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HelixTalk Episode #59 - The five oncology drugs every pharmacist should know about
Date posted: April 11, 2017, 6:00 am
In this episode, we discuss with Dr. Megan Hartranft the five oncology drugs that every pharmacist should know about, which is a great review for P4 students who are currently preparing for the NAPLEX. We cover cyclophosphamide, cisplatin, methotrexate, doxorubicin, and vincristine.
- Cyclophosphamide (Cytoxan) and other nitrogen mustards can cause hemorrhagic cystitis -- pain, inflammation, and bleeding of the bladder. Depending on the chemotherapy regimen, IV mesna may be given to prevent this adverse effect.
- Cisplatin (Platinol) and other platinum can cause renal damage. IV fluids before and after chemotherapy and adequate hydration at home are extremely important with this chemotherapy class.
- High-dose methotrexate usually requires “rescue” therapy with leucovorin. Leucovorin stops the methotrexate toxicity in healthy cells, but is not taken into cancerous cells.
- Doxorubicin (Adriamycin) and other anthracyclines can cause cardiotoxicity in the form of heart failure and arrhythmias. Patients should have echocardiograms and EKG to monitor for toxicity. To mitigate this risk, a maximum lifetime dose (550 mg/m2 or 450 mg/m2 depending if chest radiation was done) is implemented and in high-risk patients, IV dexrazoxane is sometimes considered.
- Vincristine (Oncovin) and other vinca alkaloids should never ever, ever be given via the intrathecal route -- it can be a fatal error if given via the IT route.