Antineoplastics (Cancer)

Question 1

What is the primary MOR associated with the Antineoplastics (cancer medications)?

Answer 1

Drug efflux

Question 2

When should Leucovorin be used BEFORE administering this medication?

What phase does this medication work in?

Answer 2

5-Fluorouracil

• S-phase

Question 3

When should Leucovorin be used AFTER administering these two medications?

What phase do these medications work in?

Answer 3

• Methotrexate
• 6-Mercaptopurine
• S-phase

Question 4

What are the four medications that utilize alkylating DNA as their MOA? What are they all used to treat?

Answer 4

Antineoplastics (cancer medications)

• Cyclophosphamide
• Carmustine
• Cisplatin
• Doxorubicin

Question 5

What two diseases can Cyclophosphamide be used to treat?

Answer 5

• Cancer

- Immunosuppression

Question 6

What is the primary toxicity associated with Cyclophosphamide? How can this be prevented (2)?

Answer 6

Hemorrhage cystitis

- Prevent with MESNA and hydration

Question 7

What does acrolein accumulation cause? What drug is this toxicity associated with?

Answer 7

Hemorrhage cystitis

- Toxicity of Cyclophosphamide

Question 8

How do you prevent hemorrhage cystitis (2)?

Answer 8

• MESNA

- Hydration

Question 9

Which of the Antineoplastics (cancer medications) can cross the BBB?

Answer 9

Carmustine

Question 10

What are the two primary toxicities associated with Cisplatin?

Answer 10

• Nephrotoxicity

- Acoustic nerve damage

Question 11

What three medications have an MOA that affects cells in the S PHASE?

Answer 11

• Methotrexate
• 6-Mercaptopurine
• 5-Fluorouracil

Question 12

What are the two primary toxicities associated with Methotrexate as a cancer medication? What is its other use?

Answer 12

• Mucositis
• Thrombocytopenia

Also used as an immunosuppressant

Question 13

What are the two primary toxicities associated with 6-Mercaptopurine?

Answer 13

• Bone marrow suppression

- Jaundice

Question 14

What should ALWAYS be ruled out with 6-Mercaptopurine?

Answer 14

Use of Allopurinol

- If used, combination can be potentially fatal

Question 15

What are the two primary toxicities associated with 5-Fluorouracil?

Answer 15

• Oral ulcers

- GI ulcers

Question 16

What three medications have an MOA that affects cells in the M PHASE?

Answer 16

• Paclitaxel
• Vincristine
• Vinblastine

Question 17

What are the two primary toxicities associated with Paclitaxel?

Answer 17

• Myelosuppression

- Anemia

Question 18

What is the primary toxicity associated with Vincristine?

Answer 18

Neurotoxicity

Question 19

What is the primary toxicity associated with Vinblastine?

Answer 19

Myelosuppression

Question 20

What is the primary toxicity associated with Doxorubicin?

Answer 20

Cardiotoxicity

Question 21

What phase of the cell cycle does Paclitaxel affect?

Answer 21

M phase

Question 22

What phase of the cell cycle does Vincristine affect?

Answer 22

M phase

Question 23

What phase of the cell cycle does Vinblastine affect?

Answer 23

M phase

Question 24

What phase of the cell cycle does Methotrexate affect?

Answer 24

S phase

Question 25

What phase of the cell cycle does 6-Mercaptopurine affect?

Answer 25

S phase

Question 26

What phase of the cell cycle does 5-Fluorouracil affect?

Answer 26

S phase

Question 27

What phase of the cell cycle does Bleomycin affect?

Answer 27

G2-M phase

Question 28

What are the three primary toxicities associated with Bleomycin?

Answer 28

- Hypersensitivity - Pulmonary fibrosis - Mild myelosuppression

Question 29

What is the MOA of Imatinib (Gleevec)?

Answer 29

Inhibits Bcr-Abl fusion to TKR protein | - TKR inhibitor

Question 30

What MUST be ruled out before administering Imatinib (Gleevec)?

Answer 30

Bcr-Abl fusion mutation

Question 31

What is the primary toxicity associated with Imatinib (Gleevec)?

Answer 31

Edema (eyes, ankles)

Question 32

What MUST be checked before administering Cetuximab or Erlotinib? What results would indicate NOT starting the medication?

Answer 32

EGFR expression/mutation | - If levels are NORMAL, do NOT start these drugs

Question 33

What is the MOA of Cetuximab?

Answer 33

Antibody binds to EGFR and inhibits EGFR kinase activity

Question 34

What is the MOA of Erlotinib?

Answer 34

Blocks ATP binding to EGFR and inhibits EGFR kinase activity

Question 35

What are the two primary toxicities associated with Cetuximab?

Answer 35

- Acneiform | - Hypomagnesemia

Question 36

What is the MOA of Bevacizumab?

Answer 36

Binds VEGF to prevent binding to VEGF-R (receptor)

Question 37

What are the two primary toxicities associated with Bevacizumab?

Answer 37

- Bleeding | - Thromboembolism

Question 38

What medication should be combined with Dexrazoxane to chelate iron and avoid free radical toxicity?

Answer 38

Combine Doxorubicin with Dexrazoxane

Question 39

What medication should be combined with Amifostine to reduce nephrotoxicity?

Answer 39

Combine Cisplatin with Amifostine