ONS/ONCC Chemotherapy/Immunotherapy Lesson 6: Symptoms that can be dose- limiting; Lesson 7: Cumulative Dose Exam Questions and Answers 100% Pas

ONS/ONCC Chemotherapy/Immunotherapy Lesson 6: Symptoms that can be dose- limiting; Lesson 7: Cumulative Dose Exam Questions and Answers 100% Pass Cumulative dose - Correct Answer ️️ -total amount of one antineoplastic agent given to the pt, adding up each time that the pt has received it Cumulative lifetime dose - Correct Answer ️️ --"cumulative dose should not exceed..."- total amount of specific antineoplastic agents that can be safely given over the course of a pt's lifetime -critical to track lifetime dose Chemotherapy Induced nausea & Vomiting (CINV) - Correct Answer ️️ --primary prevention strategy is through consistent use of optimal antiemetic therapy beginning with initial cycle -prevention is pivotal when attempting to maximize pt quality of life and crucial to preventing delays in treatment Two Neural Pathways associated with chemo emetic response - Correct Answer ️️ - 1.Peripheral pathway al pathway Two neurotransmitters involved in vomiting - Correct Answer ️️ -1. serotonin 2. substance P 5-HT3 receptor antagonists - Correct Answer ️️ -active in peripheral path and counteract acute nausea and vomiting by blocking serotonin activity e.g. Aloxi NK1 dependent mechanism - Correct Answer ️️ -active in central pathway and is active in the late-acute phase/delayed phase -substance P acts on NK1 receptors -Aprepitant Uncontrolled CINV can cause patient to become: - Correct Answer ️️ --malnourished -dehydrated -electrolyte imbalances -physical/mental deterioration -treatment may be delayed or patient may choose to stop beneficial chemo d/t CINV Risk Factors for CINV (6) - Correct Answer ️️ -1. Patient age (<50 years) 2. Female sex 3. History of motion sickness 4. History of N/V during pregnancy 5. Poor control of CINV in previous chemo cycles 6. History of chronic alcoholism (DECREASES risk) Types of CINV - Correct Answer ️️ --Acute -Delayed -Breakthrough -Anticipatory -Refractory Acute CINV - Correct Answer ️️ -w/in 24 hrs of chemo Delayed CINV - Correct Answer ️️ -24 hrs-5days after chemo Breakthrough CINV - Correct Answer ️️ -occurs despite preventative treatment Anticipatory CINV - Correct Answer ️️ -triggered by taste, odor, memories, visions, anxiety related to chemo Refractory CINV - Correct Answer ️️ -occurs during subsequent cycles when treatment failed earlier cycles Highly Emetogenic Chemotherapy (HEC) - Correct Answer ️️ --causes CINV in 90% of pt -e.g. carmustine, cisplatin, cyclophosphamide, decarbazine, mechl