-
antidote for extrav in anthracyclines
dexrazoxane - totect
-
antidote for extravas for cisplatin & mechlorethamine
sodium thiosulfate
-
antidote for extravas for taxanes & vinca alkaloids
hyaluronidase
-
tx for extravas for taxanes and other non specific
cold copress
-
tx for etoposide, tonepiside & vinca alkaloids
heat compress
-
tx for high emetic high risk
5HT3 + steroid + steroid + NK-1 antagonist
-
tx of moderate emetic risk
- day 1 5 HT3 + steroid
- day 2-3 5-HT3 monotherapy, steroid monotherpy, or NK1 + steroid, lorazepam, H2 blocker or PPI
-
big offenders of extravasiation
- dactinomycin
- anthracyclines
- mitoxantrone
- vinca
- oxaliplatin
- paclitaxel
- epipodophyllotoxine
- mechlorethamine
- cisplatin
-
lab values for TLS
- hyperkalemia
- hyperuricemia
- hyperphosphatemis
- hypocalcemia
-
2 of the 3 criteria to diagnose TLS
- ARF (rise in Scr to 1.5 x ULN)
- arrhythmias
- seizures
-
lab diagnosis of TLS values
- potassium >6
- phosphorus >6.5
- calcium < 7
- uric acid > 8
or a 25% increase from baseline
-
hand foot skin reaction for grade 1
urea 20% + clobetasol 0.05%
-
hand foot skin reaction tx for grade 2
urea 20% BID + clobetasol 0.05% + pain control
-
hand foot skin reaction tx for grade 3
stop tx until grade 0-1 then continue with clobetasol 0.05 % + pain control
-
big offenders with dermatologic toxicity
- sorafenib - papulopustual
- sunitinib
-
tx of dermatologic toxicities
hydrocortisone, clindamycin, stop cancer tx when get to stage 3 and add prednisone 0.5 mg/kg x 5 days
prophylaxis= doxycycline or minocycline + LD topical steroid
-
paronychia tx grade 1
continue agent, topical antibiotics & vinegar soaks
-
paronychia tx for grade 2
same as 1 but add silver nitrate
-
paronychia tx grade 3
systemic antibiotic, weekly silver nitrate, maybe nail avulsion
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