Antimetabolites
True/false: patients capecitabine do NOT need to worry about sun protection
False! Capecitabine causes photosensitivity
Which antibiotic medication interacts with methotrexate?
Bactrim
Match the vinca alkaloid to its most common adverse event.
Vincristine, Vinblastine
Bronchospasm, Constipation
Vincristine = constipation
Vinblastine = bronchospasm
What is a consideration regarding the preparation of etoposide?
it has concentration dependent stability issues
What is the lifetime dose limit for carmustine? Why does this have lifetime dose limit?
1400 mg/m2
pulmonary toxicity
Patients with dihydropyrimidine dehydrogenase deficiency are more likely to experience toxicities when using this drug
5-FU
Why is leucovorin used?
Prevent damage to normal tissue cells in patients taking MTX
What pre-medications should a patient taking paclitaxel be given?
diphenhydramine, h2 blocker, corticosteroid
What is the most common side effect of irinotecan?
Can this side effect be life threatening?
Diarrhea
Yes, diarrhea can be grade 4 due to dehydration
What is an important counseling point to give a patient that is taking lomustine? (Hint: it is an oral drug)
Take on an EMPTY STOMACH
Which antimetabolite drug can cause ocular toxicity? Is this preventable?
Cytarabine
Yes it is preventable with artificial tears or steroid drops.
What supplements are recommended for patients taking pemetrexed?
Vitamin B12 and folate supplementation.
Fluid retention is a possible side effect of this plant derivative chemo drug:
Docetaxel
True/False: Irinotecan should be prepared using D5W
True!
True/False: most alkylating agents are vesicants
True!
What adjunctive therapy is recommended for patients using azacitidine, decitabine, fludarabine and cladribine? Why is this needed?
antibiotic/antifungal/antiviral prophylaxis is recommended due to lymphopenia caused by these medications
What adjunctive therapy is recommended for patients taking pemetrexed to prevent rash?
Dexamethasone 4 mg BID x 3 days beginning the day before treatment
What is a special consideration for preparation/administration of taxane drugs?
must use NON-PVC bags and tubing
About half of patients using this drug will require blood transfusions due to anemia.
Topotecan
Which medications is Mesna used with? Why?
Cyclophosphamide, ifosfamide
hemorrhagic cystitis
Name the antimetabolite: causes drug fever, causes peripheral edema, is NOT neurotoxic, requires dose reduction when bilirubin is elevated.
Gemcitabine
True/False: NSAIDs and ASA increase elimination of MTX by effects on renal function
False! they DECREASE elimination of MTX
True/False: ixabepilone should ONLY be mixed with D5W
False! Ixabepilone must be prepared using LACTATED RINGERS
True/False: eribulin shortens the QT interval and for that reason, NS should NOT be used in tubing/lines
False!
Eribulin PROLONGS the QT interval and for that reason D5W (or any dextrose diluent) should never be used in the tubing/lines
Name the alkylating agent: causes hemorrhagic cystitis, secondary neoplasm and SIADH
cyclophosphamide