If somebodies tumour is T2 N1 M0...do they have metastatic cancer?
No as M=0
They do have one lymph node that is involved however
What is the FEC-T regime?
And what it is used to treat?
5-FU (TS inhibitor)
- All for 3 weeks, with 3-4 cycles
- Given for 3 weeks after FEC, with 3-4 cycles
Used to treat breast cancer
What is the MHRA advice on giving IV Ondansetron?
Can get potential QT prolongation
Under 75 --> Not exceed 16mg
Over 75 --> Not exceed 8mg
Over 65 and diluted --> All doses should be diluted in 50-100mL of saline
Why can dexamethasome be problemactic in diabetics?
Will increase glucose levels
Define the following....
Acute --> Occurs quickly (less than 24hrs) after chemo is given
Delayed --> Occurs more than 24 hours after chemo
Anticipatory --> Occurs before the next cycle of chemo after already having a cycle (as they know what to expect)
What are the common visible effects of a low platelet count (eg, 38)?
Bleeding from the gums
More bleeding in general
Why is Folinic Acid included in the FOLFOX chemotherapy regime?
And what is this used to treat?
To improve the clinical outcome by proloning the inhibition of TS (for 5-FU)
Treats colorectal cancer
What is a common syndrome that occurs as a result of capecitabine (5-FU pro-drug)?
And what OTC drug would interact with this
Often results in delays of treatments
Interacts with folic acid --> Possibly increasing its toxicity
Name 4 pre-medications that should be given when a patient is given the pemetrexed (antimetabolite), pembrolizumab and carboplatin regimen?
Folic acid --> 5 doses per week
Hydroxycobalabin injection (1000mg) before first pemetrexed dose
Dexamethasone 4mg BD for 3 days --> For N+V
Steroids --> to prevent pemetrexed rashes
At what GFR is Pemetrexed not allowed to be given?
In patients starting of Afatinib (an EGFR inhibitor), what advice should be given to prevent rashes/acne?
Moisturise with urea/aqueous based moisturisers (not alcohol based)
Avoid sunlight --> Use SPF 30 if subjected to it
Use soap substitutes
How does Palbociclib function?
A selective inhibitor of cyclin-dependent kinases (CDK4/6)
Prevents the phosphorylation of Rb, meaning that mitosis cannot occur
Why is there a maximum lifetime dose of anthracyclins (like doxorubicin/epirubicin)
To prevent cardiac side effects
What 3 types of pre-meds would be given to prevent hypersenstivity reactions in people taking paclitaxol?
Corticosteroid --> Dexamethasone
Antihistamine --> Chloramphenamine
H2 Antagonist --> Ranitidine
Why is bicalutamide taken with/after the single dose of goserlin?
To cover the period of time where the tumour may flare and symptoms worsen after taking goserlin
This is because goserlin is an LHRH agonist, and so will stimulate LH/androgen production....however after a few weeks the receptors become desensitised, so LH isn't stimulated and we dont need to give bicalutamide anymore
Why must prednisolone always be given with Abiraterone?
As abiraterone is a CYP17A1 inhibitor, which is vital for the production of cortisol
So we need prednisolone to compensate
What are some of the side effects of enzalutamide?
Risk of seziures (1%)