Oncology handbook

Do not use aminoglycosides or furosemide in a patient who recently received cisplatin unless there is no alternative.

F) Cytarabine (Ara-C)

Pyrimidine analog; acts as “false base” for DNA. Myelosuppression and neurotoxicity are dose-limiting. Conjunctivitis must be prevented with isotears or similar ophthalmic drops every 2 hours while awake, during and x 12 hr after infusions of  1 g/m². Cytarabine may cause fever during and up to 36 hours after the infusion. Rashes, including severe skin desquamation may occur. Maintenance hydration is adequate during high-dose Ara-C. Emesis can be moderate at high-doses.

II. SELECT TOXICITIES OF CHEMOTHERAPY
Anaphylaxis:

VP-16 (Etoposide), L-Asparaginase, Carboplatin

Cardiomyopathy:

Doxorubicin, Daunorubicin, Idarubicin, Mitoxantrone

Coagulopathy; thrombosis:

Asparaginase

Constipation/ileus:

Vincristine, Vinblastine

Fever (within 24-36 hours of dose):

Vincristine, Ara-C (often associated with rash, conjunctivitis, arthralgias: "Ara-C Syndrome")

Glomerular toxicity:

Cisplatin, Methotrexate, Carboplatin

Hemorrhagic cystitis:

Cyclophosphamide, Ifosfamide

Hepatitis:

Methotrexate, 6-MP, 6-TG, Asparaginase

Hyperglycemia – insulin-dependent (usually reversible):

Asparaginase, Prednisone, Dexamethasone

Mucositis:

Methotrexate, Adriamycin, Daunomycin, Actinomycin, Ara-C (high-dose), Etoposide (high dose)

Ototoxicity:

Cis-Platin (worsened with concomitant/subsequent use of furosemide and aminoglycosides).