05.21 - Drug Tx of Renal Cancer (Sweatman) Flashcards Preview

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Flashcards in 05.21 - Drug Tx of Renal Cancer (Sweatman) Deck (54):
1

Admin of IFN-alpha 2b

SC 3 x weekly

1

Coca Cola urine =

Rhabdomyolysis

2

Toxicity of Cyclophosphamide

Meylo; Hemorrhagic Cystitis (mesna)

3

Maculopapular rash, mucositis, anemia, fatigue

Rapamycins

4

IFN-alpha 2b is used off label to treat

Clear Cell RCC

5

Adminstration of high dose IL-2 is akin to

Induction of controlled state of septic shock

5

Pharmacologic support for patients taking Aldesleukin

Abx, Dopamine for GFR, Phenylephrine for BP support, Fever and Chills, PPI for hyperacidity

6

Destructive metastic RCC sites

Lung Liver Bone

7

Axitinib

Only approved as follow tx after failur of initial drugs

7

Black box warnings for Bevacizumab

Hemm, GI perforations, Wound healing complications

8

Patients with Bilateral RAS are dependent on ___ to maintain renal perfusion

RAAS

8

Action of Insulin on K levels

Na/H exchanger --> Drives K from blood into cells --> Serum K drops

9

Drug that causes Hypotension

Bevacizumab

9

Patients taking Aldesleukin have high potential for

Sepsis

10

Spironolactone causes what in men

Gynecomastia (similar structure to steroids)

11

Dactinomycin Toxicity

Myelo; Hepatic Dysfuncion, Infection

12

Toxicity of Carboplatin

Myelo; Infection

13

mTOR blockers

Everolimus, Temsirolimus

13

Cockroft-Gault Formula

accounts for age and sex

15

Standard chemo agents for Wilm's post nephrectomy

Vincristine, Dactinomycin, Doxorubicin (Cyclo, Etoposide)

15

Mesna

Antidote to Cyclophosphamide and Ifosfamide

16

Black box warnings for IFN-alpha 2b

Neuropsych, AI, Ischemic and Infectious disorders

17

3 causes of Hyperkalemia mention by sweatman

Lysis, Statins, Crush injury

18

Most common adverse effects of IFN-alpha 2b

Fatigue, fever, flu-like symptoms; Leukopenia, Neutropenia

20

Etoposide Toxicity

Hematologic Toxicity; BP instability

21

Sign of Rhabdomyolysis

Coca Cola urine

22

Effect of Insulin on heart

Cardiotonic, independent of Beta1

23

__ are contraindicated in Bilateral RAS

ACEi's and ARB's

24

Tx of BB or CCB overdose

Insulin + Glucose

26

Bilateral sensory "stocking-glove"

Vincristine

27

In fit patients with mets at dx and minimal symptoms, what provides the best survival strategy

Nephrectomy followed by IFN-alpha

29

Only approved as follow up therapy after failure of initial drug

Axitinib

29

How does HypoMg cause HypoK

Doesn't allow K to exit ROMK channel, just enter

31

Most common metastatic site for RCC

Lymph Nodes

32

Route of Temsirolimus vs Everolimus

Weekly IV vs Daily Oral

33

Ifosfamide Toxicity

Hemorrhagic Cystitis (mesna)

34

At physiological Mg concentrations,

Mg occludes ROMK channel, preventing K from exiting cell

35

2 CYP substrates

TKIs, Rapamycins

36

Patients taking this drug have high potential for sepsis

Aldesleukin

37

Renal fxn in men vs women

Higher in men

38

Most drugs for adult RCC target

VEGF due to etiology from vHL mutations

40

Cytotoxic chemo in Adult vs Pediatric RCC

Ineffective in adults

41

Chronic NSAID tx is not good for

elderly patients, especially if taking anti-HTN

43

Results of clinical trials with low dose intermittent pulse IL-2

Disappointing

44

Hepatic Dysfunction Tox

Dactinomycin

45

Admin of Aldesleukin

IV to hospitalized patients

46

Endogenous IFN activation results in transcriptional upregulation of

Genes responsible for Anti-viral, Anti-proliferative, and Anti-tumor activities

48

Low dose infusion of IL-2 leads to selective expansion of

A subset of NK cells that overexpress high affinity IL-2 receptor

49

Patients with recurrent Clear Cell Sarcoma involving brain respond to

ICE: Ifosfamide, Carboplatin, Etoposide

50

Resistance to the Rapamycins (-limus)

Second mTOR complex

51

Sorafenib blocks

VEGFR, PDGFR, KIT, RAF

52

Pulmonary Infiltrates

Temsirolimus and Everolimus

53

Fatigue, Fever, Flu-Like symptoms

IFN-alpha 2b

54

Aldesleukin (IL-2) and IFN-alpha are used in treatment of

Clear Cell RCC