Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

pharm > chemo for GI cancer > Flashcards

chemo for GI cancer Flashcards

1
Q

antimetabolite agents

A

fluorouracil (+leucovorin)
capecitabine
gemcitabine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

5FU MOA

A

incorporation of FdUTP into DNA interferes with DNA processing
FdUMP inhibits thymidylate synthase (TS) and depletes nucleosides needed for DNA (depletion of thymidine and dTTP)
incorporation of FUTP into RNA inhibits RNA synthesis and function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

5FU ADME

A

metabolized to FdUMP by thymidine kinase and to FUTP and FdUTP
can cross BBB to tx brain mets
distributes into ascitic fluid and pleural effusions (increased ADR risk)
radiation synergist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

leucovorin

A

reduced folic acid that increases binding of FdUMP to TS to increase effect but also increases toxicity (stomatitis, diarrhea, myelosuppression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

capecitabine MOA

A

oral prodrug of 5FU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

capecitabine ADME

A

radiation synergist
3 step conversion to FU involves carboxyl esterase, cytidine deaminase, thymidine phosphorylase
inhibits CYP2C9 (interacts with warfarin and phenytoin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

5 FU, capecitabine ADR’s - common

A

myelosuppression, mucositis / stomatitis, abd pain / diarrhea, changes in nails, dermatitis / sensitivity to sunlight, conjunctival irritation, fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

5 FU, capecitabine ADR’s - major

A

palmar - plantar erythrodysesthesia (hand food syndrome), cardiac (coronary spasm), diarrhea, hyperbilirubinemia, myelosuppression
DPD deficiency can worsen ADR’s; more active at night - dose at PM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

dosing 5 FU, capecitabine

A

FU - mg/m2 (BSA), IV bolus or continuous; possibly topical or IV solution
cap - mg/m2 (BSA), every 12 hours with food; separate from Al or Mg products and adjust for CrCl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Gemcitabine MOA

A

inhibits ribonucleic reductase and incorporation into DNA (resistant to DNA repair)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Gemcitabine use

A

pancreatic CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Gemcitabine ADR;s

A 
myelosuppression (thrombocytopenia > neutropenia); increased with infusions > 60 minutes
flu-like symptoms
rash
increased serum ALT AST
renal toxicity
low N/V
hair loss / thinning
pulmonary toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Gemcitabine dosing

A

mg/m2 (BSA)
radiation sensitizer - avoid within 7 days of SRT
synergist with cisplatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

VEGF inhibitors agents

A

bevacizumab
ziv-aflibercept
ramucirumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

VEGF inhibitors MOA

A

bind VEGF to prevent VEGFR activation (inhibit angiogenesis / normalize tumor vasculature)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

VEGF inhibitors ADR;s

A 
HTN (tx with anti HTN Rx)
HA
THromboembolism
proteinuria / nephrotic syndrome (test UA and monitor)
infusion reactions
non-GI fistula
17
Q

VEGF inhibitors black box warning

A

GI perforations / fistula
wound dehiscence (Avoid with surgery)
hemorrhage (epistaxis to hemoptosis, GI, CNS H); increased risk in NSCLC or brain mets

18
Q

VEGF inhibitors dosing

A

B - mg/kg IV
Ziv - mg/kg IV, prior to folfiri
Ram - mg/kg IV; premedicate with IV H1 antagonist prior to infusion and dexamethasone + acetaminophen if infusion reaction has occurred before

19
Q

EGFR inhibitors agents

A

cetuximab

panitumumab

20
Q

EGFR inhibitors MOA

A

competitively inhibit EGF -> prevent phosphorylation and activation of TRK’s -> inhibit cell growth, mets, and signal transduction

21
Q

EGFR inhibitors ADME

A

EGFR results in RAS wildtype mutations; mutated TRK’s are unaffected by inhibitors

22
Q

EGFR inhibitors ADR’s

A 
dermatologic - dermatitis, acneform rash, pruritus, erythema, fissures
Mg wasting
diarrhea
intersitial lung disease
infusion reactions (cetuximab more)
cardiopulmonary arrest (cet only)
23
Q

EGFR inhibitors dosing

A

cet - mg/m2 IV, initial loading dose then 2x / week; premedicat with H1 antag
pan - mg/kg IV

24
Q

Tyrosine kinase inhibitors agents

A

erlontinib

regorafenib

25
Q

erlontinib MOA

A

block ATP binding sites on intracellular TK domain of EGFR -> prohibit phorphorylation -> reduce growth, survival, and proliferation

26
Q

erlontinib ADR - common

A 
rash (onset 8 days)
diarrhea (onset 12 days)
fatigue
dyspepsia / anorexia / nv
dyspnea, cough
stomatitis
27
Q

erlontinib - major

A 
intersitial lung disease
renal fialure
hepatotoxicity
GI perf
hemolytic anemia
28
Q

erlontinib dosing

A

oral tabs on empty stomach
increase with current smokers
met by CYP3A4
separate from antacids and PPIs

29
Q

erlontinib use

A

with gemcitabine for pancreatic CA

alone for NSCLC

30
Q

regorafenib MOA

A

oral multikinase inhibitor of angiogenesis and tumor growth TK’s (VEGF, PDGFR, oncogene k’s, cKIT, REF, BRAF)

31
Q

regorafenib ADR

A 
hand-foot syndrome
HTN
hypo Ca, Na, P
diarrhea, wt loss, nv
anemia, neutropenia, proteinuria
increased ast/alt
GI fistula
32
Q

regorafenib dosing

A

PO with low fat breakfast
21 days on 7 days off
CYP3A4 metabolized
hepatic dose adjustment

pharm (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions