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29 Cards in this Set
- Front
- Back
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Definition of thrombocytopenia
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Defined as 100,000 or less. Bleeding substantially increased at 20,000 or less.
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Oprelvekin (interleukin-11)
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approved for prevention of severe thrombocytopenia in patients undergoing chemo for non-myeloid malignancies
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Dexrazoxane use in oncology patients
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intracellular chelating agent and helps reduce damange from free radicals in daunorubicin, doxorubicin, idarubicin, and epirubicin and anthracenedione
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Dexrazoxone cannot be used in what type of cancer
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EARLY breat Cancer *curable*
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Dexrazoxane can also be used in what setting?
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Metastatic breast CA who have received doxorubicin 300 mg/m2 or more and want to continue receiving benefit from doxorubicin.
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What is the antidote for extravasation of doxorubicin?
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Dexrazoxazone
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What medication prevents nephrotoxicity from cisplatin (side effects include hypotension, n/v, etc...)
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Amifostine
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What drug is used to prevent hemorrhagic cystitis from ifosfamide and in cyclophosphamide 1500 mg/m2 or greater?
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Mesna (sodium-2-mercaptoethane sulfonate).
Prevents Acrolein which is a metabolite of ifosfamide and cyclophosphamide that damages the kidneys Mesna must be present in the bladder when arolein is presented in bladder. |
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What types of cancer cause hypercalcemia (oncology emergency)?
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Lung, breast, multiple myeloma, head and neck, renal cell, Non-Hodgkins lymphoma
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What medications exacerbate hypercalcemia in oncology emergency?
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hormonal tx, thiazide diuretics
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What is the formula for corrected calcium?
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[(4-plasma albumin) x 0.8 + serum Ca)]
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What is the treatment for mild hypercalcemia (corrected Ca < 12 mg/dL)
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NS hydration
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What is the treatment for moderate hypercalcemia (12-14)
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NS hydration
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What is the treatment for severe hypercalcemia (>14)
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Hydration 3-6 L in 24 hours
Loop diuretics (THIAZIDES CONTRAINDICATED b/c of renal tubular absorption) Bisphosphonates Calcitonin Steroids Phosphates Dialysis if with renal failure |
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Tumor Lysis Syndrome
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cell death due to leukemia or lymphoma.
causes hyperuricemia, hyperkalemia, hyperphosphatemia, and secondary hypocalcemia uric acid can ppt renal failure |
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Tumor Lysis Syndrome treatment
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hydration and allopurinol
rasburicase ($$) |
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What is used with MTX as a rescue med?
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Leucovorin for doses greater than 100mg/m2.
In general MTX doses greater than 500 mg/m2 must have leucovorin rescue |
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Factors increasing MTX toxicity
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renal dysfunction, third-space fluid, other meds that decrease MTX elimination (penicillin, NSAIDs, PPIs)
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Leucovorin final result goal?
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Continue until MTX falls to less than 0.05-0.1 mM.
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Why do we use Leucovorin plus 5-FU
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Leucovorin plus 5-FU enhances 5-FU
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Which chemotherapy angents cause extravasation injuries
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doxorubicin, daunorubicin, Epirubicin, mechlorethamine, Mitomycin, Vincristine, Vinblastine, Vinorelbine, Streptozocin, (w/ or without Oxaliplatin, with or without paclitaxel)
Most damaging -- Anthracyclines |
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Vincristine is fatal if given what route?
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Intrathecal
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Management of doxorubicin, daunorubicin, and epirubicin extravasation?
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Cold and dexrazoxane
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Management of extravasation for vincristine, vinblastine, or vinorelbine
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HEAT
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What is the management of extravastation of mechlorethamine?
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sodium thiosulfate
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What chemotherapy causes diarrhea and is managed with loperamide
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Irinotecan
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What medication is used to prevent the cholinergic activity irinotecan causing diarrhea?
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Atropine
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Which chemotherapy agents are renally adjusted
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MTX, carboplatin, cisplatin, etoposide, bleomycin, topotecan, lienalidomide
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Which chemotherapy agents are hepatically adjusted
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doxorubicin, daunorubicin, vincristine, vinblastine, docetaxel, paclitaxel, sorafenib, and pazopanib
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