Post on 04-Jul-2020
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WELKOM
Nascholingsavond
Oncologie
Deze nascholing wordt mede
mogelijk gemaakt door:
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Programma
• Opening & voorstellen
• Kennistoets
• Presentatie ziektebeeld en behandelmethoden
• Pauze
• Workshops
• Plenaire terugkoppeling en afsluiting
• Hoe nu verder?
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Kennistoets
10 min
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Presentatie ziektebeeld &
behandelmethoden
1. Waarom dit onderwerp?
2. Wat is kanker
3. Incidentie
4. Behandelmethoden
5. Bijwerkingen
6. Veiligheidsmaatregelen
7. Pijn bij kanker
8. Behandeling met opioïden
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1.Waarom dit onderwerp?
• Steeds meer kanker
• Meer orale oncolytica, dus meer 1e lijn
• Deelbehandeling thuis
• Kennis niet altijd aanwezig
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Kennisvragen
• Wat is kanker?
• Wat is het verschil tussen een
goedaardige en kwaadaardige tumor?
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Kennisvraag
• Welke vorm van kanker komt het meest
voor bij mannen en welke bij vrouwen?
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3. Incidentie Incidentie: Kanker en hart- en vaatziekten in totale sterfte, 1970-2008
Meest voorkomend
• Mannen - prostaatkanker
• Vrouwen - borstkanker
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Kennisvraag
• Noem 6 risicofactoren van kanker
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6 x sterker tegen kanker
• Niet roken
• Verstandig zonnen
• Gezonde voeding
• Matig met alcohol
• Voldoende bewegen
• Gezond gewicht
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Kennisvraag
• Noem 3 behandelmethoden van kanker
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4a. Behandelmethoden
• Operatie (chirurgie)
• Bestraling (radiotherapie)
• Medicatie tegen kanker: chemotherapie, chemokuur, cytostatica, oncolytica
• Curatieve therapie
• Palliatieve therapie
• Adjuvante therapie
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4b. Medicatie tegen kanker
• Hormonen & antihormonen – Tamoxifen, Arimidex® (anastrozol), Casodex®
(bicalutamide), Megace® (megestrol), Lucrin®
• Immunomodulantia – Intron® (interferon)
• Immunosuppresiva – Thalidomide, lenaldomide
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4c. Medicatie tegen kanker(1)
• Antimetabolieten
- Xeloda®, Alkeran®
• Alkylerende stoffen
- Temodal®
• Signaaltransductieremmer
- Sutent®
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Weet wat je aflevert!
Tuchtcollege klacht ingediend:
• 5-daagse kuur
• 7 herhalingen
• Ontbreken indicatie, stopperiode
Gevolg na 25 dagen cytostaticum:
• Ziekenhuisopname
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4c. Medicatie tegen kanker (2)
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Kennisvraag
• Noem een aantal
bijwerkingen van oncolytica
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5. Bijwerkingen (1)
• Maag-darmklachten
• Onvruchtbaarheid
• Moeheid
• Beenmerg depressie
• Misselijkheid / braken
• Haaruitval
• Hand-footsyndroom
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5. Bijwerkingen (2)
Misselijkheid / braken
– Ondansetron (Zofran ®)/ granisetron (Kytril ®)
– Metoclopramide
– Dexamethason
– Aprepitant (Emend ®)
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5. Bijwerkingen (3)
Haarproblemen
• Haarverdunning
• Haaruitval
• Groeit (bijna) altijd
terug
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5. Bijwerkingen (4)
Hand- voetsyndroom
• Huidreactie handen en voeten
Klachten
• Jeuk
• Pijn of gevoeligheid
• Roodheid
• Schilferen of vervellen van de huid
• Zwelling
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6. Veiligheidsmaatregelen
• Oncolytica zijn risicostoffen, verspreiding
vindt plaats via: – Medicatie & Lichaamsvloeistoffen
• Tot 7 dagen na laatste dosis
veiligheidsmaatregelen in acht nemen.
• Mantelzorgers en zorgprofessionals (assistente) – Medicatie en behandelwijze
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7. Pijn bij kanker
• Bij 40 tot 50% v/d patiënten matige tot ernstige pijn
• Voor komen van pijn bij kanker voor 1900 hetzelfde na 2000
• Inschatting pijnintensiteit
• Misvattingen bij patiënten
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Kennisvragen
• Wat is de maximale dosering van morfine?
• Noem de meest voorkomende bijwerking van
opioïden?
• Waarom behandeling van pijn altijd met 2
verschillende opioïden?
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8. Behandeling met opioïden
Morfine geen maximale dosering
Bijwerkingen opioïden
Misselijkheid / braken - verdwijnt binnen aantal dagen
Obstipatie - laxantia
Langwerkend preparaat
altijd in combinatie
Kortwerkend preparaat
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Vragen?
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PAUZE
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Workshops
• Receptcasuïstiek
• Kruip in de huid van de cliënt
• Misvattingen over kanker
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Hoe nu verder?
• Naslagwerken
• Verbeteringen doorvoeren in apotheek
• Zorgprojecten
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Verwachtingen
Heeft de nascholing
aan je verwachtingen
voldaan?
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Evaluatie
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Wel thuis!
Deze nascholing werd mede mogelijk gemaakt door:
No elements of this document may be reproduced in any form without the written permission of Alliance Boots. All trademarks and registered trademarks are in the property of their respective owners.