Cytotoxin side effects

What oncology meds cause oral mucositis

MTX, fluoraucil, Anthracyclines

Advice to treat oral mucositis

have good oral hygiene

suck ice chips with fluorucail

if caused by MTX give folinic acid

What is Extravasation of IV drugs

severe local tissue necrosis due to leakage of the cytotoxin

What’s tumour lysis syndrome 

occurs due to rapid destruction of malignant cells

causes Hyper-K/Ph/Ca and uricaemia+ renal damage and arrythmias 

Hyperuracemia 

more present in high grade lymphoma and leukaemia 

1.)start allopurinol 24 hours before treating tumours+hydrate px

2.) alternative give feboxustat 2 days before treatment 

Bone marrow supression

causes by all drugs apart from Vincristine and bleomycin

check FBC before treatment

avoid treatment during acute infection

Reproductive system

mostly teratogenic

use contraception during and after treatment

alkylating drug/procarbazine increases risk of permanent sterility/premature menopause

N/V side effects

mild N/V caused by fluouracil, etoposide, MTX, vinca alkaloida

Moderate: Taxanes, doxorubicin, low doses of cyclophasmides

High: Cisplatin, high cyclophasmide doses 

What’s the treatment for prevention of anticipatory symptoms for n/v

Lorazepam 

What’s the treatment for prevention of delayed symptoms of N/V

moderately emetogenic drugs: dexamethasone+onadestron 

highly emetogenic drugs: dexamethasone+ aprepitant 

after 24 hours of oncology treatment

What’s the treatment for prevention of acute symptoms 

low risk px: dexamethasone/lorazepam 

high risk px: ondansetron+dexamethasone+aprepitant

within 24 hours of treatment 

Alkylating agents- key facts

causes urothelial toxicity-give antidote MESNA

increased risk of permanent male sterility 

Anthracyclines key facts

1.) causes red urine

2.) formulations aren’t interchangeable (conventional, liposomal, pegylated liposomal)

3.) can cause cardio toxicity

4.) liposomal formulation reduces chance of cardio-toxicity

Antimetabolites- key points 

causes myelosupression and mucositis 

Cytotoxic antibiotics key facts

causes progressive pulmonary fibrosis+ pulmonary toxicity

What are the key facts about Vinca Alkaloids 

give IV not intraethecally as its fatal 

causes bronchospasm

causes neurotoxicity 

What are the key facts about taxanes

monitor cardiac output

monitor for sepsis and pneumonitis

causes hypersensitivity reactions