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WorksheetsChemo Induced Cardiotoxicity and Cancer Associated VTE
Total questions: 18
Worksheet time: 12mins
What drug chemotherapy class casues Type 1 Cardiotoxicity
Anthracyclines
HER-2 Agents
Alkylating agents
Antimetabolites
Doxycycline a Type I Cardiotoxic drug has what characteristics below?
Direct reversible damage
Results in cellular apoptosis
Incidence independent of dosing
Least favorable
9-18% incidence rate
Type 2 Cardiotoxicity chemo medications consists of what drug class?
Anthracyclines
HER-2 Agents
Taxanes
Antimetabolites
HER-2 agents cause ____ damage
Irreversible
Reversable
Agents other than Anthracyclines and HER-2 agents that cause cardiotoxicity include
Alkylating agents
Angiogenesis inhibitors
Tyrosine kinase inhibitors
Immune checkpoint inhibitors
Arsenic trioxide
Cardiomyopathy, Myocarditis, Pericarditis, Acute coronary syndrome, Congestive heart failure, Left ventricular dysfunction are all types of
Systemic Injury
Hepatic Injury
Cardiac Injury
Neuropathic Injury
Which of the following is not a patient realted risk factor for cardiac injury?
Increasing age over 55
Diabetes
Right Ventricular Heart Failure
Genestic Predispositions
Therapy related risk facotrs for cardiac injusry include
Concomitant use of mediastinal radiation
Bolus administered chemotherapy
Previous utilization of other cardiotoxic chemotherapies
Chemotherapy (any type)
Combination chemotherapy
Symptoms of cardiac injury include
SOB
Weight loss
Dizziness
Stomach distention
Chronic cough
What diagnostic imaging test would be best for for cardiac injury diagnosis?
Cardiac Magnetic Resonance Imaging (CMR)
Multiple-gated acquisition (MUGA)
Echocardiography (ECG)
Positron Emission Tomography (PET)
What is the LVEF threshold for starting cardiotoxic chemotherapy?
30%
45%
55%
75%
What range of LVEF decline determines if cardiotoxicity is being caused by anthracyclines?
> 30% decrease when baseline LVEF is not normal
> 20% decrease in left ventricular ejection fraction (LVEF) when baseline is normal (55% or higher)
> 10% decrease when baseline LVEF is not normal
> 10% decrease in left ventricular ejection fraction (LVEF) when baseline is normal (55% or higher)
What range of LVEF decline is seen in patients recieving HER-2 chemotherapy that determines if cardiotoxicity is occuring?
10% to 55% decrease in LVEF with (s/sx) of HF
5% to 55% decrease in LVEF with (s/sx) of HF
10% to 55% decrease in LVEF without s/sx of HF
5% to 55% decrease in LVEF without s/sx of HF
Before starting a a patient on a cardiotoxic chemotherapy regimine what should be done first to help prevent cardiac injury?
Evaluate/reduce cardiovascular risk prior to treatment selection
Evaluate/reduce myopathy risk prior to treatment selection
Evaluate/reduce stress levels prior to treatment selection
Evaluate/reduce medication cost prior to treatment selection
When administering anthracyclines, what measures can be taken to reduce cardiotoxicity?
Be aware of cumulative lifetime dosing
Only give bolus doses
Administer cardio protectants (dexrazoxane)
Use liposomal formulations
What is the maximum lifetime dosage for doxorubicin?
550 mg/m2
450 mg/m2 in patients who have received mediastinal radiation
1550 mg/m2
1450 mg/m2 in patients who have received mediastinal radiation
What medication is used in the prevention of cardiotoxicity in anthracycline use?
Dexrazoxane (Zinecard®)
Dexamethasone (Decadron®)
Dexrazoxane (Totect®)
Other than Zinecard® what medications can be used in the prevention/treatment of cardiotoxicity in patients recieving chemotherapy?
ACEIs
ARBs
Statins
Beta Blockers
