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28 Cards in this Set
- Front
- Back
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what is the biological role of N/V? is chemo induced nausea a learned or triggered response? |
protect the body from ingesting toxins its both, psych plays a huge role |
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how do you reduce the anxiety of the anticipated N/V? how does a history of alcohol abuse effect chem n/v? |
use benzos like lorezapam, antidepresseants, cousneling, control n/v better it has a protective effect |
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what effects the severity of the n/v? how do you determine the anti emetic drugs when a patient is on a multidrug chemo regimen? what increases this risk? |
dose the drug that has the highest level of emetogenic risk determines the therapy patient specific risk factors |
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what is the difference between acute and delayed CINV? what drugs are known to have delayed CINV? |
acute is with 24 hours of chemo delayed occurs after 24 hours and can go beyond 7 days platinum agents, cyclophosphamide, ifofamide, doxorubicin |
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what corticosteriod is used in anti emetic therapy? what do all the serotonin receptor antagonists names have a suffix? all neurokinin 1 receptor antagonists names have as a suffix? |
dexamethasone setron pitant |
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what is unique about the effect of palonosetron? |
has immediate and lasting effects up to 5 days, it is given on day 1 |
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what drugs have strong anithistamine activity? what drug has week anti histamine activity? |
diphenhydramine, promethazine procholorerazine |
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what drug has strong anti muscaranic activity? what drug has weak muscarinic activity? |
scopolamine diphenhydramine, promethazine |
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what drug has strong anti dopamine activity? what drugs have weak ant dopamine activity? what drugs are the cannabinoid agonists? |
haloperidol, olanzapine, procholorperazine metoclopramide, promethazine dronabinol, and nabilone |
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how is acute prophalyxis against cinv done? how is delayed ""? how is breakthrough""? |
IV at infusion center prior to chemo rx to take home and use as scheduled always get an rx for prn, different moa than prophalxis meds |
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what medication are used for mucositis? how does it work? what are the usual components of magic mouthwash? |
palifermin keratinocyte growth factor anti inflamatory, analgesic, anti fungal, ant acid |
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other than drugs, what can be suggested to a patient to prevent muositis/stomastitis? |
dental hygiene, artificial saliva, dry mouth lozenges, saline/baking soda as a rinse for pain, drinking 3 L of water a day, avoid citrus fruits, avoid hard foods, dont smoke, suck ice cubes |
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what is neutropenia a problem in chemotherapy? what drugs are used to treat this? what blood cells are increased? |
it delays treatments GCSF stimulating factor like filgrastim or pegfilgrastim, sargramostim BENM, rbc, megakaryocyte |
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what can be done to treat a patients anemia? what hbg level should you be below to consider using? what do you give it with? |
blood transfusion or erythropoetin or darbopoetin below 12 iron |
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what is cancer pain generally treated with? what other pain is a concern and should be treated? |
opioids emotional pain |
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define opioid naieve what type of opioid products should you start with? what should you do if pain remains uncontrolled? |
patients who have not taken 60 mg of morphine (or equivalent) a day for a week or more short acting, then move to long acting when possible, then add breakthrough dose increase long acting dose |
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what tool is used to assess pain? |
Palliative or aggravating factors Quality of pain Radiation of pain Severity of pain Time of pain during the day U- emotion and relationships |
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what are the adjuctive medications used to treat pain? what are the side effects of opioids? what side effect will you never get used to ? |
steroids, antidepressants, anti convulsants, nsaids n/v/c respiratory depression, euphoria the constipation |
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what is very common side effect from morphine and related products? is this an allergy? how do you treat it? |
itching and rash histamine reaction no anti histamine |
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how do you treat the constipation caused by opioids? which of these is preffered? why? which ones are prn use? |
senna, bisacodyl, miralax, docusate senna/biscodyl...are stimulants that reverse the reduced peristalis caused by the opioid stimulant ones described above, and docusate |
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lets say you had a true morphine allergy, what drugs can you use? what is the caveat to fentanyl? |
fentanyl, methadone, tapendatol, or tramadol need to be on a stable dose of opioid first |
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how does cancer cause spinal cord compression? what cancer usually causes it? what drug is important to use to control this? |
tumors put pressure on structures small cell lung cancer or lymphoma dexamethasone, reduces edema and inhibit inflammation |
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what electrolyte does bone cancer cause? what are normal levels? |
causes a huge increase in calcium 8.5-10.5 |
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what is tumor lysis syndrome? |
tumors that are highly sensitive to treatment cause a rapid release of intracellular anions and cations, nucleic acids and proteins leading to renal failure, arrhythmia and seizure |
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how do you prevent tumor lysis syndrome?
what does rasuricase do? |
hydration, allopurinol, normalizing electrolytes, rasburicase
reduces uric acid |
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what drugs are the dna binding vesicant drugs? what drugs are the non dna binding vesicant drugs? |
nitrogen mustards, anthracyclines vinca alkaloids and taxanes |
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how do treat vesicants or irritants ? |
neutrlize dna binding agents, cold/dry compresses, dilute vincas taxanes and platinum agents and use warm/dry compresses |
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what are the antitdotes for antrhacyclines vesicants? "" for vincas and taxanes? |
dexrazoxane and topical dmso hyaluronidase |
