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12. Chemotherapy > Brands/Generics/Class > Flashcards

Brands/Generics/Class Flashcards

(118 cards)

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1
Q

Anzemet

  • Forms
  • Class
A

Dolasetron

  • Form: IV & PO
  • Class: 5-HT3 Serotonin Receptor Inhibitors
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2
Q

Kytril
Sancuso

  • Form
    • Sancuso
    • Kytril
  • Class
A

Granisetron

  • Form IV/PO
  • Sancuso: Transdermal 1 patch Q24-48H b/4 chemo. Can be worn for 7 days. Avoid sun
  • Class: 5-HT3 Serotonin Receptor Inhibitors
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3
Q

Zofran
Zuplenz

  • Form
  • Class
A

Odansetron

  • Zofran IV/IM/PO/ODT
  • Zuplenz: thin strip melts on tongue
  • Class: 5-HT3 Serotonin Receptor Inhibitors
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4
Q

Aloxi

  • Form
  • Half life
  • Class
A

PaLONosetron

  • IV/PO
  • LONg t1/2. Use this if worry ~ QT
  • Class: 5-HT3 Serotonin Receptor Inhibitors
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5
Q

Decadron

A

Dexamethasone

  • Corticosteroids
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6
Q

Medrol

A

Methylprednisolone

  • Corticosteroids
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7
Q

Emend

  • Metabolize
  • Class
  • Use in combo:
A

Fosaprepitant (pro-drug): IV
Aprepitant PO

  • Rapidly convert to aprepitant
  • Class: Neurokinin-1-receptor antagonists => working by blocking substance P
  • Used in combo with corticosteroid or 5HT3 inhibitors
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8
Q

Marinol

  • Class
  • Storage
  • Frequency
  • CS:
A

DRONabinol

  • Class: Cannabinoids
  • Refridgerated
  • TID-QID
  • CS: III
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9
Q

Cesamet

  • Class
  • Storage
  • Frequency
  • CS
A

NaBilone

  • Class: Cannabinoids
  • Non-refrigerated
  • BID
  • CS: II
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10
Q

Reglan

  • Form
  • MOA
  • Give w/ what to reduce what SEs
A

Metoclopramide

  • PO/IV/IM
  • MOA: Block dopamine in brain
  • Give w/ Benadryl to reduce extrapyramidal SEs
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11
Q

Diphenhydramine

A
  • Benadryl

- Class: Antihistamines

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12
Q

Atarax

  • Class
A

HyDROXyzine

  • Class: Antihistamines
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13
Q

Lorazepam

  • Class
A

Ativan

  • Class: Benzodiazepines
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14
Q

Alprazolam

  • Class
A

Xanax

  • Class: Benzodiazepines
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15
Q

Epogen
Procrit

  • Indication:
  • Dose/Form/Frequency
  • Exp of Multi-vial
A

Erythropoietin

  • Indication: for chemo induced anemia
  • 150-300 units/kg SC/IV 3x/wk
  • Multi-dose vials: discard 21 days after initial entry
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16
Q

Aranesp

  • Indication:
  • Dose/Frequency
    • Counseling on bottle
  • Storage:
  • – Epogen and Aranesp —-
  • CI
  • Warning
  • Monitoring
A

DARbepoetin alfa

  • Indication: for chemo induced anemia
  • 2.25 mg/kg SC weekly
  • Do not shake
  • Refrigerate/protect from light

—— Epogen, Procrit, Aranesp—-
- CI: Uncontrolled HTN
- Warning: CVD, thromboembolic event, tumor progression.
D/C if Hgb b/w 10-12.
- Monitor:
BP, CBC w/ diff, Hgb
Ferritin: low (give iron, B12, and folate)

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17
Q

Neumega

  • Indication:
  • MOA:
  • Dose/Route
  • Monitor
A

Oprelvekin (Oh Prel ve kin)

  • I: chemo induced thrombocytopenia
  • MOA: Interleukin -11 (IL-11) is a thrombopoietic growth factor that increases platelet production
  • Dose: 50 mcg/kg SQ QD start 6-24H after chemo & cont until platelets count is >50000 cells/mL
  • Monitor: Fluid retention and electrolyte => CHF and arrhythmia
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18
Q

Neupogen

  • Indication
  • Storage
  • Dose
  • SEs
A

FilgrasTIM GCSF

  • I: granulocytes to tx neutopenia. Use to reduce febrile neutropenia after chemo
  • Refrigerate: use w/in 24H if at RT
  • D: 5mcg/kg/day ingle dose SC or IV infusion over 15-30min
  • SE: bone pain
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19
Q

Neulasta

  • Indication:
  • Storage
  • Dose
  • SEs
A

PegfilgrasTIM

  • I: granulocytes to tx neutopenia. Use to reduce febrile neutropenia after chemo
  • Refridgerate/protect from light. Use w/in 48H at RT
  • Dose: 6mg SC x 1 each chemo cycle
  • SE: bone pain
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20
Q

Kayexalate

A

Sodium polystyrene sulfonate (SPS)

  • I: Shift K intracellular
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21
Q

Chemo drugs are never in mg/kg, it’s in:

A
  • mg/m2
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22
Q

One inch = ? cm

A

1’ = 2.54 cm

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23
Q

1kg = ? lb

A

1 kg = 2.2 pounds

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24
Q

PLANTINol

  • Class:
  • SEs
    • Cause most:
  • Give w/ what as ppx to prevent nephrotoxic
  • Give what for promote excretion
  • Reduce nephrotoxicity by:
A

CisPlatin

  • Alkylating agents

SEs

  • Nephrotoxicity
  • Ototoxicity
  • Peripheral Neuropathy
  • Electrolyte imbalance: decr PO4, K, Ca, Mg
  • Cause MOST GI upset
  • Amifostine: given as ppx to prevent nephrotoxicity
  • Manitol: promote excretion

Reduce Nephrotoxicity by:

  • Hydration: 2-3L NS over 8-12H
  • Mannitol 25-50g IV b/4
  • Amifostine: start b/4 chemo
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25
Ethyol - Indication - SEs - D/C which med:
Amifostine - Give as ppx to prevent nephrotoxicity in cisplatin SEs - Severe HyperTN - Infusion rxn: flushing, chills, hiccups, sneezing, n/v - D/c all HTN med
26
Paraplatin - Is amifostine indicated for this drug?
Carboplatin - Amifostine is no indicated => cause less nephrotoxicity
27
Eloxatin - Indication - SE
OxaliPtin - Use for colorectal cancer w/ 5-FU + leucovorin - SE: Peripheral neuropathy
28
Myleran - SEs
Busulfan SEs - Increase uric acid (Hyperuricemia): Watch for other drugs (thiazide, loop, niacin, low dose ASA) - Pulmonary fibrosis (SOB & chest x-ray) - Hyperpigmentation of skin: stop ASAP and give steroid - SZ - BMS
29
Cytoxan - Prevent hemorhagic cystitis - SEs - Monitor
C(4)yclophoSphamide Prevent hemorhagic cystitis - Mesna to bind to acrolein - Hydration SEs - Hemorhagic cystitis: cause by acrolein - Renal tubular necrosis - Hepatotoxicity - Cardiac SEs - Alopecia - Sterility Monitor - CBC, plt, BUN, UA, Electrolytes, SrCr
30
Ifex - Mesna
Ifosfamide - Mesna comes with the ifosfamide package
31
Mesna indication
- Bind to acrolein as ppx to prevent hemorhage cystitis in cyclophosphamide and ifosfamide
32
BiCNU - Indication: - SEs
C(2)ARMustine - I: lipid soluble => treat cns malignancies (brain tumor) SEs - Hepatotoxicity - Nephrotoxicity - Pulmonary fibrosis => CAR = carbon dioxine = lung toxic - Bone marrow suppression
33
CeeNu - Indication: - SEs
Lomustine - I: lipid soluble => treat cns malignancies (brain tumor) SEs - Hepatotoxicity - Nephrotoxicity - Bone marrow suppression - Pulmonary fibrosis
34
Zanocar - SEs - Dose limiting due to
StrEptozocin SEs - Pancreatic damage - Nephrotoxicity - Extravasation - Dose limiting - 90% get DM I
35
Alkeran - SEs
Melphalan SEs - Fertility Impairment - BMS
36
Which drug cause fertility imp and no pharmacist can work while pregnant
- Melphalan (Alkeran) - Mechlorethamine (Mustargen) - Altretamine (Hexalen)
37
Mustargen - SEs
mEchlorethamine SEs - Extravasation: severe necrosis => tx w/ Na thiosulfate - Fertility impairment
38
Hexalen - Route - Indication - SEs - MOAIs:
Altretamine - PO - I: tx ovarian cancer SEs - Peripheral Neuropathy - Fertility Impairment - MOAIs: may cause severe othostatic hypoTN
39
Mutalane - SEs in Pediatric - Monitor: - Give with MOAIs
Procarbazine - SEs in Ped: tremors, convulsion - Disulfiram rxn - M: CBC, renal, hepatic - MOAIs: high tyramines or MOAIs = fatal HTNsive crisis
40
Drugs that have MOAI effects
- Altretamine (Hexalen) | - Procarbazine (Mutalane)
41
Drugs Cause Tumor Lysis Syndrome
- Bendamustin (Trenda)
42
**Anti-Metabolites**
**Anti-Metabolites**
43
Folinic acid - Indication
Leukovorin - Give with methotrexate as a rescue drug to save the good cells - Give with 5-FU to increase its action. When used together, 5-FU works better, thus use less amt of 5-FU
44
Glucarpidase (Voraxaze) - Indication
- An injectable carboxypeptidase enzyme that breaks down MTX in the body so the drug can be easily eliminated when the kidneys are not working properly
45
5-FU Adrucil - INR - SEs
FluOrouracil - Increase INR SEs - Hand & foot syndrome - Mucositis - Neurotoxiticy - Alopecia - Ocular toxicity - Photosensitivity - Light sensitive
46
Light sensitive drugs
- Methotrexate - 5-FU - Cisplatin
47
Xeloda - Indication - Dose: - Administration
Capecitabine - prodrug of 5-FU Indication - Metastatic breast cancer resistant to paclitaxel - 1st line for metastatic colorectal carcinoma - Dosage Form: PO 150 mg and 500 mg Tab - D: Cyclical 1250 mg/m2 BID - 2 wk on 1 wk off - Take with water w/in 30 min after AM and PM meals
48
Purinethol Purixan - SEs - DDIs
Mercaptopurine (6-MP) SEs: - Hepatotoxicity - Hyperuricemia - Hyperpigmentation of skin - Rash - Mucositis - Diarrhea DDIs - Allopurinol: will increase 6-MP. 6MP active metabolite is catalyzed by xanthine oxidase. Allopurinol is a xanthine oxidase inhibitor - Bactrim: inc 6-MP
49
Cytosar - SEs
Cytarabine => PPPH SEs - Conjunctivitis/CNS - Hepatotoxicity - Pancreatitis - Pulmonary tox - Peripheral neuropathy - *Cytarabine syndrome*: fever, myalgia, bone pain, occasional chest pain, rash - *CNS changes when used IV intrathecal - *Vision change: conjunctivitis & Keratitis => use dexamethasone eye drops w/ high doses
50
Fludara - SEs
FludarabiNe SEs - Sig immunosuppression "AIDS in a bottle" - Neurotoxicity: irreversible blindness, coma, death
51
Trenda - Diluent use: - Storage - Solution color - SEs
BENdaMustin - D: 100mg/m2 IV on day 1 & 2 of a 28 days cycle up to 6 cycles - Diluent: NS - Stable 24H refrigerated or 3H RT - Colorless/clear lightly yellow soln - Protect from light SEs - Myelosuppression - Infusion rxn & anaphylaxis - Tumor Lysis syndrome
52
Rheumatrex Otrexup Trexall - Indication - Dose - SEs - Drugs impair MTX excretion - Monitor - Rescue drugs
Methotrexate Dose - RA: 7.5mg/wk PO single dose or 2.5 mg PO Q12H x 3 doses given once weekly. Max 20mg weekly - Intrathecal - 12 mg - High dose: 500-12000 mg/m2 IV q2-3wks SEs - Hepatotoxicity - Renal insufficiency: keep urine alkaline w/ NaHCO3 to prevent crystallization & well hydrated to avoid renal tox - Pulmonary tox - Photosensitivity => use sunscreen - Light sensitive - Mucositis - Folic acid antagonist => give 1mg/d Impair MTX excretion: - NSAIDs, ASA, Penicillins, Bactrim, PPI => stop b/4 MTX Monitor - LFT, Renal fxn, CXR, and CBC Rescue - Leukovorin - Glucarpidase
53
**Antibiotics**
**Antibiotics**
54
Bleomycin | - SEs
- Blenoxane SEs - Pulmonary tox: non productive cough. Occur when acc dose > 450-500mg. Never give > 500mg life time - Skin tox: hyper-pigmentation: red spots that are not uniform
55
Adriamyacin Doxil - SEs - Accumulate life time dose
DoxoRUbicin SEs: - CHF: irreversible due to Fe - Urine color: red - ** Preg Cat D - Extravasation: apply COLD (december is cold) Accumulate life time dose - 550 mg/m2
56
DaunoXone: Liposomal Cerubidine: Conventional - SEs - Accumulate life time dose
DaunoRUbicin SEs: - CHF: irreversible due to Fe - Urine color: red - Extravasation: apply COLD (december is cold) Acc life time dose - 900 mg/m2
57
Zinecard - Indication
Dexrazoxane - Iron chelator: protects against cardiotoxicity of doxorubicin and daunorubicin - Comes in liposomal form => less toxicity
58
Valstar - Turn urine color: - SEs:
ValRUbicin - Transient urine discoloration RED - Irritable bladder symptoms
59
Cosmegen - SEs - CIs
DACtomycin - Extravasation ass w/ severe necrosis - CI: active chicken pox or herpes zoster
60
Novoantrone - SEs
Mitoxantrone - Turn urine to a blue/blue green color and the white part of your eyes turn a bluish colors => this is normal and not a cause for concern
61
Plant Alkaloids
- Docetaxel, paclitaxel - Etoposide, Teniposide - Irinotecan, Topotecan
62
Taxotere - SEs
Docetaxel SEs - Hypersensitivity => premed w/ dexamethasone 8mg BID 3-5d, start 1 day prior - Fluid retention/Pulmonary edema => use lasix
63
Taxol - SE - Tube to use - Diluent contains - CI:
PacliTAXel - SE: Hypersensitivity => PreMed - use NON-PVC tubing - Diluent contains: contain EtOH => disulfram rxn - CI: Castor oil
64
Toposar - SEs
EtoPOside - Etoposide VP-16: cap refrigerate SE - HypoTN due to rapid infusion
65
TeniPOside (Vumon) - SEs
Vumon SE - HypoTN due to rapid infusion
66
Camptosar - SE - Early treatment - Late treatment
Ironotecan SES - Diarrhea & dehydration: life threatening - Early: tx w/ atropine - anticholinergic - Late: Loperimide: regardless of max dose => OTC max = 8mg => Rx max = 16 mg => Replenish fluid & electrolytes
67
Hycamtin - SEs
Topotecan SES - Diarrhea & dehydration: life threatening - Early: tx w/ atropine - anticholinergic - Late: Loperimide: regardless of max dose => OTC max = 8mg => Rx max = 16 mg => Replenish fluid & electrolytes
68
**Vinka Plant Alkaloids**
**Vinka Plant Alkaloids**
69
Oncovin Marqibo: liposome - SEs
VinCristine SEs - Most *CNS tox - Peripheral neuropathy: most w/ vincristine - Constipation: start stool softener
70
Velban - SEs
VinBlastine SEs - *BMS - Peripheral neuropathy: most w/ vincristine - Constipation: start stool softener
71
Navelbine - SEs
VinOrelbine SEs: - Most *alopecia - Peripheral neuropathy: most w/ vincristine - Constipation: start stool softener
72
Preparing Vinca Plant Akaloids - Label required:
- Prepared only in small volume infusion bag for rapid IV infusion per nursing standards - Labeled "For IV USE ONLY - FATAL if given intrathecally"
73
Dispensing Intrathecal Chemo
- Labels for intrathecal route - No other chem/med dispense at the same time - The person ordered will review w/ pharmacist, verify his/her status w/ MD, fellow or chemo certified nurse by signing of the med
74
**Tyrosine Kinase Inhibitors**
**Tyrosine Kinase Inhibitors** - Form: Only come in PO forms - SEs: Diarrhea and Nausea
75
Gleevec - Class - SEs - DDI - Monitor
Imatinib - Class: Tyrosine kinase inhibitors - SEs: fluid retention - Substrate; strong inhibitor of 3A4 - Monitor: CBC, LFT, wt gain
76
Tarceva - Indication - Administration - SEs
ErLOtinib - Class: Tyrosine kinase inhibitors - Indication: lung & pancreatic cancer - Adm: 100-150mg PO on Empty stomach SEs - Increase LFT - Pulmonary sx - GI bleeding - Corneal ulceration
77
Tykerb - Class - Indication
Lapatinib - Class: Tyrosine kinase inhibitors - I: breast cancer
78
Tasigna - Class - Indication - Watch out for
NilOTinib - Class: Tyrosine kinase inhibitors - I: Leukemia - Watch for QT prolongation
79
Bosulif - Class
Bosutinib - Class: Tyrosine kinase inhibitors
80
Iclusig - Class
Ponatinib - Class: Tyrosine kinase inhibitors
81
Inlyta - Class
Axitinib - Class: Tyrosine kinase inhibitors
82
CarBOXantinib (Cometriq) - Administration - Class
CarBOXantinib - Take on empty stomach = Empty BOX - Class: Tyrosine kinase inhibitors
83
Sprycel - Class
Dasatinib - Class: Tyrosine kinase inhibitors
84
Iressa - Class
Gefitinib - Class: Tyrosine kinase inhibitors
85
PaZOpanib (Votrient) - Class
PaZOpanib - Class: Tyrosine kinase inhibitors
86
SORAfenib (Nexavar) - Class
SORAfenib - Class: Tyrosine kinase inhibitors
87
Sutent - Class
Sunitinib - Class: Tyrosine kinase inhibitors
88
VANdetanib (Caprelsa) - Class
VANdetanib - Class: Tyrosine kinase inhibitors
89
REGOrafenib (Stivarga) - Administration - Class
REGOrafenib - Take with food - Class: Tyrosine kinase inhibitors
90
VorinOstat (Zolinza) - Class - Indication - Administration - Caution
VorinOstat - Class: Histone Deacetylase Inhibitor - I: lymphoma - Adm: 400 mg cap PO with FOOD - Caution: QT prolongation
91
RomiDEPsin (Istodax) - Class - Indication - DF
RomiDEPsin - Class: Histone Deacetylase Inhibitor - I: cutaneous T-cell lymphoma - DF: IV
92
Hydrea - Indication
Hydroxyurea - Indication: antineoplastic use, sickle cell anemia
93
Thalomide - SEs - Special program
Thalidomide SEs - Birth defect - Thrombo-embolitic events - Peripheral neuropathy => Require Thalidomide Education & Prescribing Safety (STEPS): dispensing right to authorized MDs or pharmaCIES => Pt must be on 2 forms of contraceptive
94
Pomalidomide (Pomalyst) - Indication - Derivative of - Special Program:
Pomalidomide - I: mulitple myeloma - Derivative of thalidomide - Program: Women of reproductive potential must use 2 forms of contraception or continuously abstain from heterosexual sexual intercourse during and for 4 weeks after stopping treatment. Pomalidomide is only available through a restricted distribution program called Pomalyst Risk Evaluation and Mitigation Strategy (REMS)
95
**Chemo Man**
**Chemo Man**
96
Erythropoetin/Darbepoetin - CI - Warning/Precaution - Monitoring Parameters
CI: - Uncontrolled HTN Warning/Precaution - Thromboembolism events - Tumor Progression => High Hgb: inc risk of MI, stroke, clot => Keep Hgb b/w 10-12g/dL => Once chemo stop, stop Epogen or Aranesp Monitoring - BP, CBC w/ diff, platelet, Hgb - Sr Ferritin => start Fe if Start if saturation Correct Fe, B12, Folate prior to tx
97
How long does the followings live? - Platelets - RBC - Granulocytes
- Platelets: 10 days - RBC: 120 days - Granulocytes: 6-8H => neutropenia occurs w/in hrs of chemo.
98
Tumor lysis syndrome - Results in: - Problems
Result in ARF, multiple organ failure, death - Hyperkalemia - Hyperuricemia - Hyperphosphatemia - Hypocalemia Problems - Cardiac arrhythmia: hyperK = arrhythmia. HypoCa = QT int lengthening = V. arrhythmia - Electrolytes: transcellular shift of K - Hyperuricemia: give allopurinol & hydration to prevent uric acid crystal within collecting ducts = ARF
99
Treatment of tumor lysis syndrome
Administer IV CaCl - Tx HyperK or HypoCa - Protect myocardium from arrhythmias - CaCl contains 3x Ca++ element (1g = 290mg) than Ca gluconate (1g = 90 mg). Na Bicarbonate - Shift K intracellular Insulin (Novolin, Humulin) & dextrose - Shift K intracellular Kayexalate - Exchange Na for K and binds to K in gut => decr total body K. - OSA: PO 2-12H. Per rectal = longer osa - Give as 2nd stage of therapy to reduce total body K - SEs: constipation - Don't give w/ sorbital = GI necrosis
100
General Policy & Procedures of Fan/Blower
See Book page 5
101
Disulfiram reaction
- Procarbazine | - PacliTAXel
102
Alterna Gel - Class - Indication
Aluminum hydroxide - Class: Phosphate binder - Indication: hyperphosphatemia
103
PhosLow - Class - Indication
Calicium acetate - Class: Phosphate binder - Indication: hyperphosphatemia
104
Fosrenol - Class - Indication
Lanthanum carbonate - Class: Phosphate binder - Indication: hyperphosphatemia
105
Renagel - Class - Indication
Sevelamer - Class: Phosphate binder - Indication: hyperphosphatemia
106
Velphoro - Class - Indication
Sucroferric oxyhydroxide - Class: Phosphate binder - Indication: hyperphosphatemia
107
CaCl and Ca-gluconate Which has more Ca
CaCl has more Ca 1gCaCl = 270mg Ca 1g CaG = 90 mg Ca
108
Aloprim
Allopurinol
109
Zyloprim
Allopurinol
110
Elitek
Rasburicase
111
Kayexalate - SEs
Sodium polystyrene sulfonate - SEs: constipiation
112
Chemo induced neuropathy - Drugs
PPT ``` P = platinum drug P = Plan alkaloids T = Taxanes ```
113
Valchlor - Storage - Form - Major SE:
Mechlorethamine - Storage: fridge - Form: topical gel - Major SEs: Fertility imp
114
Voraxaze - Indicatio
Glucarpidase - Indication: MTX rescue med
115
Vectibix - Form - Class - Indication
Panitumumab - Form: IV - Class: EGFR - Indication: Colorectal cancer
116
Erbitux - Form - Class
Ceteximab - Class: EGFR - Form: IV
117
Avastin - Mix with - Class
Bevacizumab - Mix with NS - Class: VEGF
118
Beleodaq - Class - Indications - Form
Belinostat - Class: histone deacetylase inhibitor - Indication: lymphoma - Form: IV

12. Chemotherapy (6 decks)

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