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21 Cards in this Set
- Front
- Back
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Palifermin
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Kepivance
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What are the risk factors for mucositis and stomatitis?
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Chemotherapy
Hematopoietic Stem Cell Transplant (HSCT Radiation therapy to head and neck |
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What problems are mucositis and stomatitis associated with?
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Pain
Restriction of PO intake Secondary infection Need for TPN Increased narcotic analgesics Increased cost Dose reduction |
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What are some ways to prevent oral mucositis?
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Oral Care
Treat underlying xerostomia Oral cryotherapy Palifermin |
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Palifermin
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Kepivance
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How does oral cryotherapy work?
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Causes vasoconstriction in the oral cavity which reduces the delivery of toxic agents to the oral epithelium
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When should ice chips be given to the patient in relation to chemotherapy?
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5 minues prior to standard dose of chemotherapy (bolus 5-FU or edatrexate) or high dose melphalan
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What is the mechanism of action of palifermin?
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Palifermin is a keratinocyte growth factor (KGF) that increases mucosal epithelium--> downregulates TNF-alpha which prevents further augmentation of NF-kappa beta
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What are the adverse reactions associated with Kepivance?
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Skin toxicity: rash, edema, pruritus, erythema
Oral toxicity: dysesthesia, tongue discoloration/thickening, alteration of taste Ototoxicity |
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What is the dose of Kepivance?
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60mcg/kg/day IV for 3 days prior to treatment and 3 days post transplantation.
Should not be administered less than 24 hours prior to or following treatment. |
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What can be used to prevent GI mucositis?
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Basic bowel care
Amifosine Sulfasalazine H2 blockers or PPI |
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What is the dose of Sulfasalazine to prevent GI mucositis?
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500mg BID
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How can you treat mucositis?
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Bland rinses (NS, sodium bicarbonate, mixture)
Magic mouthwash (lidocaine, benadryl, aluminum hydroxide) Sucralfate Loperamide/octreotide Systemic analgesics Gelclair |
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What are the causes of xerostomia?
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Radiation to the head/neck
Antimuscarinics Paclitaxel Carboplatin 5-FU |
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What are the general measures for treating xerostomia?
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Increase fluid intake
Avoid smoking, alcohol and caffiene Treat underlying candidiasis Avoid drugs that cause xerostomia |
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What are the major treatment options for xerostomia?
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Salivary substitutes
Salivary stimulants Radioprotectants |
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What salivary substitutes can you use for xerostomia?
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Mucin or methylcellulose based
Mucin is better tolerated and has a longer duration of action. |
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What are the salivary stimulants that can be used to treat xerostomia?
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Sugar free gum
Ascorbic acid, malic acid Pilocarpine |
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What is the dose of Pilocarpine?
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5-30mg in divided doses, max 30mg/day
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What are the side effects of Pilocarpine?
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Cholinergic effects: perspiration, lacrimation, urinary frequency, GI disturbances
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What is pilocarpine contraindicated in?
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Asthma
COPD Heart disease Epilepsy Hyperthyroidism PD |
