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Oncology > Chemotherapy > Flashcards

Flashcards in Chemotherapy Deck (31):
1

What is a cycle?

repeating pattern of treatment & rest

2

What is a course?

complete pattern of cycles

3

What is a line?

order of treatments

4

What type of chemotherapy?
Patient with osteosarcoma, aim is to make tumour smaller before surgery

Neoadjuvant

5

What type of chemotherapy?
Patient with breast cancer undergoing chemo post-mastectomy

Adjuvant

6

What type of chemotherapy?
Patient with in-situ breast cancer given tamoxifen before invasive carcinoma is recognised

Prophylactive

7

Why is chemo usually given as a combo of drugs? (3 reasons)

1. Synergism: different drug classes have different actions & may kill more cells together
2. Less chance of drug-resistant cells
3. Different sites of toxicity

8

What are two cell types commonly affected by chemo & the resulting SEs?

haematopoietic stem cells: myelosuppression

Lining GI tract: mucositis

9

What is intravesical chemo?
Pros

Drug directly into bladder
High dose at tumour site with minimal systemic toxicity

10

What is intraperitoneal chemo?
What cancer can it be used for?

Into peritoneum
Ovarian cancer

11

what is an indication for intra-arterial chemo

Tumour with a well-defined blood supply

12

How is chemo dose calculated?

Based on body surface area using the DuBois formula

13

What drug is commonly used for chemo-induced nausea & vomiting?
What are two common SE?

Ondansetron
5 HT antagonist

SE: constipation & headache

14

Define:
1. Myelosuppression
2. Leucopaenia
3. Thrombocytopenia

1. Decreased bone marrow activity
2. Low WBCs
3. Low platelets

15

How long does haematopoietic recovery take?

3-4 weeks

16

What is the low-point of myelosuppression called? and when does this occur?

Nadir
10-14 days after beginning a treatment cycle

17

A patient receiving chemo has peripheral neuropathy & high tone hearing loss. What chemo agent are they on?

Cisplatin (an alkylating agent)

18

Which agent can cause haemorrhagic cystitis?

ifosfamide

19

What is extravasation?

leakage of intravenously (IV) infused, and potentially damaging, medications into the extravascular tissue around the site of infusion

20

What is hand-foot syndrome? and its likely cause
How is it managed?

(plantar erythema)
5-FU
Withdrawal & emolients

21

What are beau's lines?

Grooved lines in the nails, recurring evenly spaced lines

22

Give 3 long-term complications of chemo

Secondary malignancy (due to sub-lethal DNA damage). Alkylating agents are most carcinogenic
Fertility problems
Pulmonary (fibrosis - bleomycin & busulphan)

23

What is it important to discuss with patients re: reduced fertility from chemo

Council prior to treatment & discuss sperm storage/ storage of fertilised ova if applicable

24

What types of cancer are myelosuppression mos common in? (i.e. due to bone marrow infiltration)

Heamatological malignancies
Solid tumours: breast, lung & prostate

25

What is the most common type of aneamia due to repeated chemo?

Macrocytic
(think fewer blood cells)

26

When can anaemia impair QOL?
How should this be treated?

Hb <10

Transfusion or recombinant erythropoietin

27

What are some clinical signs of thrombocytopaenia?

petechial haemorrhage, spontaneous nosebleeds, corneal haemorrhage, haematuria

28

What is severe thrombocytopaenia & its management?

Platelet count <10 x 109/L

Significant risk of spontaneous bleed (e.g. intra-cerebral)

Urgent indication for platelet transfusion

29

If a patient has WBC <1x10^9 with fever, what is the immediate management?

Broad spec antibiotics

30

When examining a patient with suspected neutropenic sepsis, what two examinatios should you never do & why?

Rectal & vaginal exam
Risk of bacteraemia if mucosa is breached

31

Why is adequate renal function important for chemo?

Many cytotoxics are renally excreted