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13 Cards in this Set
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- Back
- 3rd side (hint)
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Cyclophosphamide (Alkylating agent)
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-Bladder Toxicity(dose-related, hemorrhagic cystitis)
-SIADH -Cardiotoxicity with high doses(>= 1800mg/m2/dose) |
-Hyperhydration before, during, and following administration (urine output 3mL/kg/hr) + frequent bladder emptying
-Urine dips for blood with each void -Mesna as chemoprotectant |
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Ifosfamide (Alkylating agent)
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-Bladder toxicity(dose-related, hemorrhagic cystitis)
-Neurotoxicity-lethargy, confusion, cerebellar ataxia, weakness, hallucinations, and seizures -SIADH-reported less commonly than with cyclophosphamide |
-Hyperhydration before, during, and following administration(3mL/kg/hr) + frequent bladder emptying
-Urine dips for blood with each void -Mesna as chemoprotectant -Methylene blue can be used for management of encephalopathy |
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Carboplatin (Alkylating agent)
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-NV-less emetogenic than cisplatic
-Nephrotoxicity with electrolyte imbalance(hypomagnesemia, hypocalcemia, hypokalemia) -Neurotoxicity characterized by peripheral neuropathy-dose-related -Hypersensitivity reactions characterized by skin rash, urticaria, and pruritus may occur-increased likelihood with number of cycles |
-CBC, renal function(BUN, SCr, ins/outs), electrolytes(K, Mg, Ca), audiogram
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Cisplatin (Alkylating agent)
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NV- HIGHLY EMETOGENIC
-Nephrotoxicity with electrolyte imbalance(hypoMg, hypoCa, hypoK, hypoPO4) -Ototoxicity(cumulative)-high-frequency hearing loss and tinnitus SIADH -Neurotoxicity reactions characterized by skin rash, urticaria, and pruritus may occur-increased likelihood with number of cycles |
-Hydration may include Mg, Ca and/or K to decrease acute electrolyte losses
-Mannitol may also be included in IVF to facilitate diuresis -CBC, renal function(BUN, SCr, ins/outs), electrolytes(K, Mg, Ca), audiogram |
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Daunorubicin (Antitumor antibiotics)
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-Mucositis-continuous infusion > bolus
-Cardiotoxicity-dose-related and cumulative -Increased risk when exceed 450mg/m2 in adults and 300 mg/m2 in children -Red/orange tint to secretions(urine, tears, sweat) -Risk of radiation recall-caution if receiving or have received radiation therapy -Extravasation-cold compress, dexrazoxane or DMSO |
-CBC, renal f(x), liver f(x) tests, cardiac function(baseline and periodically during treatment)
-Dexrazoxane-cardioprotection |
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Doxorubicin (Antitumor abx)
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-Mucositis-continuous infusion > bolus
-Cardiotoxicity-dose-related and cumulative -Increased risk when exceed 450mg/m2 in adults and 300 mg/m2 in children -Red/orange tint to secretions(urine, tears, sweat) -Risk of radiation recall-caution if receiving or have received radiation therapy -Extravasation-cold compress, dexrazoxane or DMSO |
-CBC, renal f(x), liver f(x) tests, cardiac function(baseline and periodically during treatment)
-Dexrazoxane-cardioprotection |
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Cytarabine (Antimetabolites)
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-Neurotoxicity-characterized by cerebellar ataxia,lethargy, and confusion (can occur with IT administration)
-Ara-C syndrome-Characterized by fever, bone pain, myalgia, and macropapular skin rash; steroids are beneficial for management -Mucositis -Hand-foot syndrome (desquamation of skin pronounced on palms and soles of feet) -Conjunctivitis at high doses(> 0.5-1gm/m2)-steroid ophthalmic drops (dexamethasone, hydrocortisone) should be initiated with the first dose and continue on a scheduled basis for at least 24 hours following administration of last dose |
-CBC, renal f(x), LFTs
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MTX
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-Mucositis and diarrhea are common
-Nephrotoxicity - IV hydration with NaHCO3 to ensure excretion; minimize drug interactions(D/C PCNs, Bactrim, NSAIDs, and PPIs) -May accumulate in fluid collections (ex. pericardial effusions, pleral effusions, etc.) |
-CBC, renal f(x), LFTs, drug levels, stool output(drug excreted in feces)
Leucovorin as chemoprotectant |
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Etoposide (Plant derivatives)
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-Hypotension during administration
-Mucositis-continuous infusion > bolus -allergic reactions |
-VS during infusion; stop infusion and administer 10mL/kg bolus if hypotension and resume infusion at slower rate
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Vincristine (Plant derivatives)
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-Neurotoxicity manifesting as peripheral neurophathy and autonomic dysfunction (jaw pain, constipation, ileus, obstruction)
-SIADH-watch sodium and order urine/serum osmolality -Extravasation-VESICANT -warm compress |
LFTs(bilirubin), stool output
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(Vinblastine/Vinorelbine)
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-Myelosuppression - severe compared to vincristine
-Neurotoxicity - less frequent compared to vincristine -Extravasation - VESICANT - warm compress |
-CBC, LFTs
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Dexamethasone/Prednisone
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-Mood swings/ irritability
-Appetite changes; weight gain -Hyperglycemia -Increased risk of peptic ulcers - consider H2 blocker or PPI -Hypo- or hypernatremia -HTN -May mask fever -Immunosuppression -Skin changes; poor wound healing -Osteoporosis, osteopenia -Avascular necrosis |
-BG, behavioral changes, assess infection risk
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Pegaspargase, L-asparaginase
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-Allergic reactions ranging from hivees to anaphylaxis - need Epi-pen at bedside and provide at discharge
-Pancreatitis -Hyperglycemia -Decreased serum proteins - decreased albumin, decreased ATIII -Thrombosis - high index of suspicion for swelling or pain in extremities or respiratory distress |
-Vital signs during administration, amylase/lipase, glucose, coagulation studies
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