Breast Cancer

Question 1

3 SERM

Answer 1

tamoxifen
toremifene
raloxifene

Question 2

Steroidal estrogen receptor down regulator (antagonist?)

Answer 2

fulvestrant (Faslodex)

Question 3

aromatase inhibitors 3

Answer 3

anastrozole
exemestane
letroxole

Question 4

Tamoxifen is typically given ..

Answer 4

post surgery or chemo

Question 5

tamoxifen 4 uses

Answer 5

prevention in high risk women
ductal carcinoma in situ - lower risk of invasive cancer
metastatic breast cancer therapy
add on therapy for breast cancer

Question 6

6 tamoxifen warnings

Answer 6

1. hypercalcemia
2. uterine malignancies
3. endometrial hyperplasia/polyps
4. DVT or PE
5. liver abnormallites
6. ocular distrubances

Question 7

tamoxifen uses what p450 enzymes

Answer 7

3A4/5, and 2D6

Question 8

how is tamoxifen excreted?

Answer 8

via the stool

Question 9

why do about 1/3 not respond to tamoxifen?

Answer 9

variations in 2D6

Question 10

possible interaction between tamoxifen and what type of meds?

Answer 10

antidepressants

Question 11

tamoxifen can increase endometrial cancer risk by

Answer 11

2 to 3 times

Question 12

tamoxifen drug interactions 5

Answer 12

1. warfarin
2. anastrozole/letrozole (aromatase inhibitors)
3. rifampin
4. Paroxetine, fluoxetine (antidepressants)
5. bupriopion (antidepressant and smoking cessation)

Question 13

raloxifene is approved for

Answer 13

breast cancer prevention in high risk post menopausal women

Question 14

raloxifene

Answer 14

fewer cases of clotting, cataracts, and uterine cancer than tamoxifen

Question 15

ospemifene is a ___

Answer 15

SERM: selectie estrogen receptor modulator ..sometimes agonist or antagonist in differet tissues

Question 16

ospemifene indication

Answer 16

dyspareunia from volvovaginal due to menopause

Question 17

CI for ospemifene

Answer 17

DVT, PE or history, CVA, MI or history, pregnancy, neoplasia, undx genital bleeding

Question 18

__ is a derivative of tamoxifen

Answer 18

toremifene

Question 19

tomremifene indication

Answer 19

for mestastatic breast cancer post menopausal women

Question 20

ADR toremifene

Answer 20

hot flashes, cataracts, LFT high, clots, sweat/edema/N

hypercalcemia, QT prologation dose dep, endometrial hyperplasia

Question 21

toremifene is effective as

Answer 21

tomoxifene

Question 22

bazodexifene/CE indicated for

Answer 22

moderate to severe vasomotor sx

prvt post menopausal osteoporosis

Question 23

black box warning bazodeifene

Answer 23

women with a uterus - endometrial cancer
higher risk CVA or DVT
yet prvts EVD or dementia

Question 24

breast cells have high concentration of ___

Answer 24

aromatase

Question 25

2 nonsteroidal aromatase inhibitors

Answer 25

anastrozole and letrozole

Question 26

steroidal aramoatase inhibitor

Answer 26

exemestane (Aromasin)

Question 27

first line for adjuvant breast cancer tx in post menopausal women

Answer 27

exemestane

Question 28

___ is a suicide inhibitor of aromatase

Answer 28

exemestane

Question 29

risks of exemestane

Answer 29

higer risk osteoporosis , fracture | cardiovascular issues

Question 30

___ class of breast cancer med can lead to increase bone groths in short boys and increase testosterone levels in adult men?

Answer 30

aromatase inhbitors

Question 31

____ is best hormonal therapy to start for breast cancer when it is early stage and hormone receptor positie

Answer 31

aromatase inhibitors have more benefits and fewer serious side effects

Question 32

SERD

Answer 32

selective estrogen receptor down regulator

Question 33

fulvestrant

Answer 33

pure antiestrogen SERD inhibits and degrades estrogen receptors

Question 34

fulvestrant use

Answer 34

indicated post menopause with breast cancer that progressed while on tamoxifen

Question 35

fulvestrant ADR

Answer 35

no p450 interactions N, asthenia, hot flashes, headache give injections slowly to decrease a reaction