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ASCO Boards > Chemotherapy MOA > Flashcards

Chemotherapy MOA Flashcards

1
Q

Gemcitabine
MOA
excretion
side effect common after infusion
Rare bad S/E (4)

A

Antimetabolite (pyrimidine)
renal
fever, flu-like symptoms
Capillary leak syndrome, HUS/TTP, PRES, pneumonitis

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2
Q

Abraxane what is it and what are the side effect differences
dose adj

A

nab-paclitaxel, protein-bound taxol (stabilizes microtubules)
hepatic adjustments, no renal
compared to taxol, abraxane has:
Less: hypersensitivity reactions, neutropenia
More: neuropathy, nausea, diarrhea

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3
Q

5-Fluorouracil
specific MOA
metabolism
specific derm SE
overdose symptoms
rare bad SE (1)
Check med list and avoid this drug

Avoid concurrent use of this drug

A

Anti-metabolite (thymidylate synthetase inhibitor)
hepatic avoid in severe impairment but no renal dose adj even on HD
hand and foot syndrome
cytopenias, mucositis, diarrhea
Cardiac ischemia
Avoid with warfarin

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4
Q

Oxaliplatin
MOA
dose adjust
Bad SE (5)

A

Alkylating platinum agent
Renal dose adjustment (no hepatic dose adj)
Allergic reactions at any time
Cold sensitivity/neuropathy
Immune-mediated TCP
PRES
Pneumonitis
Hepatotoxicity

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5
Q

Irinotecan
MOA
metabolism/excretion
lab cut-off contraindication
infusion side effects and treatment
main SE (1)

A

Topoisomerase I inhibitor
liver
bilirubin >2 contraindicated
Cholinergic syndrome- pre-treated with atropine
Diarrhea

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6
Q

Eribulin
Moa
Se

A

Microtubule destabilizing
Neutropenia, neuropathy, Qtc prolongation

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7
Q

Docetaxel
moa
metabolism
lab cut-off contraindication
cause of the allergic reaction
premed needed and why

A

Microtubule stabilizer
hepatic
contraindicated with elevated bilirubin (above normal)
Mixed in castor oil which people can react to
dexamethasone ppx for fluid retention/capillary leak

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8
Q

Paclitaxel
MOA
metabolism
specific cardiac side effect
allergy risk

A

Microtubule stabilizer
liver (no renal adj)
bradycardia
cremophor-based allergy, strong premed need

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9
Q

If pt forgot steroid premedication

A

Increase dexametasone in infusion to 20

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10
Q

Cabazitaxel
Use

A

Can be still used if taxane resistant
Not docetaxel candidate
Needs growth factor due to prolonged nadir

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11
Q

Paclitaxel allergic reaction cause and symptoms

A

cremophor, slow infusion trial to see if improvement, redness, flushing, rash

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12
Q

methotrexate MOA and excretion

A

antimetabolite
Dihydrofolate reductase

renal excretion

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13
Q

topotecan MOA specific #, excretion

A

topo I, renal excretion

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14
Q

Ifosfamide MOA, excretion, toxicity and the byproduct cause and sister drug given with it and why

A

alkylating agent, hepatic and renal,

acrolein induced hemorrhagic cystitis and chloroacetaldehyde nephrotoxicity and neurotoxicity

mesna

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15
Q

Cetuximab
MOA
common SE
cause of allergy and what do you switch to
electrolyte issue

A

chimeric human/mouse IgG1 monoclonal antibody against EGFR
rash
mouse part of antibody –> switch to panitumumab (humanized anti EGFR)
magnesium low

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16
Q

cardiac toxicity in 5-FU is associated with bolus or infusion

A

infusion, could consider trial of bolus in rechallenge

17
Q

5-FU toxicity genetic issue
gene
symptoms of the toxicity

A

DPD deficiency
mucositis, pancytopenia, diarrhea

18
Q

leucovorin when used with 5-FU goal

A

enhances 5-FU inhibition of thymidylate synthase

19
Q

po morphine equivalent for iv morphine

A

3 (take IV morphine and multiply by 3 for po)

20
Q

tramadol po to morphine po

A

1/10 (take po tramadol and divide by 10 for po morphine)

21
Q

dilaudid po to morphine po

A

4 (take po dilaudid and multiply by 4 to get po morphine)

22
Q

oxycodone to morphine po

A

2 (take oxy and mutiply by 2 to get po morphine)

23
Q

vedolizumab
use
moa

A

grade 3-4 autoimmune colitis refractory to steroids
integrin antagoinst to block migration of T cells to the gut

24
Q

infliximab
use
avoid in which scenario
moa

A

grade 3-4 autoimmune colitis refractory to steroids
avoid with autoimmune hepatitis
TNFa inhibitor

25
Q

gene related to topoisomerase toxicity
symptoms

A

UGT1A1
diarrhea predominant

26
Q

Drugs associated with radiation recall (5)

A

Doxorubicin, docetaxel, paclitaxel, gemcitabine, capecitabine

27
Q

Vincristine/vinblastine/vinorelbine
MOA
metabolism
side effect to tell patients about (4)
what happens if given intrathecally

A

Microtubule destabilization
hepatic
alopecia, constipation with prophylactic bowel reg, bronchospasm/pulm tox, needs port (vesicant)
paralysis and death if IT

28
Q

bevacizumab
specific MOA
dose adj?
bad SE (5)

A

VEGF-A inhibitor
no dose adj with liver or kidney dysfunction
nephrotic syndrome, bowel perforation, thrombotic events including MI/stroke, PRES

29
Q

ariprepitant
MOA
avoid with this chemo drug

A

antiemetic that antagonizes substance P/neurokinin 1 (NK1)
ifosfamide due to CYP3A4 overlap

30
Q

ondansetron, granisetron, palonosetron
MOA

A

serotonin-5-HT3 antagonists (hydroxytryptamine)

31
Q

proclorperazine MOA

A

D2 dopamine receptor and cholinergic receptors

32
Q

high emetogenic drugs definition
antiemetic treatment
examples

A

> 90% emesis risk
4 drug regimen with zofran, aprepitant, steroid, olanzapine

AC
doxorubicin >60
cisplatin
ifosfamide
melphalan
sacituzumab govitecan
carbo AUC >4
cyclophosphamide >1500

33
Q

vandetanib
use
MOA
cardiac SE

A

medullary thyroid cancer
EGFR inhibitor
Qtc prolongation

34
Q

everolimus
MOA
lab to monitor
side effect to tell patients

A

mtor inhibitor
lipids
mouth sores requiring steroid mouthwash

35
Q

ixabepilone
use
moa

A

breast cancer metastatic single agent (TNBC or HR+HER2-)
microtubule stabilizer
hepatically cleared
think about docetaxel, paclitaxel similar class

36
Q

Pemetrexed
dose adj
MOA specific
supportive meds
bad SE (3)

A

antimetabolite that distrupts folate metabolic processes via inhibition of multiple targets in the pathway (TS, DHFR, FARFT, AICARFT)–> purine and thymidine nucleotide synthesis inhibition
dose adj for renal, use not recommended with crcl <45
folic acid, b12 injections
SJS/TEN, nephrotoxicity, pulmonary toxicity

37
Q

Lenvatinib
MOA
SE bad (11)

A

Multi TKI
QTc prolongation, hemorrhage, fistula, hepatotoxicty, renal toxicity/proteinuria, hypocalcemia, hypothyroidism, hyperthyroidism, PRES, thrombotic events, poor wound healing (hold for a week before and after surgery)

ASCO Boards (13 decks)

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