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Chapter 12: Oncology Overview and Supportive Care

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Select the genitourinary adverse reaction associated with cyclophosphamide.

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a. Cardiomyopathy

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b. Myelosuppression

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c. Ototoxicity

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d. Hemorrhagic cystitis

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Answer d is correct. Cyclophosphamide (and ifosfamide) is metabolized to acrolein and this metabolite damages the bladder leading to hemorrhagic cystitis.

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Answer a is incorrect. Anthracyclines are associated with cardiac toxicity.

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Answer b is incorrect. While all antineoplastic agents have the ability to cause myelosuppression, the question specifically asked about genitourinary effects.

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Answer c is incorrect. Platinum agents are associated with ototoxicity.

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A nurse is reviewing a patient profile and notices that the patient has an order for high-dose busulfan. What prophylaxis medication should patients on high-dose busulfan receive?

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a. Anticonvulsant

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b. Fluids

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c. Colony stimulating factor

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d. Leucovorin

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Answer a is correct. Seizures have been reported with busulfan and patients receiving high-dose busulfan should receive anticonvulsant prophylaxis.

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Answers b, c, and d are incorrect. Patients receiving high-dose busulfan would not need prophylaxis empirically with any of those. Fluids would be reserved for patients that need hydration (eg, prevention of hemorrhagic cystitis from cyclophosphamide or prevention of nephrotoxicity from cisplatin). Colony stimulating factors would be reserved for neutropenia and only select patients would receive. Leucovorin would be reserved for high high-dose methotrexate therapy (≥1 g/m2).

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Select the antineoplastic that is associated with causing tinnitus.

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a. Cyclophosphamide

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b. Cisplatin

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c. Cytarabine

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d. Dactinomycin

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Answer b is correct. Cisplatin is associated with causing ototoxicity manifested by tinnitus or loss of high frequency hearing.

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Answers a, c, and d are incorrect. Those antineoplastic agents are not associated with tinnitus.

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Select the antifolate antimetabolite that is associated with mucositis, fatal hepatotoxicity, pneumonitis, and lymphomas.

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a. Cytarabine

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b. Hydroxyurea

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c. L-asparaginase

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d. Methotrexate

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Answer d is correct. Methotrexate is an antimetabolite that irreversible binds to dihydrofolate reductase resulting in inhibition of purine and thymidylic acid synthesis. Methotrexate has multiple uses and dosing regimens and is associated ...

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