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PT 2 > Chemo > Flashcards

Chemo Flashcards

1
Q

What are the 6 important alkylating agents?

A
  1. Cyclophosphamide
  2. Ifosfamide
  3. Temozolamide
  4. Cisplatin
  5. Carboplatin
  6. Oxaliplatin
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2
Q

MOA and CCS of the alkylating agents

A

MOA - alkylate DNA (N7 of guanine specifically for Cyclo and Ifos)

CCNS

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3
Q

Which alkylating agent needs to be bioactivated?

A

Cyclophosphamide

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4
Q

Which two alkylating agents cause hematuria and how is this addressed?

A

Cyclophosphamide and Ifosfamide

Coadminister with mesna

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5
Q

Alkylating agent - pneumocystis pneumonia

A

Temozolamide

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6
Q

Alklyating agent - administer with hydration and mannitol diuresis

A

Cisplatin

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7
Q

Dosing based on creatinine clearance and AUC target

A

Carboplatin

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8
Q

Acute cold-induced neuropathy + chronic sensory neuropathy

A

Oxaliplatin

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9
Q

Uses for cyclophosphamide (2)

A

Breast

Lymphoma

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10
Q

Uses for Ifosfamide (2)

A

Sarcoma

Testicular

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11
Q

Use for Temozolamide (1)

A

Brain tumors

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12
Q

Uses for Cisplatin and Carboplatin (5)

A 
Bladder
Head and neck
Lung (both)
Ovarian
Testicular
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13
Q

Uses for Oxaliplatin

A

Colorectal
Gastric
Pancreatic

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14
Q

Which 2 alkylating agents have a non-myelosuppression dose limiting toxicity?

A
  1. Cisplatin (renal toxicity)

2. Oxaliplatin (neurotoxicity)

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15
Q

List the 4 plant alkaloids and their MOAs/CCS.

A
  1. Vincristine (prevent tubulin polymerization)
  2. Vinblastine (ditto)
  3. Paclitaxel (prevent tubulin disassembly)
  4. Etoposide (topoisomerase II inhibitor)

All CCS (1-3 = M)

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16
Q

Which plant alkaloid has a non-myelosuppressive dose limiting toxicity

A

Vincristine (neuropathy - sensory and autonomic)

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17
Q

Premedicate this plant alkaloid with steroids to avoid infusion reactions

A

Paclitaxel

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18
Q

Which plant alkaloid is leukemogenic?

A

Etoposide

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19
Q

What are the 2 uses of Vincristine?

A

ALL

NHL

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20
Q

What are the 2 uses of Vinblastine?

A

Breast

Lung

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21
Q

What are the 4 uses of Paclitaxel?

A

Breast
Gastroesophageal
Lung (non)
Ovarian

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22
Q

What are the 3 uses of Etoposide?

A

Lung (small)
Lymphoma
Testicular

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23
Q

What are the three antitumor antibiotics, their MOA, and CCS?

A
  1. Doxorubicin (topoisomerase II inhibitor, CCNS)
  2. Irinotecan (topoisomerase I inhibitor, CCNS)
  3. Bleomycin (binds to DNA, causes breaks, CCS)
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24
Q

Schedule dependent cumulative cardiac toxicity (not dose limiting)

A

Doxorubicin

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25
Acute cholinergic diarrhea treated with atropine, late secretory diarrhea
Irinotecan
26
Cumulative pulmonary toxicity
Bleomycin
27
NO myelosuppression
Bleomycin | High dose MTX
28
4 uses of doxorubicin
Breast Leukemia Lymphoma (both H/NH) Sarcoma
29
1 use of irinotecan
GI tract
30
1 use of bleomycin
Testicular
31
2 uses of prednisone (high dose)
Lymphoma | Multiple myeloma
32
2 uses of dexamethasone
Reduce cerebral edema and initial treatment for spinal cord compression In combination with other drugs to treat chemo-related emesis
33
Used to block the flare reaction caused by leuprolide acetate?
Flutamide
34
What are the 4 anti-metabolites, their MOA, and CCS?
1. MTX (blocks dihydrofolate reductase) 2. Cytarabine (inhibits DNA polymerase) 3. 5-FU (conversion to F-dUMP, blocks thymidylate synthetase) 4. 6-MP (incoporation into DNA) All CCS (S)
35
Intrathecal administration
MTX | Cytosine arabinoside
36
Anti-metabolite with schedule dependent cytotoxicity
Cytarabine
37
Cerebellar toxicity
High dose cytarabine (Also hepatic toxicity) 5-FU (ataxia)
38
What is the 3+7 regiment for AML?
3 days doxo/daunorubicin + 7 days of continuous infusions of cytarabine
39
Leucovorin enhances cytotoxicity and toxicity
5-FU
40
Dihydropyrimidine deficiency
5-FU toxicity
41
Hand-foot syndrome
5-FU
42
Oral prodrug of 5-FU?
Capecitabine
43
Reduce this drug by 50-75% if given with allopurionl
6-MP
44
4 uses of MTX?
Leukemia Lymphoma Psoriasis RA
45
1 use of Cytarabine?
AML
46
3 uses of 5-FU?
Breast GI Head and Neck
47
1 use of 6-MP?
ALL
48
1 use of asparaginase?
ALL
49
AE - asparaginase?
Allergic reactions, pancreatitis, clots (reduced anti-thrombin III), elevated ALT/AST
50
1 use of hydroxyurea?
Emergently decrease high WBC counts in AML
51
2 drugs to treat acute promyelocytic leukemia?
All-trans retinoic acid | Arsenic trioxide
52
Symptoms of retinoic acid syndrome
Fevers Pulmonary infiltrates Dyspnea Pleural/pericardial effusions
53
AE - arsenic trioxide
Retinoic acid syndrome | Prolonged QT
54
MOA - imatinib
TK inhibitor
55
2 uses of imatinib
CML, GI stromal tumor
56
MOA - cetuximab
Inhibits EGFR
57
AE - hypomagnesemia (2)
Cetuximab | Cisplatin
58
2 uses of Cetuximab
Lung cancer | Metastatic wildtype KRAS/NRAS colorectal cancer
59
MOA of erlotinib
Small molecular inhibitor of the TK domain associated with EGFR
60
Metabolized by CYP3A4
Imatinib | Erlotinib
61
DoC - metastatic adenocarcinoma with an activating EGFR mutation
Erlotinib and NO chemo
62
Rx - Her2Neu breast and gastric cancer
Trasuzumab
63
MOA - Trastuzumab
Binds to Her2Neu receptor (EGFR)
64
Non-cumulative cardiac toxicity
Trastuzumab
65
VEGF inhibitor
Bevacizumab
66
AE - reversible posterior encephalopathy syndrome
Bevacizumab
67
2 uses of bevacizumab
Lung | Metastatic colorectal
68
MOA - crizotinib
Binds anaplastic lymphoma kinase
69
DoC - metastatic adenocarinoma with ALK rearrangement
Crizotinib
70
BRAFv600e mutation in melanoma
Vemurafenib
71
4 drugs with non-myelosuppressive DL toxicity
Cisplatin (renal) Oxaliplatin (neuro) Vincristine (neuro) Bleomycin (pulmonary)
72
4 vesicants
Vincristine Vinblastine Paclitaxel Doxorubicin
73
2 drugs - dose reduction in renal insufficiency
Cisplatin | MTX
74
4 drugs - dose reduction in jaundice
Vincristine Vinblastine Doxorubicin Irinotecan
75
1 drug - dose reduction in hepatic disease
Paclitaxel
76
1 drug - dose reducation for both hepatic and renal disease
Etoposide
77
AE - trichomegaly
Cetuximab
78
AE - conjunctivitis (2)
High dose MTX | High dose cytosine arabinoside
79
Radiation sensitizer
5-FU
80
UG1A1*28 (Gilbert's syndrome) increases toxicity of what drug
Irinotecan
81
This drug does not work without chemo
Bevacizumab
82
AE - hyperpigmetnation
Bleomycin | 5-FU

PT 2 (15 decks)

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