title: An approach to chemotherapy-associated toxicity.
abstract: The effects of chemotherapy in multiple organ systems may be challenging to discern from the sequelae of malignancy and systemic illnesses with concomitant immunocompromise. Chemotherapeutic agents typically affect multiple organ systems. Intrathecal medication errors may pose particularly devastating neurologic consequences and death, often requiring emergent intervention. This article provides an overview of commonly used chemotherapeutic drugs, indications for use, their adverse effects by organ system, and the management of commonly encountered toxicities. Intrathecal medication errors and specific antidotes are discussed in pertinent management sections. Emergency department management should focus on rapid patient assessment, immediate intervention following intrathecal medication errors, exclusion of infection, and excellent supportive care.
authors.affiliation: Weill Cornell Medical College, New York Presbyterian Hospital, 525 East 68th Street, New York, NY 10065, USA. Electronic address: zhl9006@med.cornell.edu.
authors.forename: Zhanna
authors.initials: Z
authors.lastname: Livshits
authors.forename: Rama B
authors.initials: RB
authors.lastname: Rao
authors.forename: Silas W
authors.initials: SW
authors.lastname: Smith
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D004636:Emergency Service, Hospital; D006801:Humans; D016867:Immunocompromised Host; D008508:Medication Errors / Q000009:adverse effects; D009369:Neoplasms / Q000188:drug therapy*; D014481:United States
chemical_list: D000970:Antineoplastic Agents
keywords: Adverse effects; Cancer; Chemotherapy; Extravasation; Toxicity