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Chemo effects countermeasures by lp.doc

CHEMO EFFECTS COUNTERMEASURES **** 5/25/2007 for L L P

Tx: Taxotere - eliminated from body –excreted – in first 3 days – residual in the cells

Allergic reactions
hypersensitivity reaction, Hypersensitivity reactions *** stop
especially during the first may be signaled by very
and second infusions
rapid onset of itching/
flushing, redness / rash of
facial skin, palms of hands
and/or reddening and
itching of whites of eyes
(erythema).
Blood pressure may fall
rapidly (hypotension)
and/or you may feel
bronchospasm (inability
to breath).
According to the
manufacturer, this allergic
reaction occurred in 2.2%
of 92 patients
premedicated with 3-day
corticosteroids.
Nausea Vomiting
* Zofran (constipating)
* Marijuana pills
Infection Symptoms
WBC low neutrophils
Temp oral over 100.4 F
* Emergency Dept
Temp EAR over 100.4 F ? * Antibiotics
(RR 2 to 7.5)
* NO dental work
Neutropenia
* Neulasta (Neulasta caused paralytic pain 2nd
cycle - Percocet helped the 3rd cycle)
Granulocytopenia
* G-CSF Neupogen (Filgrastim)
Bruising Bleeding
Low Platelets
PLTS <20 (RR 380)
* Numega (Oprelvekin)
Easy bleeding
* Transfusion
Low HGB below 120
* Aranesp, Procrit, Epogen
(Erythropoietins alpha & beta)
Chemo build up with
* Rest more
Diarrhea
* Immodin-AD, Lomotil
* Low fibre food & avoid gas
* Not longer than 24 hrs – action required
Constipation
* Colace & Senekot
* Citrucel better than Metamucil (gas)
*Up fibre & fluid & exercise
* Not longer than 3 days – action required
Embolism & DVT
Postive D-DIMER test
* Action needed
Heartburn
* Antacids
CHEMO EFFECTS COUNTERMEASURES **** 5/25/2007 for L L P

Tx: Taxotere - eliminated from body –excreted – in first 3 days – residual in the cells
Bowel inflammation

* Low acid foods
* Bentyl for the stomach discomfort caused by
the decadron
Mouth sores
body’s need for glutamine * Rinse salt/baking soda mixture
/ throat irritation
can increase dramatically
* Avoid metals
tumor acts as a
following injury, infection, * Antiviral Herpes labalis breakoout
‘glutamine trap’
or the progression of
* Ice in mouth during infusion
depleting the host of
cancer and in these cases, * Glutamine rinse mouthwash 2 X/day
glutamine and resulting
the need for glutamine can * Oral glutamine (as a mouthwash)
exceed the ability of the
glutamine seems to prevent gut and oral toxic
in cachexia (weight
body to supply it;
side-effects, and may increase the effectiveness
glutamine is one of the
of some chemotherapy
major energy sources
* 10 g X 4/day during any chemotherapy
needed for the
treatments
gastrointestinal tract cells * Glutamine heaping teaspoon full twice a day,
to recover from
except the day of chemotherapy
chemotherapy;
(Glutamine is a white powder that doesn't
dissolve well. Stir well and use a cold to warm to
hot liquid when mixing it. The decomposition
temperature of glutamine is 185ºC)
* infusion of ethyol with each chemotherapy -
No problems with my
fingers -- only toes.
Muscle pain Joint pain
Hair loss
* Rub head with contents of 4 to 6 Vit E pills -
(w olive oil) - night before, night of and night
after chemo - just before bed and cover head in
tee shirt to control messing sheets
* 2 x 200cc carrot juice, 2 x 300 cc cabbage
juice + turmeric - didn't loose hair with juicing.
Edema / swelling
Hand / feet
Skin irritations - Rash
* Aquaphore for feet and hands (dry skin)
Eye tearing
* Eye drops four times a day for dry eyes
* night before, night of and night after chemo -
few vit E pills rub over eye lids - to protect tear
* any glaucoma, prednisone may increase your
intraocular pressure
Nail changes
* Ice on finger nails during infusion
* Vit E pills rub onto fingers and toes - to protect
nails - night before, night of and night after
chemo - repeat for a couple or three nights
again mid-cycle, around day 10.
Nose bleeds
* bioflavinoids to reduce nose bleeds
CHEMO EFFECTS COUNTERMEASURES **** 5/25/2007 for L L P

Tx: Taxotere - eliminated from body –excreted – in first 3 days – residual in the cells
Tingling

Sleep Problems
* Melatonin
Weakness
Numbness
Emotional
* Estradiol patches or gel
Photosensitivity
Odd sensations
TAXOTERE 75 mg/m2 every 3 weeks
+ prednisone 5 mg twice daily
Number of men in trial = 332
Side effect
Anemia Low hemoglobin (red cell) count. If severe may cause fatigue. Can be treated with Procrit®,
Aranesp®, or blood transfusion.
Neutropenia - low neutrophil (white blood cell) count. Makes you more vulnerable to infection. May lead to
treatment interruption until counts recover. Can be treated with Neupogen® or Neulasta®.
Thrombocytopenia - low platelets (the cells that form blood clots that stop bleeding). May cause purple
blotches on skin especially at site of injections. Chemo will be interrupted (delayed) if platelets fall below a
certain level. Severe drop (not common in this trial) may bring on a medical emergency (bleeding) requiring
hospitalization and platelet transfusion.
Febrile neutropenia - fever and a significant reduction in white blood cells. Any temperature over 100.5 F
(Fahrenheit) or 37.5 C (Celsius) should be reported to the medical oncologist without delay and you should go
to the ER (Urgent Care) for work up and antibiotics.
Infection
Epistaxis (nosebleed)
Allergic Reactions, Hypersensitivity reactions see below
Fluid Retention*
Peripheral Edema*- Fluid retention and swelling in feet, ankles, legs or arms
Weight Gain*
Neuropathy Sensory- Nerve damage causing tingling or pain, usually in feet or hands
CHEMO EFFECTS COUNTERMEASURES **** 5/25/2007 for L L P

Tx: Taxotere - eliminated from body –excreted – in first 3 days – residual in the cells
Neuropathy Motor
- Weakness but no tingling, pain or numbness. Cramps or muscle twitching may be
present.
Rash/ Flaking skin
Alopecia - Hair loss
Nail Damage -- keeping finger tips and toes in ice water during the chemo may help. See "Frozen Glove
Reduces Skin and Nail Damage from Docetaxel Chemotherapy" (NCI)

Diarrhea
Stomatitis/Pharyngitis - mouth sores
Taste Disturbance may be a metallic taste
Vomiting
Anorexia - weight loss from lack of interest in food
Dyspnea shortness of breath
Impaired cardiac left ventricular function
Arthralgia joint pain
Myalgia aches and pains, muscle pain
Irritated, teary eyes
use artificial tears during and after each treatment to flush the Taxotere from the surface of the eye to prevent
this problem.
If it persists, tearing can be relieved by a tiny silicone tube inserted in the irritated tear ducts. If you are taking Taxotere and your eyes tear too much, tell your cancer doctor and get checked by an eye doctor who has experience placing these tubes.

Source: http://www.hrpca.org/chemotaxoteresideeffects.pdf

inference.phy.cam.ac.uk

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