Term
def:
leakage of Iv fluid out of vein into interstitial |
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Definition
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Term
def:
agent that causes redness, blistering than lead to necorsis |
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Definition
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Term
DEf:
if extravasated, this agent rarely produces tissue necorsis |
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Definition
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Term
| vesicanta are on slide 5 and are all in the word doc |
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Definition
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Term
| irritant agents are on sldie 6 and on the word doc |
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Definition
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Term
| how do anthracycliens cause tissue destruciton |
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Definition
| DNA binding (it causes cell death and thi scna spread to surrounding cells) |
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Term
| doxorubiicn can remain in tissue and cause destruciton for how long? |
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Definition
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Term
| MOa of vinca alklaoids tissue destruction |
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Definition
| non DNA binding (immediate cell destruction in soft tissue) |
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Term
| vinca alkaloids have shorter duration of tissue dest than anthracyclines and so better healing* |
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Definition
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Term
| Pt risk factors for extravesation-5 |
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Definition
mult. venipunctures
young/old
heavily sedated
paresthesias
cant communicate |
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Term
| which catheter should be used to prevent extravasation |
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Definition
| central venous (flexibile) |
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Term
| repeat venipunctures should be done where to prevent extrvasation |
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Definition
| proximal to prior needle site |
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Term
| admin IV through _ if given peripherally to prevent extravasation |
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Definition
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Term
| clinical presentaiton fo extravasation-3 |
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Definition
| pain and burning, swelling, lack of blood return |
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Term
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Definition
1) stop infusion
2) aspirate drug from cannula before reomved
3)apply heat for vinca and epipodophyllo; otherwise cold packs |
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Term
| what 2 tx dont use for extravasation |
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Definition
glucocorticoids
Na bicarb (increase Ph and icnrease anthracyclines) |
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Term
| specific tx for extravasation form anthracyclines-2 |
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Definition
cold compress
DMSO topical x 1 weeks or dexrazoxane 3 Iv doses |
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Term
| when shoudl DMSO not be given to anthracycline extravasated pt |
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Definition
| if they are on Dexrazoxane |
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Term
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Definition
local irritaiton
infeciton
increase LFTs/SrCr |
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Term
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Definition
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Term
| Tx for mechlorethamine extravasation-2 |
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Definition
cold pack
1/6M sol sodium thiosulfate |
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Term
| Tx for vinca alkaloids extravasation-2 |
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Definition
heat pack
hyaluronidase 150 io Iv/SQ |
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Term
| when would you do plastic surgery for extravasation |
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Definition
| if lasts > 48 hrs after antitode |
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Term
| 3 most common cancers for hyperC |
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Definition
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Term
normal Ca level-
non ionized inactive prot bound make sup?
active free ionized?
inactive complexed? |
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Definition
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Term
Ca levels must be corrected for changes in serum-
**ask someone for corrected Ca equation |
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Definition
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Term
| the majority of hypercalcemias is? |
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Definition
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Term
| whcih type fo hypercalcemia is asoc with bone metastses |
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Definition
| local osteolytic hypercalcemia |
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Term
osteolytic HCM:
what factros foe the tumor cell releasE?
what do they stimulate? |
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Definition
protaglanding E, growth factors, cytokines
osteoclast |
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Term
osteolytic HCM
osteoclastic activity releases TGF -b that stimulates- |
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Definition
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Term
which catheter should be used to prevent extravasation
osteolytic HCM
bone resportion release _ resulting in? |
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Definition
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Term
| lok at slide 29 for MOa of Hypercalcemia in humoral hyeprcalcemia**** |
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Definition
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Term
| GI signs fo hypercaclemia-4 |
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Definition
constipaiton
nausea
vomit
anorexia |
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Term
| Renal signs of hypercalcemaia-4 |
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Definition
polyuria
polydipsoa
dehydraiton
decreased GFR |
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Term
| neurologic signs of hypercalcemia-4 |
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Definition
lethargy/confusoin
fatgie
seizures
irritble |
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Term
| cardiac signs of hyperCa-3 |
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Definition
wide T wave
shortened QT
arrythmias |
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Term
| Tx for hypercalcemia depedns on what 2 things |
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Definition
symtpoms
serum calcium levels |
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Term
| 3 basic intervention for HyperC- |
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Definition
tx underlying laignancy
d/c drugs that increase Sr Cr/decrease renal
encoruage ambulaiton |
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Term
| Tx for Corrected Ca <12 and asympt |
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Definition
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|
Term
| when do you treat hyper C? |
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Definition
Corrected Ca12-14 + symtpoms
Correct Ca >14 regardless of symptoms |
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|
Term
hydration for hyperC
-what do you sue to manage fluid overload |
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Definition
normal saline 200 mL/hr
furosemide |
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Term
| whihc bisphosphonates and doses are used for hyper Ca tx |
|
Definition
zoledronic acid- 4 mg IV
pamidronate 60 mg Iv |
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Term
| are the bisphosphonats mentioned for tx of hyperCa non N or nitrogen containing? |
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Definition
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Term
| tables of bisphosphantes on slide 39 |
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Definition
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Term
compared to etidronate pamidronate antiresporptive potency is?
aldenronate
zolendronate |
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Definition
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Term
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Definition
inhibit oseoclast recutirmnt
inhibit osteoclast apoptosis
inhibit osteoclast activity |
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Term
| zoledronic vs pamidronate, which had more effiacy and whihc day was this shown |
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Definition
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Term
| duraito of response for pamidronate vs zoledronic |
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Definition
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Term
| montior what prior to each dose of a bisphisphante? |
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Definition
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Term
infusion for
pamidornate vs zoledronic acid |
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Definition
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Term
| osteonecoris is an ADE of bisphosphantes, pathogenesis is unknown and sxs are loose teech, pain, exposed bone*** |
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Definition
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Term
| what % of ppl reported prior dental events preceeding osteonecorsis of jaw? |
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Definition
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Term
| why give calctionin for hyperCa?-2 |
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Definition
| inhibits osteoclast resportion and increase renal excretion of Ca |
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Term
| what can youg ive as tx for rapid reduciton of Ca? |
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Definition
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Term
ADE of calcitonin
max day of use for this drug? |
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Definition
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Term
| corticosterois to be used in hyperCa (tho these arent sed a lot, why?) |
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Definition
prednisone 40 mg PO QD
due to ADes |
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