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Flashcards in Management of Cancer SE Deck (146)
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1

SE of Anti-Neoplastic Agents

Alopecia
Anorexia
Cardiotoxicity
Constipation
Skin or Cutaneous Responses
Diarrhea
Fatigue
Hemorrhagic cystitis
Hepatotoxicity
Hypersensitivity reactions
Mucositis/Stomatits/ Esophagitis
N/V
Nephrotoxicity
Neurotoxicity
Pulmonary toxicity
Sexual & reproductive dysfunction
Myelosuppression
Anemia
Neutropenia
Thrombocytopenia

2

Assessment of Alopecia

Usually within 2 weeks
Reversible

3

Education with Alopecia

Emotional support

4

Assessment of Anorexia

Dietary history
Weight
Lab values

5

Education for Anorexia

Weekly weights
Small frequent meals

6

Medications for Treatment of Anorexia

Antiemetics
Megesterol (Megace)
Dronabinol (Marinol)
Remeron: Antidepressant

7

Cardiotoxicity

Related to effect of drugs or radiation to cardiac muscle, pericardium

8

Chronic Cardiotoxicity

Cumulative dosing of cardiotoxic drugs
Radiation to large volumes of heart or pericardium

9

Medications that have Cardiotoxicity

Doxorubicin
Daunorubicin
Mitoxantrone
High dose cyclophosphamide
High dose 5FU
Paclitaxel

10

Assessment of Cardiotoxicity

History of HTN
Smoking
Pre-existing cardiac disease

11

Collaborative Management of Cardiotoxicity

MUGA scan
Exercise
Diet modification
Dose reduction
EKG
Dexrazoxone (Zinecard)

12

Education for Cardiotoxicity

Inform of possible cardiotoxicity
S/S of CHF
Daily weights
Symptoms management

13

Pathophysiology of Constipation

Result of neurotoxic effects resulting in decreased peristalsis

14

Assessment of Constipation

Patients receiving vinca alkaloids
Hypercalcemia
Opioid pain management
Dehydration

15

Management of Constipation

Bowel program
Exercise
Diet modifications
Laxative & stool softener

16

Education for Constipation

Increasing fluids
Dietary interventions
Establish a bowel program

17

Assessment of Skin or Cutaneous Responses

Rash
Photosensitivity
Hypersensitivity

18

Education for Skin or Cutaneous Responses

Prepare patients for potential changes
Monitor S/S of infection
Avoid heat & vasodilation

19

Management of Skin or Cutaneous Responses

Call Rad Onc to discuss skin care
Call Med Onc to discus medical management

20

Acral Erythema (Hand-foot syndrome)

Painful palms & soles with erythema, desquamation, & ulceration

21

What is Acral Erythema Commonly Associated with what medications

5FU
Capecitabine
Doxirubicin

22

How to prevent aural erythema?

Holding ice packs during infusion
Taking pyridoxine

23

Pathophysiology of Diarrhea

GI mucosa very sensitive to cytotoxic drugs due to high mitotic index

24

Assessment of Diarrhea

Neutropenic status
Bowel elimination patterns
Hydration

25

Collaborative Management of Diarrhea

IV/fluid support
Loperamide
Diphenoxylate

26

Education for Diarrhea

Low residue diet
Fluid requirements
Watch for S/S of dehydration
Perianal care

27

Pathophysiology of Fatigue

Anemia
Changes in sleep patterns
Pain
Psychosocial factors

28

Assessment of Fatigue

Risk factors
Acute vs. chronic
Fatigue level

29

Collaborative Management of Fatigue

Multidisciplinary referrals

30

Education for Fatigue

Setting realistic goals
Energy management
Cause & factors of fatigue