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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.