Managing the Adverse Effects of Cytotoxic Chemotherapy at the Level of Primary Healthcare

Primary healthcare clinics play a crucial role in managing the side effects of cytotoxic chemotherapy for cancer patients. Loperamide and octreotide are used to control diarrhea, with mouthwashes for mucositis and transdermal fentanyl patches for severe pain. Pilocarpine may help with xerostomia, while a combination of neurokinin-1 receptor antagonists, serotonin receptor antagonists, glucocorticoids, metoclopramide, and olanzapine are utilized for nausea and vomiting. Peripherally acting μ-opioid receptor antagonists can alleviate opioid-related constipation. Granulocyte colony-stimulating factor is recommended for neutropenic fever, and its use in neutropenia without fever depends on the patient's condition. Minoxidil and scalp cooling are options for hair loss, with topical steroid ointments for hand-foot syndrome. Selective serotonin reuptake inhibitors are preferred for depression due to minimal drug interactions and good tolerance. With the growing burden of cancer patient management, it's important for primary healthcare providers to be knowledgeable about these strategies.