Misc Healthcare Topics
Malignancy: Cytotoxics
Compiled By Masterpiecesolutions
Edition: 2025/26
, Medical & Nursing | Misc Healthcare Topics I of V pages
1. Oral mucositis/ a sore mouth is a common complication of cancer chemotherapy; it is most ofen associated
FluorouracilMethotrexateThe Anthracyclines like doxorubicin (also cardio with these)
2. To prevent oral mucositis with fluorouracil what can be helpful?
Good oral hygiene (rinsing the mouth frequently and effective brushing of the teeth with a soft brush 23 times
3. Once a sore mouth has developed, treatment is much less effective. What are the options?
Saline mouthwashes should be used but there is no good evidence to support the use of antiseptic or
mouthwashes. In general, mucositis is self-limiting but with poor oral hygiene it can be a focus for
4. Patients most at risk of tumour lysis syndrome are those with what malignancies?
Non-Hodgkins lymphoma (especially if high grade and bulky disease).
Burkitts lymphoma
Acute lymphoblastic leukamia
Acute myeloid leukamia.
Sometimes those with solid tumours. Basically the more blood related ones in general.
5. What can be predisposing factors to developing tumour lysis syndrome other than the type of malignancy
Pre-existing hyperuricaemia
Dehydration
Renal impairment
6. The features of tumour lysis syndrome include what? (6)
HYPERkalaemia
HYPERuricaemia
HYPERphosphataemia
HYPOcalcaemia
Renal damage
Arrhythmias
7. Hyperuricaemia, which may be present in high-grade lymphoma and leukaemia, can be worsened by
What (common) xanthine oxidase inhibitor should be started 24 hours before treating such tumours?
Allopurinol
Patient should also remain adequately hydrated.
Febuxostat is also a xanthine oxidase inhibitor which can be used but it is seen less commonly and is started
8. The dose of what drugs may need to be reduced to 1/4 of their original dose if allopurinol needs to be given
The dose of mercaptopurine or azathioprine should be reduced if allopurinol needs to be given concomitantly.
9. Hyperuricaemia, which may be present in high-grade lymphoma and leukaemia, can be markedly worsened
chemotherapy and is associated with acute renal failure. If allopurinol is not used what are the two
Febuxostat: 2 days before cytotoxic therapy.
Febuxostat is another xanthine oxidase inhibitor.
Rasburicase, a recombinant urate oxidase, is licensed for hyperuricaemia in patients with haematological
It rapidly reduces plasma-uric acid concentration and may be of particular value in preventing complications
Misc Healthcare Topics 2025/26 Edition
Malignancy: Cytotoxics
Compiled By Masterpiecesolutions
Edition: 2025/26
, Medical & Nursing | Misc Healthcare Topics I of V pages
1. Oral mucositis/ a sore mouth is a common complication of cancer chemotherapy; it is most ofen associated
FluorouracilMethotrexateThe Anthracyclines like doxorubicin (also cardio with these)
2. To prevent oral mucositis with fluorouracil what can be helpful?
Good oral hygiene (rinsing the mouth frequently and effective brushing of the teeth with a soft brush 23 times
3. Once a sore mouth has developed, treatment is much less effective. What are the options?
Saline mouthwashes should be used but there is no good evidence to support the use of antiseptic or
mouthwashes. In general, mucositis is self-limiting but with poor oral hygiene it can be a focus for
4. Patients most at risk of tumour lysis syndrome are those with what malignancies?
Non-Hodgkins lymphoma (especially if high grade and bulky disease).
Burkitts lymphoma
Acute lymphoblastic leukamia
Acute myeloid leukamia.
Sometimes those with solid tumours. Basically the more blood related ones in general.
5. What can be predisposing factors to developing tumour lysis syndrome other than the type of malignancy
Pre-existing hyperuricaemia
Dehydration
Renal impairment
6. The features of tumour lysis syndrome include what? (6)
HYPERkalaemia
HYPERuricaemia
HYPERphosphataemia
HYPOcalcaemia
Renal damage
Arrhythmias
7. Hyperuricaemia, which may be present in high-grade lymphoma and leukaemia, can be worsened by
What (common) xanthine oxidase inhibitor should be started 24 hours before treating such tumours?
Allopurinol
Patient should also remain adequately hydrated.
Febuxostat is also a xanthine oxidase inhibitor which can be used but it is seen less commonly and is started
8. The dose of what drugs may need to be reduced to 1/4 of their original dose if allopurinol needs to be given
The dose of mercaptopurine or azathioprine should be reduced if allopurinol needs to be given concomitantly.
9. Hyperuricaemia, which may be present in high-grade lymphoma and leukaemia, can be markedly worsened
chemotherapy and is associated with acute renal failure. If allopurinol is not used what are the two
Febuxostat: 2 days before cytotoxic therapy.
Febuxostat is another xanthine oxidase inhibitor.
Rasburicase, a recombinant urate oxidase, is licensed for hyperuricaemia in patients with haematological
It rapidly reduces plasma-uric acid concentration and may be of particular value in preventing complications
Misc Healthcare Topics 2025/26 Edition
