ChemoQ from Book

Your patient is receiving oxaliplatin. He instructed to avoid cold fluids during therapy for five days after therapy. He also wears gloves and a scarf and covers his mouth and breathing cold air, such as an opening refrigerator. These precautions are useful to avoid which complications of oxaliplatin?

Acute neurotoxicity

Which of the following chemotherapy agents is most likely to potentiate the problem of esophagitis in patients also receiving radiation therapy to the esophagus?

Dactinomycin or Doxorubicin

an important teaching point for patient with prostate cancer who are receiving ketoconazole therapy is:

Ketoconazole should be taken on an empty stomach with an acidic environment

When administering capecitabine to a patient, who is also taking warfarin is important to frequently monitor the international normalized ratio or prothrombin time. What is the nature of this drug interaction?

Capecitabine interferes with the metabolism of warfarin in the liver

Capecitabine is an oral agent used to treat patients with metastatic colorectal or breast cancer. Which of the following statements, best describes how this drug becomes activated in the body?

This drug undergoes enzymatic changes before becoming fluorouracil

Mrs. Collins has breast cancer and is about to begin Docetaxel. She has taken her Decadron as premedication. As you check her lab test you notice her liver function test results are elevated. Which of the following statements is important regarding your course of action?

The docetaxel dose may need to be reduced because of elevated liver function results

The rationale for the use of preoperative chemotherapy in patients with osteogenic sarcoma is, which of the following?

It decreases the size of the primary tumor, possibly facilitating limb salvage surgery

When telling Jan about cyclophosphamide, methotrexate, and Fluoruracil, you are careful to give her instructions regarding which of the following potential side effects?

Symptoms of bladder infection as early signs of hemorrhagic cystitis

Side effects of cyclophosphamide, methotrexate and 5FU

Myelosuppression, hair loss, and hemorrhagic cystitis

Mechanism of cancer, cell resistance with alkylating agents and cisplatin

DNA damage repair

Ketoconazole mechanism of action

Slows growth in prostate cancer by blocking hormones in testes and adrenals

Capecitabine use

Metastatic breast and colorectal cancer

Capecitabine mechanism of action

Pro drug of 5FU

Oxaliplatin use

Colorectal, all GI( liver, pancreas, stomach, esophagus), ovarian and testicular, NHL

Nursing care of patients receiving capecitabine therapy includes teaching patients to discontinue their drug at the first sign of a grade 2 toxicity. Which of the following side effects of capecitabine would warrant discontinuing the drug.

Four bowel movements over their normal or one nocturnal stool in a 24 hour period.

Although fluorouracil is the cytotoxic agent of choice for colorectal cancer, it is most commonly administered in combination with:

Leucovorin

Capecitabine is stopped at the first sign of the following grade 2 toxicity

Stomatitis with pain or discomfort

Capecitabine is stopped at the first sign of the following grade 2 toxicity

Vomiting more than once in a 24 hour period.

Capecitabine is stopped at the first sign of the following grade 2 toxicity

Hand – foot syndrome with pain or discomfort, or affecting activities of daily living

Capecitabine is stopped at the first sign of the following grade 2 toxicity

Nausea. Loss of appetite or decrease in food intake over a 24 hour Period.

Floxuridine use

Intraportal chemotherapy through the portal vein or hepatic artery into the liver for liver metastasis

Jane has been diagnosed with multiple myeloma and will begin therapy with melphlan and prednisone. You will monitor Jane closely for adverse drug effects such as:

Bone marrow suppressive effects

Jane has been diagnosed with multiple myeloma and will begin therapy with melphlan and prednisone. You will monitor Jane closely for adverse drug effects such as:

Increased blood urea nitrogen, and creatinine

One week into his first treatment with capecitabine, your patient calls, report some redness and slight peeling of the palms of his hands and soles on his feet. He also has some tolerable discomfort. You instruct him to do which of the following?

Discontinue therapy until symptoms go away and resume at full dose

two week into his first treatment with capecitabine, your patient calls, report some redness and slight peeling of the palms of his hands and soles on his feet. He also has some tolerable discomfort. This has occurred once before. You instruct him to do which of the following?

Hold therapy until toxicity reaches grade 0 to one and then restart a 75% dose

Three weeks into his first treatment with capecitabine, your patient calls, report some redness and slight peeling of the palms of his hands and soles on his feet. He also has some tolerable discomfort. This has occurred twice before. You instruct him to do which of the following?

Discontinue therapy until symptoms go away then restart at 50% dose

2 weeks into his first treatment with capecitabine, your patient calls, report some redness and slight peeling of the palms of his hands and soles on his feet. He also has some tolerable discomfort. This has occurred three times before. You instruct him to do which of the following?

Discontinue medication

Chemotherapy agents damage the hair most when it is in which phase of hair growth?

Anagen

Which of the following chemotherapy agents is most likely to cause hair loss?

Etoposide

Which of the following chemotherapy agents is most likely to cause hair loss?

Cyclophosphamide

Which of the following chemotherapy agents is most likely to cause hair loss?

Doxorubicin

Which of the following chemotherapy agents is most likely to cause hair loss?

Dactinomycin

Which of the following chemotherapy agents is most likely to cause hair loss?

Daunorubicin

Which of the following chemotherapy agents is most likely to cause hair loss?

Etoposide

Which of the following chemotherapy agents is most likely to cause hair loss?

Idarubicin

Which of the following chemotherapy agents is most likely to cause hair loss?

Ifosfamide

Which of the following chemotherapy agents is most likely to cause hair loss?

Irinotecan

Which of the following chemotherapy agents is most likely to cause hair loss?

Mechlorethamine

Which of the following chemotherapy agents is most likely to cause hair loss?

Paclitaxel

Which of the following chemotherapy agents is most likely to cause hair loss?

Topotecan

Which of the following chemotherapy agents is most likely to cause hair loss?

Vincristine

Delayed nausea and vomiting, occurs more commonly with which of the following agents?

Cisplatin

Which of the following chemotherapy agents is commonly associated with Palmer-planter erythrodysesthesia?

Sunitinib

Which of the following chemotherapeutic agents caused cumulative and often delayed thrombocytopenia?

Mitomycin

Monica is experiencing hyperpigmentation. You explain to her this might be a reaction to:

Bleomycin

Which of the following chemotherapy drugs cause acute cerebellar dysfunction especially in older patients?

5-FU

Metabolic encephalopathy manifested as blurred vision, seizures, motor system dysfunction, and irreversible, has been reported and up to 20% of patients receiving which drug?

Ifosfamide

The dose limiting toxicity of 5-FU when given as a continuous infusion is?

Mucositis

The dose limiting toxicity of 5-FU when given as a bolus is?

Myelosuppression

Which of the following chemotherapy agents is associated with a high incidence of emesis?

Cytarabine

Mr. Jones is undergoing chemotherapy for high grade testicular cancer. He complains of being jittery and his lab test revealed low, magnesium, aluminum, common and calcium. He is most likely experiencing, which of the following complications of chemotherapy?

Low magnesium due to cisplatin therapy

Which of the following chemotherapy agents is known to cause flu retention that may manifest as abdominal ascites as a pleural effusion or as a combination?

Docetaxel

Chemotherapy related constipation is associated with, which of the following?

autonomic nerve dysfunction manifested as colicky abdominal pain

Physiologically, the ideology of chemotherapy induced diarrhea, involves, which of the following?

Micro Villi flattening and reducing the absorptive surface

5-FU is commonly given with Luca Von to treat gastrointestinal malignancies. The best reason to combine these two drugs is:

To potentiate the effect of 5 – FU

Which of the following chemotherapy agents is likely to cause diarrhea?

5-FU

Which of the following metabolic disorders is most common impatient who receives Cisplatin therapy?

Hypomagnesemia

The earliest symptom of chemotherapy induced pulmonary toxicity is:

bilateral basilar rales

Which of the following chemotherapeutic agents cause anemia by inhibiting the maturation of a erythroid lineage cells in the bone marrow?

Cisplatin

Several drugs cause cardio toxicity, especially the anthracycline. Which of the following statement statements about cardiotoxicity is true?

Acute effects are dose related, and dose reduction is not indicated

Which of the following chemotherapeutic agents is most likely to cause constipation?

Vinblastine

In the stem cell transplant population, what drug is reported to cause acute pericarditis when given in high doses?

Cyclophosphamide

Which medication is known to cause diffuse alveolar damage, leading to capillary leak syndrome?

Cytarabine

Which medication is known to cause diffuse alveolar damage, leading to capillary leak syndrome?

Mitomycin C

Which medication is known to cause diffuse alveolar damage, leading to capillary leak syndrome?

Methotrexate

Which of the following agents is most frequently associated with pulmonary toxicity?

Bleomycin

Which of the following chemotherapy agents is most frequently associated with moderate to severe hair loss?

Doxorubicin

Accumulative and delayed thrombocytopenia has been associated with which of the following chemotherapeutic agents?

Carmustine

Thrichomegaly is associated with which of the following agents?

Cetuximab, Erlotinib, Gefitinib

Which of the following agents pose a high risk for the development of alopecia?

Ifosfamide

Which of the following chemotherapy agents is most likely to potentiate the problem of esophagitis and patient also receiving radiation therapy to the esophagus?

Dactinomycin and Doxorubicin

Thromboembolism is most frequently seen with which of the following?

Pancreatic cancer

Which of the following may be effective in preventing neurotoxicity associated with oxaliplatin based therapy?

Venlafaxine

factors that increase the risk of neurotoxicity within vincristine include:

Dose greater than 2 mg and severe liver dysfunction

Factors that increase the risk of neurotoxicity vincristine

Those greater than 2 mg, frequently administer drug, older than 60 years, concomittant isoniazid, tenioposide, Etoposide, severe liver dysfunction, co-administration of azole antifungals, polymorphisms in CYP3A5 expression

A patient receiving Paclitaxel has recently complained that she has had some trouble walking without stumbling. After examining the patient the physician changes for chemotherapy. What is the most logical explanation for switching her chemotherapy?

The Paclitaxel could be causing progressive peripheral neuropathy

Which of the following chemotherapy drugs is associated with arthralgia and myalgia?

Paclitaxel

Which of the following is considered risk factors for ifosfamide induced encephalopathy?

Hepatic insufficiency and previous cisplatin use

Which medication causes cerebellar toxic use that may be irreversible?

Cytosine arabinoside

Cushing’s triad includes:

Bradycardia, widening pulse pressure with systolic hypertension, and alterations and respiratory pattern from neurogenic to cheynne-stoked to apneic

Example, examples of a chemotherapeutic agent that may cause a metallic case during administration leading to take changes is:

Cyclophosphamide, nitrogen mustard, cisplatin