2

• female
• younger
• poor emetic control in previous cycles
• Hx of motion sickness
• Hx of morning sickness

Question 3

ondansetron MoA

Answer 3

inhibits serotonin receptors

Question 4

ondansetron adverse effects

Answer 4

headache
constipation
diarrhea
QT prolongation

Question 5

ondansetron phase use

Answer 5

acute

delayed

Question 6

aprepitant MoA

Answer 6

inhibit NK1 receptors

Question 7

apreptiant adverse effects

Answer 7

fatigue
dizziness
diarrhea

Question 8

apreptiant phase use

Answer 8

acute

delayed

Question 9

phenothiazine drugs

Answer 9

prochlorperazine

promethazine

Question 10

phenothiazines MoA

Answer 10

inhibit D2 receptors

Question 11

phenothiazines adverse effects

Answer 11

CNS depression
anticholinergic
extrapyramidal symptoms
hypotension

Question 12

benzamide drug

Answer 12

metoclopramide

Question 13

metoclopramide MoA

Answer 13

inhibit D2 and serotonin

Question 14

metoclopramide adverse effects

Answer 14

sedation
diarrhea
EPS
QT prolongation

Question 15

metoclopramide phase use

Answer 15

breakthrough/refractory

Question 16

phenothiazine phase use

Answer 16

acute
delayed
breakthrough

Question 17

atypical antipsychotic for N/V

Answer 17

olanzapine

Question 18

olanzapine MoA

Answer 18

inhibit dopamine and serotonin

Question 19

olanzapine adverse effects

Answer 19

somnolence
dry mouth
dizziness
QT prolongation

Question 20

olanzapine phase use

Answer 20

acute
delayed
refractory

Question 21

corticosteroid of choice for NV

Answer 21

dexamethasone

Question 22

dexamethasone phase use

Answer 22

acute

delayed

Question 23

benzodiazepine of choice for NV

Answer 23

lorazepam

Question 24

lorazepam phase use

Answer 24

anticipatory

breakthrough

Question 25

cannabinoids phase use

Answer 25

breakthrough/refractory

Question 26

cannabinoids adverse effects

Answer 26

anticholinergic sedation appetite stimulation hallucinations

Question 27

general prophylaxis treatment for high risk NV

Answer 27

5HT3 + dexameth + aprepitant +- olanzapine

Question 28

general prophylaxis treatment for moderate risk NV

Answer 28

5HT3 + dexameth +- aprepitant

Question 29

general prophylaxis treatment for low risk NV

Answer 29

5HT3 or steroid or phenothiazone

Question 30

treatment for mucositis

Answer 30

- mouthwash and coating agents - analgesics - corticosteroids

Question 31

treatment of diarrhea

Answer 31

- hydration - BRAT diet and clear liquids - loperamide, octreotide

Question 32

treatment of constipation

Answer 32

- stop nonessential meds - increase fluids - any laxitive

Question 33

signs and symptoms of hypercalcemia

Answer 33

- fatigue and altered mental status - AKI - NV, anorexia, PUD - short QT, ventricular arrhythmia

Question 34

Risk factors for tumor lysis syndrome

Answer 34

- highly proliferative - malignancies - high treatment sensitivity - renal dysfunction

Question 35

management of spinal cord compression

Answer 35

- dexamethasone 10-100 mg bolus, 4-8 q6h - spinal radiation - surgery - chemo - pain management