ch 22 pharm

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Author:
jackiedh
ID:
81655
Filename:
ch 22 pharm
Updated:
2011-04-25 11:49:42
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red CANCER CHEMO
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ch 22 pharmacology
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  1. anti-cancer chemo kills cells progressing through the _____ phases of ________ cell cycle
    • active
    • reproductive
  2. what is no aptoptosis (physiologic cell death) and cells grow called?
    malignancy
  3. what are 3 commonly used anticancer agents?
    • methotrexate
    • 5-fluorouracil
    • doxorubicin
  4. what is a new anticancer agent?
    monoclonal antibody therapy
  5. trastuzumab (Herceptin) inhibit proliferation of breast cancer cells. What kind of therapy is this?
    monoclonal antibody therapy
  6. what is an ADE of suppression of bone marrow?
    increased susceptibility to infection
  7. what is an ADE of GI disturbance?
    nausea
  8. what is an ADE of cutaneous manifestations?
    alopecia (does NOT affect dental tx)
  9. what is an oral manifestation ADE?
    mucositis
  10. what is the term to describe physiologic programmed cell death called?
    apoptosis
  11. what is the MOST COMMON ORAL COMPLICATION?
    mucositis
  12. drugs associated with oral manifestations from chemo are: 3
    • fluorouracil
    • interferon
    • methotrexate
  13. what is the MAJOR concern of mucositis?
    • painful
    • systemic infection
    • erythema
    • ulceration
  14. what are the most feared complication
    candida species
    may spread to other sites
    noncandidal infections on the rise?
    fungal infections
  15. which dna viruses are the most frequent cause of viral infection? how many days for recurrent infection?
    • herpes simplex virus infections
    • 7-14 days
  16. what may reduce platelet formation, inducing thrombocytopenia
    gingival bleeding or submucosal called?
    hemorrhage
  17. _________ contributes to pt's discomfort and risk of infection. it contributes to oral _______ and opportunistic bacterial pathogens
    • xerostomia
    • candidiasis
  18. which oral manifestations are neurologic complications of pain and neuropathy? 3
    • mucosistis
    • xerostomia
    • infection
  19. what is a chemotherapy induced neuropathy?
    alkaloids
  20. poor oral health will result in _____
    what has severe oral complications
    reduced ability to receive adequate doses of chemo?
    ONJ osteonecrosis of the jaw
  21. these are preventive strategies BEFORE chemo: 2
    • oral examination
    • radiographic evaluation
  22. what percentage of pt's may experience acute or chronic complications from chemo?
    40%
  23. what is the basis for future comparisons and assists in monitoring and tx of oral complications? 3
    • dental exam with surgical and restorative care
    • proper oral hygiene procedures/instructions
    • perio exam and tx
  24. t/f during all surgical procedures and hygiene appt should be treated 10 days before neutropenia
    true
  25. teeth nonrestorable or with severe periodontal involvement before initiation of therapy should be ______
    removed
  26. who determines what should be done for an antibiotic prophy?
    physician
  27. t/f determine specific regimen in close consultation with managing physician-severe neutropenic-specific to microbes (antibiotic prophy)
  28. true
  29. when using topical agents with mucositis, what is inhibited?
    cox 1 inhibitors
  30. what are the three topical anesthetic agents that will comfort the pt with mucositis? 2
    • viscous lidocain
    • dyphenhydramine syrup
  31. what may be combined with coating agents -miracle mix for mucositis?
    aluminum hydroxide (milk of magnesia, Mylanta)
  32. what are cox- 1 inhibitors cx with viscous lidocaine and diphenhydramine syrup
    APAP and opioid receptor agonists in combo
  33. what is the MOST neutral and least damaging mouthwash?
    Saline
  34. for OHI of saline it should ___ tsp salt in ___ oz water. _____x/day for ____days
    • 1/2 tsp
    • 8oz
    • 5-6 days
  35. what does salt water do?
    help kill the bacteria
  36. with mucositis, remove dental plaque with ___ _____ brush, avoid products irritating to ____ tissues, clean teeth every ____ hours(q4h), and _____ from wearing removable prostheses, eat soft, bland diet
    • soft bristle
    • soft
    • refrain
  37. how often should cleansing be performed with mucositis?
    every 2-4 hours
  38. what is a modified mechanical approach for mucositis?
    disposable sponge, gauze, cotton swab soaked in non-alcohol chlorhexidine .12%
  39. what is the MOST FREQUENTLY RECOMMENDED AGENT for a fungal infection?
    FLUCONAZOLE (nystatin is no longer recommended in myleosuppression)
  40. what is the drug of last resort for non-responsive fungal infections?
    parenteral amphotericin B
  41. SLIDE 28
    k

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