cancer drugs

Question 1

dose limiting toxicity

Answer 1

toxicity that may result in a dosage decrease or treatment delay or discontinuation

ex myelosuppression

Question 2

hallmark toxicity

Answer 2

a toxicity that is significant or unique for a particular drug

not always dose-limiting

ex. teratogenicity, hair loss

Question 3

cyclophosphamide, ifosfamide MOA

Answer 3

alkylating agents

Question 4

HMT of alkylating agents

Answer 4

hemorrhagic cystitis (s/s of UTI)

hydrate before & after therapy! urinate frequently!

mesna may help

Question 5

cisplatin, carboplatin, oxiplatin MOA

Answer 5

platinum agents

Question 6

cisplatin HMT & special info

Answer 6

N/V

significant!!! pretreat & hydrate

delayed hypersensitivity

Question 7

carboplatin HMT & special info

Answer 7

myelosuppression

dosed based on area under the curve

delayed hypersensitivity

Question 8

oxaliplatin HMT & special info

Answer 8

peripheral neuropathy exacerbated by cold

prolonging admin way help

delayed hypersensitivity

Question 9

methotrexate MOA

Answer 9

folate analog - inhibits DHFR which depletes cofactors for thymidylate and purine synthesis

Question 10

methotrexate HMT & special info

Answer 10

myelosuppression, mucositis & diarrhea, nephrotixicity

interactions w bactrim & NSAIDs
Leucovorin helps with HMTs
keep urine pH >7 to help w nephrotox

Question 11

5-FU & capecitabine MOA

Answer 11

pyrimidine analogs

nucleoside analaogs

Question 12

5-FU HMT & special info

Answer 12

stomatitis, diarrhea

drug interactions w warfarin
leucovorin helps enhance efficacy and toxicity

Question 13

capecitabine HMT & special info

Answer 13

hand-foot syndrome

PO
counsel about hand-foot syndrome! can get worse

Question 14

6-mercaptopurine MOA ?????

Answer 14

purine analog

converted to inactive metabolite by xanthine oxidase

allopurinol inhibits xanthine oxidase, so we must decrease the dose of 6-mercaptopurine if using allopurinol

Question 15

vincristine MOA

Answer 15

vinca alkaloid - bind to tubulin and block polymerization into microtubules

Question 16

vincristine HMT & special info

Answer 16

peripheral toxicity

fatal if given intrathecally –> dispense in mini-bags

Question 17

paclitaxel MOA

Answer 17

microtubule-damaging agent

Question 18

paclitaxel HMT & special info

Answer 18

complete alopecia

hypersensitivity - pre-med w dexamethasone, benadryl, H2antagonist

Question 19

ironotecan MOA

Answer 19

camptothecin analog

Question 20

ironetecan HMT & special info

Answer 20

delayed diarrhea

loperamide 4mg at onset then 2mg q2

UGT1A1 mutation

Question 21

doxorubacin MOA

Answer 21

anthracycline

Question 22

doxorubicin HMT & special info

Answer 22

delayed cardiotoxicity

baseline EF before tx
maximum lifetime dosage 550mg/m2

Question 23

lenalidomide MOA

Answer 23

anti-angiogenesis agent

Question 24

lenalidomide HMT & special info

Answer 24

fatigue

REMS program b/c high risk of teratoginicity

increased risk of DVT/PE w dexamethasone

Question 25

protein kinase inhibitors special info

Answer 25

many drug-drug interactions!!! | CYP3A4

Question 26

osimertinib & cetuximab MOA

Answer 26

EGFR inhibitor

Question 27

osirmertinib & cetuximab HMT & special info

Answer 27

rash - wear sunscreen & protective clothing cardiomyopathy teratogenic

Question 28

Imatinib MOA

Answer 28

BCR-ABL inhibitor

Question 29

imatinib HMT & special info

Answer 29

edema dizziness & blurred vision - caution driving

Question 30

alectinib MOA

Answer 30

ALK inhibitor

Question 31

alectinib HMT & special info

Answer 31

elevated CPK - monitor q 2 weeks!

Question 32

Dabrafenib & trametinib MOA

Answer 32

BRAF V600 E mutation

Question 33

Dabrafenib & trametinib HMT & special info

Answer 33

decreased LVEF MUGA scan before tx, 1 mo post, q 2-3 mos must be used together!

Question 34

niraparib MOA

Answer 34

PARP inhibitor

Question 35

niraparib special considerations

Answer 35

dose adjust for weight <77kg or plts <150

Question 36

pazopanib& bevacizumab MOA

Answer 36

VEGEF inhibitor

Question 37

pazopanib & bevacizumab HMT & special considerations

Answer 37

hypertension, bleeding use in caution w pt w HTN or MI/stroke

Question 38

bortezomib MOA

Answer 38

protease inhibitor

Question 39

bortezomib HMT & special info

Answer 39

peripheral neuropathy SQ route decreases incidence

Question 40

palbociclib MOA

Answer 40

cycllin-dependent kinas inhibitor

Question 41

palbociclib HMT & special info

Answer 41

infection give in combo w aromatase inhibitor

Question 42

rituximab MOA

Answer 42

CD 20 - targeted antibody

Question 43

rituximab HMT & special info

Answer 43

infusion rxn start at slow rate then advance

Question 44

trastuzumab MOA

Answer 44

HER2/neu positive treatment

Question 45

trastuzumab HMT

Answer 45

ventricular dysfunction do not administer concurrently w anthracyclines baseline echo

Question 46

pembrolizumab & nivolumab MOA

Answer 46

anti-PD-1 monoclonal antibodies

Question 47

pembrolizumab & nivolumab HMT

Answer 47

immune-mediated toxicities tx w steroids

Question 48

CAR-T therapies special info

Answer 48

premedicate w diphenhydramine & avoid steroids

Question 49

male most common & most lethal cancers

Answer 49

prostate, lung, colorectal lung, prostate, colorectal

Question 50

female most common and most lethal cancers

Answer 50

breast, lung, colorectal lung, breast, colorectal