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.
EMBARGOED UNTIL 2.00 PM TUESDAY 4 AUGUST 1998 NZ FINANCIAL PLANNING COMPANY THE PROBLEM WITH PEOPLES' REPUBLICS ROGER KERR EXECUTIVE DIRECTOR CHRISTCHURCH NEW ZEALAND BUSINESS ROUNDTABLE 4 AUGUST 1998 THE PROBLEM WITH PEOPLES' REPUBLICS A few months ago I read a report that more people were on Prozac in Christchurch than anywhere else in New Zealand. I wondere
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