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28 Cards in this Set
- Front
- Back
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review: 3 areas of rapidly dividing cells that are also affected by chemo |
1. bone marrow 2. digestive tract 3. hair follicles |
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review: drug mechs |
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mech of Chemo induced N/V (CINV) central mechanism |
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peripheral mech of CINV |
Damage to GI mucosa Stimulation of GI NT receptors |
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timing of CINV 1. acute 2. delayed 3. anticipatory |
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list drugs that are 1. low emetic risk 2. intermediate or moderate emetic risk 3. .high emetic risk |
remember Cisplatin: popular exam question as most emetogenic chemotherapy drug.. |
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Myelosuppression: ways chemo can affect cell counts |
1. pancytopenia 2. anemia 3. Neutropenia (emerg!) 4. thrombocytopenia |
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thresholds in thrombocytopenia for 1. being able to tolerate minor trauma and procedures 2. risk of spont. bleeding |
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Digestive toxicities: oral... |
note: can occur anywhere from gum to bum |
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Chemotherapy induced diarrhea 1. life-threatening fluid loss/elyte imbalance! 2. infectious complications 3. specific patient management guidelines |
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how does chemotx affect peripheral nerves? |
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Symptoms of chemo-induced peripheral neuropathay (CIPN) |
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which drug can cause cold-triggered neuropathy |
Oxaliplatin (strange and startling side effect for patient). |
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CIPN: not too many good pharmacological interventions |
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soo. how to manage CIPN 3 |
1. reduce dose 2. stop and go strategy 3. discontinue and switch if seriously reducing function |
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List the skin side fx |
1. dry skin 2. hyperpigmentation, rash, allergic rxn, photosensitivity 3. Nail changes 4. Hair loss (not all chemotx) |
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nail changes that occur 6 |
Nail changes – hyperpigmentation,Beau’s lines, Mee’s lines, leukonychia, onycholysis, onychodystrophy |
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Fertility and chemo: male effects? |
reduced sperm count and motility dose dependent and drug dependent. |
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female fertility and chemo? 3 |
Acute Ovarian Failure –riskincreases with age of diagnosis Infertility (without acute ovarianfailure) – risk increases with age of diagnosis Early menopause (before age 45) –increased risk with younger age of diagnosis |
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teratogenicity and chemo |
greatest risk in 1st trimester chemotx can sometimes be given in 2nd and 3rd |
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other toxicities: cardiac, hepatic, nephro, etc etc |
d |
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adverse effects of the Mabs (eg Bevacizumab, with binds VEGF) |
Bevacizumab –binds to vascular endothelial growth factor (VEGF) to prevent it frominteracting with endothelial cells thereby inhibiting new blood vessel growth Hypertension, bleeding,proteinuria, stroke, heart attack |
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adverse effects panitumumab |
Panitumumab –binds to epidermal growth factor receptor (EGFR) and prevents it from sendinggrowth signals Mouthsores,diarrhea, acneformrash, nail changes, hypertrichosis |
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panitumumab continued |
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nibs adverse effects (small molecule that targets tyrosine kinase. example sunitinib) |
targets VEGFRs, PDGFRs and c-KIT has anti-angiogenic andanti-proliferative effects common toxicities – hypertension,mouth sores, diarrhea, hand-foot syndrome, neutropenia, hair depigmentation |
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adverse effects SERMS (selective estrogen receptor modulators eg Tamoxifen) |
blocks the proliferative actionestrogen in breast tissue acts as an agonist in endometrium toxicity: hotflashes, weight gain, decreased libido, hair thinning, increased risk ofendometrial cancer, thromboembolic disease |
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adverse effects aromatase inhibs (eg anastrazole) |
blocks the aromatase enzyme whichconverts androgen to estrogen in muscle, fat, liver, breast tissue does not block ovarian estrogenproduction (ie can only be used inpost-menopausal patients) toxicities – hot flashes, vaginaldryness, osteoporosis, hypercholesterolemia, heart disease |
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Androgen deprivation therapy: adverse effects? |
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