Deze nascholing wordt mede mogelijk gemaakt door:
WELKOM Nascholingsavond Oncologie
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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. 2. 3. 4. 5. 6. 7. 8.
Waarom dit onderwerp? Wat is kanker Incidentie Behandelmethoden Bijwerkingen Veiligheidsmaatregelen Pijn bij kanker 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 8 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.
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
13
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 15 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.
4c. Medicatie tegen kanker (2)
16
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 18 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.
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 20 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.
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 22 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.
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:
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