Emetogenicity of Chemotherapy

[adidastoes15]

Does anyone have any tips on easy ways to memorize Emetogenicity of Chemo? I've got an oncology module exam this friday and this stuff is not sticking well at all. Any help would be greatly appreciated!

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[cycloketocaine]

Does anyone have any tips on easy ways to memorize Emetogenicity of Chemo? I've got an oncology module exam this friday and this stuff is not sticking well at all. Any help would be greatly appreciated!

Cisplatin.

Done.

 

[wes011]

Memorize the highly emotegenic drugs, there are only like 5 of them.

AC (doxarubicin or epirubicin + cyclophosphamide)
Carmustine > 250 mg/m^2
Cisplatin > 50 mg/m^2
cyclophosphamide > 1500 mg/m^2
dacarbazine

Treatment options
Low - 1 drug
Moderate - 2 drugs
High - 3 drugs

start with dedamethasone, add 5HT-3 antagonist, add apprepitant

 

[Protongenic]

http://www.asco.org/ASCOv2/Department%20Content/Cancer%20Policy%20and%20Clinical%20Affairs/Downloads/Guideline%20Tools%20and%20Resources/Antiemetics/2011/Antiemetic%20Dosing%20Clinical%20Tool_9.21.11.pdf

 

[rph3664]

The platinum-based drugs are all highly emetogenic, and Zofran was mainly invented to deal with cisplatin, a drug some people refused to take a second time because the N/V caused by it is/was very severe and did not respond to other antiemetics.

If you know what the drugs look like, a good guideline is this (excepting the Pt-based drugs, which are all colorless): If the drug has a color, it's probably on the highly emetogenic list. One exception is methotrexate, which isn't at low doses but is at high (multiple grams) doses and is also bright yellow.

Carmustine is bright red.

Mustargen is olive green.

 

[ucrx]

The platinum-based drugs are all highly emetogenic, and Zofran was mainly invented to deal with cisplatin, a drug some people refused to take a second time because the N/V caused by it is/was very severe and did not respond to other antiemetics.

Cisplatin >> carboplatin for emetogenicity. Cisplatin is the classic example of a highly emetic agent, and also causes significant delayed N/V. Carboplatin is moderately emetic per ASCO and causes much less N/V than cisplatin. There are several other differences in toxicity between the two agents.

I don't have a good system to memorize them. I just use the info so much it stuck.

 

[Quiksilver]

The platinum-based drugs are all highly emetogenic, and Zofran was mainly invented to deal with cisplatin, a drug some people refused to take a second time because the N/V caused by it is/was very severe and did not respond to other antiemetics.

If you know what the drugs look like, a good guideline is this (excepting the Pt-based drugs, which are all colorless): If the drug has a color, it's probably on the highly emetogenic list. One exception is methotrexate, which isn't at low doses but is at high (multiple grams) doses and is also bright yellow.

Carmustine is bright red.

Mustargen is olive green.

mitomycin is purple n not highly ematogenic and methotrexate is always yellow as a solution. Even in tiny GVHD doses, the bag has a yellow tinge, and this rule doesn't hold true because IT MTX is concentrated urine yellow but doesn't make it highly ematogenic.

The best way to learn the table is to know the drug classes MOA and common side effects. Each of them have side effects common with related structures ( i.e. the anthracyclines, vinca analogues, taxels, etc.) This is how you can group them. I know that sometimes they don't always fall into the same category per NCCN antiemesis guidelines, but it'll help you a lot more with the rest of the module and picking out side effects. The other way to learn is to learn regimens including supporting meds which may be difficult to do over a short period of time.

 

[rxlea]

Carmustine is not bright red.

 

[rph3664]

Carmustine is not bright red.

It is before it's diluted. Ever heard it referred to as "the red death"? It's also very lipophilic, and will go through your skin should you spill any on you.

 

[rxlea]

It is before it's diluted. Ever heard it referred to as "the red death"? It's also very lipophilic, and will go through your skin should you spill any on you.

Haven't heard it called that. That would be doxorubicin.

Carmustine is a colorless to yellowish solution.