neutropenia and non-GI toxicities Flashcards Preview

PT3 Oncology > neutropenia and non-GI toxicities > Flashcards

Flashcards in neutropenia and non-GI toxicities Deck (29):
1

ANC equation

((%neutrophils + %bands) x WBC) / 100

2

Diagnosis of febrile neutropenia

*often asymptomatic besides fever
-CBC/CMP
-physical exam
-2 blood cultures

3

risk factors for neutropenia

-cancer type
-myelosuppressive chemo
-poor performance status
-malnourishment
-mucositis
-gut translocation

4

cancer type risk of neutropenia from low to high

solid
lymphoma
autologous
leukemia
allogeneic

5

most common pathogen involved in febrile neutropenia

pseudomonas

6

MASCC score

risk calculator for neutropenia
-low is >=21
-high is <21

7

oral antibiotics for low risk MASCC

-cipro + augmentin
-cipro/levo/moxi mono
-cipro/levo + clindamycin

8

what don't we give to patients with febrile neutropenia

tylenol so the fever isn't hidden as it is the main indicator of infection

9

empiric IV antibiotics for high risk MASCC

cefepime
pip/tazo
meropenem
ceftazidime

10

indications for vancomycin in high risk MASCC

-hemodynamically unstable
-catheter
-severe sepsis
-potential MRSA
-pneumonia

11

if decompensated fever after 2-4 days, what do we do

-consider adding another drug
-repeat CXR
-beta d glucan and galactomannan

12

if decompensated fever after 4-7 days, what do we do

-add antifungal

13

how long to treat febrile neutropenia with antibiotics

-when afebrile for 48 hours and ANC > 500
-resolution of infection

14

growth factor prophylaxis drugs for febrile neutropenia

pegfilgrastim or filgrastim

15

tyrosine kinase inhibitor unique adverse effects

-acneiform
-hard-foot syndrome
-elevated blood pressure
-endocrine

16

acneiform rash prophylaxis

all EGFR inhibitors
-sunscreen
-hydrocortisone BID
-doxy/mino

17

acneiform rash presentation

within 7-10 days of exposure of EGFR inhibitors

18

hand foot syndrome presentation

redness, swelling, blistering/peeling on palms and soles of feet

19

common causes of hand foot syndrome

VEGF antagonists
sunitinib
bevacizumab

20

treatment for hand foot syndrome

-lukewarm showers
-avoid friction
-wear well-fitted shoes
-moisturizers
-lidocaine
-clobetasol

21

common toxicities of immune therapy

dermatitis
colitis
thyroiditis
hepatitis
pneumonitis

22

treatment for immune therapy toxicities

-corticosteroids
-infliximab for colitis

23

manifestations of cardiotoxicity

-arrhythmias
-edema
-heart failure
-hypertension
-left ventricular dysfunction
-qt prolongation
-thromboembolism

24

risk factors for cardiotoxicity

-prior chemotherapy
-radiation therapy
-concurrent meds

25

type I cardiotoxicity features

-permanent
-cumulative
-dose related
-caused by doxorubicin

26

type II cardiotoxicity features

-reversible
-not cumulative
-not dose related
-caused by HER2

27

treatment strategy of neuropathy toxicity

*mainly peripheral
gabapentin
pregabalin
vitamin B6

28

drug that causes pulmonary fibrosis

bleomycin

29

management of bleomycin associated pulmonary fibrosis

-lifetime cumulative dose of 450 units
-baseline pulmonary function test