Chemotherapy Drugs 🧪
Quick reference for common chemotherapy drugs: classes, dosing, side effects, and monitoring requirements for NCHDs.
⚠️ Important Safety Notes
- Chemotherapy handling requires specialized training and PPE - never handle without proper training
- Always follow local oncology protocols and consult with oncology team before any administration
- Many drugs are vesicants (cause tissue damage) - extravasation protocols must be followed
- Monitor for hypersensitivity reactions - have emergency equipment ready
- Check renal/hepatic function before administration of most agents
Common Side Effects & Management
- Nausea/Vomiting: 5-HT3 antagonists (ondansetron), NK1 antagonists (aprepitant), steroids
- Myelosuppression: Monitor FBC, consider G-CSF, blood transfusions if needed
- Mucositis: Good oral hygiene, mouthwashes, pain management, nutritional support
- Diarrhea: Loperamide, fluid replacement, consider dose reduction
- Hand-foot syndrome: Emollients, avoid friction, consider dose reduction
- Neuropathy: Gabapentin/pregabalin, dose modification, physiotherapy
- Alopecia: Scalp cooling, wigs, psychological support
Emergency Situations
- Extravasation: Stop infusion immediately, aspirate, apply cold/heat as per protocol, notify oncology
- Hypersensitivity: Stop infusion, give antihistamines/steroids, consider adrenaline if severe
- Tumor lysis syndrome: IV fluids, allopurinol, rasburicase, monitor U&E closely
- Febrile neutropenia: Immediate antibiotics, consider G-CSF, hospital admission
- Cardiotoxicity: Stop anthracyclines, cardiology review, consider dexrazoxane
Pre-treatment Assessment
- Full blood count (FBC) - check for adequate counts
- Renal function (U&E, eGFR) - many drugs require dose adjustment
- Liver function (LFTs) - hepatotoxicity risk
- Cardiac function (echo) - for anthracyclines and trastuzumab
- Pregnancy test - if applicable
- Performance status assessment
- Baseline neurological assessment for neurotoxic drugs
💊Chemotherapy Drugs Reference
| Drug | Class | Common Doses | Key Side Effects | Monitoring |
|---|---|---|---|---|
| Methotrexate | Folate antagonist | 15-25mg/m² weekly | Mucositis, hepatotoxicity, myelosuppression | LFTs, FBC, creatinine |
| 5-Fluorouracil (5-FU) | Pyrimidine antagonist | 400-500mg/m² daily | Mucositis, diarrhea, hand-foot syndrome | FBC, LFTs |
| Capecitabine (Xeloda) | 5-FU prodrug | 1000-1250mg/m² BD | Hand-foot syndrome, diarrhea, myelosuppression | FBC, LFTs |
| Gemcitabine (Gemzar) | Nucleoside analogue | 1000-1250mg/m² weekly | Flu-like syndrome, myelosuppression, rash | FBC, LFTs, U&E |
| Cytarabine (Ara-C) | Pyrimidine analogue | 100-200mg/m² daily | Cerebellar toxicity, myelosuppression | FBC, neurological assessment |
Methotrexate
Folate antagonistDose:15-25mg/m² weekly
Side Effects: Mucositis, hepatotoxicity, myelosuppression
Monitoring: LFTs, FBC, creatinine
5-Fluorouracil (5-FU)
Pyrimidine antagonistDose:400-500mg/m² daily
Side Effects: Mucositis, diarrhea, hand-foot syndrome
Monitoring: FBC, LFTs
Capecitabine (Xeloda)
5-FU prodrugDose:1000-1250mg/m² BD
Side Effects: Hand-foot syndrome, diarrhea, myelosuppression
Monitoring: FBC, LFTs
Gemcitabine (Gemzar)
Nucleoside analogueDose:1000-1250mg/m² weekly
Side Effects: Flu-like syndrome, myelosuppression, rash
Monitoring: FBC, LFTs, U&E
Cytarabine (Ara-C)
Pyrimidine analogueDose:100-200mg/m² daily
Side Effects: Cerebellar toxicity, myelosuppression
Monitoring: FBC, neurological assessment
⚠️
Important Safety Notes
Chemotherapy handling requires specialized training and PPE. Always follow local oncology protocols and consult with the oncology team before any administration. Many drugs are vesicants and require extravasation protocols.
Educational reference only. Medical disclaimer