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CSO Exam 2022 > Chemotherapies, etc > Flashcards

Chemotherapies, etc Flashcards

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1
Q

Bendamustine (Treanda)

A

Alkylating agent

IV

B-cell NHL, CLL

M, N, V, fatigue, hypersensitivity rxn, tumor lysis syndrome

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2
Q

Busulfan (Myleran or Busulfex)

A

Alkylating agent

IV

CML, HCT prep, polycythemia vera

M, N, V, D, mucositis, pulmonary symptoms, insomnia, dizziness, anxiety, alopecia

hepatic and adrenal insufficiency

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3
Q

Carboplatin (Paraplatin)

A

Alkylating agent

IV

Breast, cervix, endometrium, ovaries, bladder, esophagus, H&N, lung, sarcomas, germ cell

M, N, V, hypersensitivity rxn, mild alopecia

hypomagnesia, peripheral neuropathy, renal toxicity

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4
Q

Carmustine (BCNU)

A

Alkylating agent OR considered nitrosourea

IV

Brain, HD, NHL, MM, cutaneous T-cell lymphoma

M, N, V

Hepatic, renal and pulmonary toxicity

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5
Q

Chlorambucil (Leukeran)

A

Alkylating agent

Oral

CLL, HD, NHL, cancers of breast, ovaries and testes

N, V, skin rash, seizures in children

hyperuricemia, pulmonary toxicity

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6
Q

Cisplatin (Platinol, CDDP)

A

Alkylating agent

IV

H&N, esophagus, lung, stomach, ovaries, testes, cervix, bladder; NHL

M, N, V (acute and delayed), metallic taste

Renal toxicity, SIADH, ototoxicity (hearing loss), hypersensitivity rxn, peripheral nueropathy

hypomagnesemia, low calcium, hypokalemia

HYDRATION, receives fluids before and after infusion, must produce 250 mL urine before administration (SMH)

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7
Q

Cyclophosphamide (Cytoxan, CTX)

A

Alkylating agent

IV, oral, intrapleural

CLL, HD, NHL, MM, mycosis fungoides, lung, breast, endometrium, ovaries and testes, neuroblastoma, Wilms’, sarcomas

M, N, V, SIADH, alopecia

Bladder and cardiac toxicity

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8
Q

Dacarbazine (DTIC)

A

Alkylating Agent

IV

medullary thyroid, sarcoma, neuroblastoma, malignant melanoma, HD

M, N, V, flu-like symptoms (fever, chills)

CNS toxicity (neuroblastoma), photosensitivity (Melanoma)

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9
Q

Ifosfamide (Ifex)

A

Alkylating Agent

IV

H&N, Lung, bladder, cervix, germ cell, HD, NHL, sarcoma

M, N, V, anorexia, SIADH, alopecia

Bladder toxicity (hemorrhagic cystitis, dysuria), Neurotoxicity (seizure, lethargy)

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10
Q

Mechlorethamine (nitrogen mustard)

A

Alkylating agent

IV

CLL, CML, HD, NHL, mycosis fungoides, breast and lung

M, N, V, hyperuricemia, alopecia

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11
Q

Melphalan (Alkeran)

A

Alkylating agent

IV, oral

Breast, ovarian, neuroblastoma, polycythemia vera, MM, HCT prep

M, N, V, D, mucositis, hypersensitivity rxn

ice chips 30 mins before infusion to reduce risk of mucositis

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12
Q

Oxaliplatin (Eloxatin)

A

Alkylating agent

IV

M, N, V, D

Neurotoxicity (cold sensitivity, peripheral neuropathy, esophageal dysethesia (pins and needles/ discomfort)
Hepatic toxicity

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13
Q

Temozolomide (Temodar)

A

Alkylating Agent

Oral

astrocytoma, glioblastoma

M, N, V, D, headache, rash, constipation, photosensitivity, hepatic toxicity

Take on an empty stomach

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14
Q

Thiotepa (Thioplex)

A

Alkylating Agent

IV, IM, IT, SC

HD, NHL. bladder, breast, ovarian

M, N, V, mucositis, skin changes (bronzing of the skin)

Renal toxicity

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15
Q

Azacitidine (Vidaza)

A

Antimetabolite (acts as false metabolite, S- phase)

SC, IV

CML, MDS

M, N, V, D, fatigue, constipation

hypokalemia, renal toxicity

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16
Q

Capecitabine (Xeloda)

A

Antimetabolite (acts as false metabolite, S- phase), Pyrimidine antagonist

oral- take with food

Esophagus, pancreas, rectum, colon, mBreast

M, N, V, D, fatigue, increased bilirubin

Hand Foot syndrome

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17
Q

Cytarabine (ARA-C)- think blood

A

Antimetabolite (acts as false metabolite, S- phase), Pyrimidine antagonist

IV, SC, IT, IM

ALL, AML, Acute promyeloctic leukemia (APL), CML, NHL

M, N, V, mucositis, anorexia, acute pancreatitis, conjunctivitis, keratitis (inflamed cornea)

Neuro, hepatic, and pulmonary toxicity

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18
Q

Fludarabine (fludara)

A

Antimetabolite (acts as false metabolite, S- phase)

IV

CLL, NHL, acute leukemias

M, N, V, D

neurotoxicity

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19
Q

Fluorouracil (5- FU)

A

Antimetabolite (acts as false metabolite, S- phase), Pyrimidine antagonist

IV, topical

H&N, thymic, neuroendocrine, breast, stomach, GI, pancreas, hepatobiliary, colon and rectum, cervix, unknown primary

M, N, V, D, mucositis, taste changes, photosensitivity, cardiac toxicity

ice chips 30 mins before infusion to reduce risk of mucositis

hand foot syndrome

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20
Q

Gemcitabine (Gemzar)

A

Antimetabolite (acts as false metabolite, S- phase), Pyrimidine antagonist

IV

lung, breast, sarcoma, pancreas, ovaries, bladder, NHL

M, N, V, rash, flu-like symptoms

pulmonary toxicity

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21
Q

Hydroxyurea (Hydrea)

A

Antimetabolite (acts as false metabolite, S- phase)

Oral

H&N, ovaries, blood disorders, CML

M, N, V, D, mucositis

darkening or thickening of the nails

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22
Q

Mercaptopurine (6-MP)

A

Antimetabolite (acts as false metabolite, S- phase)

oral- NO dairy

ALL, APL, lymphoma, ulcerative colitis/ Crohn’s

M, N, V, D, mucositis

hepatic toxicity, hyperuricemia

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23
Q

Methotrexate (MTX)

A

Antimetabolite (acts as false metabolite, S- phase)

IM, IV, IT, Oral

H&N, osteosarcoma, breast, bladder, NHL, ALL, rheumatoid arthritis

M, N, mucositis- oral and GI ulcerations, photosensitivity

Renal and hepatic toxicity

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24
Q

Pemetrexed (Alimta)

A

Antifolate antimetabolite (acts as false metabolite, S- phase)

IV

lung cancer, mesothelioma

M, N, V, D, fatigue, rash

***Folic acid and vitamin B12 are used to minimize some of the side effects of pemetrexed.

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25
Thioguanine (6- TG)
Antimetabolite (acts as false metabolite, S- phase) Oral AML, CML M, N, V, D, mucositis hepatic and renal toxicity
26
Bleomycin (Blenoxane)
Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis) IV, SC, IM H&N, melanoma, squam skin cancer, cervix, vulva and testes, HD, NHL, malignant pleural effusions hyperpigmentation, nail and skin changes, hypersensitivity infusion rxn pulmonary and renal toxicity
27
Dactinomycin (Actinomycin D) | -think peds
Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis) IV Ewing Sarcoma, rhabdomyosarcoma, Wilms tumor, testicular cancer M, N, V, D, mucositis, anorexia, alopecia
28
Mitomycin- C (Mutamycin)
Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis) IV H&N, esophagus, lung, stomach, pancreas, bladder, anus M, N, V, D, mucositis, anorexia, alopecia pulmonary and renal toxicity
29
Daunorubicin (Daunomycin)
Anthracycline Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis) IV ALL, AML, APL M, N, V, D, mucositis, anorexia, hyperuremia, red urine, hyperpigmentation, alopecia cardiotoxicity
30
Doxorubicin (Adriamycin)
Anthracycline Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis) IV squam H&N, lung, breast, stomach, liver, ovaries, prostate, sarcomas, NHL, HD, MM, ALL, AML M, N, V, D, mucositis, anorexia, hyperpigmentation, red- orange urine, alopecia cardiotoxicity, hand foot syndrome avoid black cohosh
31
Doxorubicin Liposomal (Doxil)
Anthracycline Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis) IV Aids- related kaposi sarcoma, breast, ovaries and other solid tumors M, N, V, D, mucositis, hyperpigmentation, alopecia, red- orange urine, infusion rxn cardiotoxicity, hand foot syndrome
32
Epirubicin (Ellence)
Anthracycline Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis) IV Breast M, N, V, D, mucositis, red urine, alopecia, skin rash cardiotoxicity
33
Idarubicin (Idamycin)
Anthracycline Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis) IV AML, ALL, CML, MDS M, N, V, D, mucositis, red urine, alopecia, elevation of liver enzymes cardiotoxicity, hand foot syndrome
34
Etoposide (Vespid, VP-16)
Epidophyllotoxin (Damages cells in late S/ early G2 phase, inhibits topoisomerase II) IV, Oral lung, stomach, uterus, bladder, prostate, germ cell, HD/ NHL M, N, V, mucositis, anorexia, hypersensitivity rxn, alopecia, orthostatic HTN, yellowing of skin and eyes metallic taste at infusion, Diarrhea ***
35
Teniposide (Vumon, VM- 26)
Epidophyllotoxin (Damages cells in late S/ early G2 phase, inhibits topoisomerase II) IV childhood ALL M, N, V, hypotension, pulmonary toxicity
36
Paclitaxel (Taxol)
Taxane (M-phase, microtubule agent that prevents mitosis) IV H&N, esophagus, lung, breast, pancreas, ovaries, prostate, bladder M, N, V, D, mucositis, alopecia, hypersensitivity rxn arthralgia/ myalgia, peripheral neuropathy, swelling of feet and ankles
37
Docetaxel (Taxotere)
Taxane (M-phase, microtubule agent that prevents mitosis) IV H&N, lung, breast, stomach, pancreas, bladder, ovaries, prostate, sarcomas M, N, V, D, mucositis, hair and skin changes, alopecia, hypersensitivity rxn, peripheral neuropathy fluid retention syndrome avoid black cohosh
38
Paclitaxel Protein Bound (Abraxane)
Taxane (M-phase, microtubule agent that prevents mitosis) IV NSCLC, breast, pancreas M, N, V, D, mucositis, alopecia, eye problems, peripheral neuropathy arthralgia/ myalgia, swelling of the feet and ankles
39
Vincristine (Oncovin)
Vinca Alkaloid (bind to protein tubulin, disrupt mitotic spindle formation, prevent mitosis) IV brain and thyroid cancers, neuroblastoma, Wilms', Ewing Sarcoma, rhabdomyosarcoma, ALL, AML, HD, NHL M, N, mucositis, taste changes, SIADH, hypersensitivity rxn, alopecia abd cramps, constipation, jaw pain
40
Vinblastine (Velban)
Vinca Alkaloid (bind to protein tubulin, disrupt mitotic spindle formation, prevent mitosis) IV H&N, lung, breast, testes, bladder, sarcomas, ND, NHL, blood disorders M, mucositis, stomatitis (sore mouth), HTN, alopecia constipation, taste changes, jaw pain
41
Vinorelbine (Navelbine)
Vinca Alkaloid (bind to protein tubulin, disrupt mitotic spindle formation, prevent mitosis) IV NSCLC, breast, ovaries, HD M, N, V, stomatitis, anorexia, alopecia, transient elevated liver function tests Constipation
42
Targeted Therapy
Specific to tumor type or concentrate on a genetic change falls into 2 categories- acts on specific genes or proteins in cancer cells OR acts on tissues/ environment r/t cancer growth ex: Monoclonal antibodies and small- molecule drugs
43
Targeted Therapy Side Effects
Different side effects than chemo/ RT vascular, coagulatory, dermatologic, immunologic, ocular, pulmonary toxicities
44
Monoclonal Antibodies
Target specific receptors on the outside of the cell to disrupt cell function and cause apoptosis used alone of in conjunction with other therapies, can be used as vehicles for radioactive molecules (tositumomab) includes immune checkpoint inhibitors like pembrolizumab (keytruda) and nivolumab (Opdivo)
45
BRAF V600E
Cell growth signaling protein
46
CD20 | Ibrutumomab (Zevalin)
B-lymphocyte antigen CD20 IV NHL, follicular lymphoma M, Asthenia (weakness), infections, mild N/V, cough, dyspnea, infusion rxn
47
CD20 | Rituximab (Rituxan)
B-lymphocyte antigen CD20 IV NHL, CLL M, mild N/V, tumor lysis syndrome, possible infusion rxn, skin rxn
48
EGFR | Cetuximab (Erbitux)
epidermal growth factor receptor IV mColorectal, NSCLC, squam H&N, squam skin N, V, D, anorexia, pulmonary toxicity, skin rash, pruritis, possible infusion rxn hypomagnesemia
49
EGFR | Panitumumab (Vectibix)
epidermal growth factor receptor IV colorectal Diarrhea, pulmonary toxicity, acneiform skin rash, pruritis, possible infusion rxn, malaise hypomagnesemia
50
ERBB2 | Pertuzumab (Perjeta)
human epidermal growth factor receptor 2 IV ERBB2+ breast cancer M, N, V, D, rash, possible infusion reaction
51
ERBB2 | Trastuzumab (Herceptin)
human epidermal growth factor receptor 2 IV ERBB2+ breast cancer, gastric cancer M (rarely), N, V, D (all mild), cardiotoxicity, pulmonary toxicity, possible infusion rxn
52
ERBB2 | Ado- trastuzumab emantansine (Kadcyla)
human epidermal growth factor receptor 2 IV ERBB2+ metastatic breast cancer M, N, peripheral neuropathy, increased liver enzymes, decreased serum potassium, possible infusion rxn
53
PD-1/ PD- L1 | Ipilimumab (Yervoy)
programmed cell death ligand 1 IV melanoma N, V, D, anemia, rash, pruritis, pulmonary symptoms
54
PD-1/ PD- L1 Nivolumumab (Opdivo)
programmed cell death ligand 1 IV melanoma, NSCLS, renal cell cancer M, N, V, C, colitis, pruritis, pulmonary symptoms, pneumonia hyponatremia, hypokalemia, hypomagnesemia
55
PD-1 Pembrolizumab (Keytruda)
programmed cell death ligand 1, for tumors that express PD-L1 IV melanoma, NSCLC, squam H&N, endometrial Anemia, N, pruritis, pulmonary symptoms, increased liver enzymes hyponatremia, hypoalbuminemia, hyperglucemia
56
RANKL Denosumab (Xgeva OR Prolia)
receptor activated nuclear factor KappaB ligand IV Xgeva: bone mets, giant cell tumor of the bone Prolia: osteoporosis with high risk of fracture N, V, D, hypocalcemia, osteonecrosis of the jaw
57
CD52 | Alemtuzumab (Campath)
IV CLL M, N, V, poss infusion rxn
58
VEGF
Vascular endothelial growth factor- small molecule drug, angiogenesis inhibitor recognizes and binds to VEGF, thus stopping it from activating the VEGF receptor. This action helps to arrest endothelial cell proliferation and angiogenesis
59
Side Effects of Monoclonal Antibodies
infusion related symptoms- flushing, chills, fever, fatigue, headache, dyspnea, HTN/ hypotension Muscular-skeletal side effects like aches and pains skin- related changes like rash, facial erythema, hand foot syndrome GI effects- mouth sores, N, V, D, decreased appetite
60
Small Molecule Drugs
Protein targeted agents or angiogenesis inhibitors PTA- Uses small molecules that penetrate malignant cell membranes to interact with specific areas of the target proteins AI- hinder formation of new blood vessels in primary and metastatic tumors
61
Side Effects of Angiogenesis Inhibitors
HTN, arterial thromboembolic events (MI, stroke, angina), nosebleeds, hematuria, GI bleeding, vaginal bleeding, GI perforation Some people can develop hypothyroidism Proteinuria occurs in 1/3 of patients treated with bevacizumab
62
Immunotherapy
AKA biotherapy or biological therapy treatment to boost or restore the ability of the immune system to fight cancer infection consists of substances made by the body or made in a lab Ex. monoclonal antibodies, small molecule drugs or long lasting cancer vaccines (HPV and Hep-B)
63
Tyrosine Kinase Inhibitors
Tyrosine kinases are involved in tumor growth, angiogenesis, and metastasis Ex. Imatinib (Gleevac), Crizotinib (Xalkori), Erlotinib (tarceva- *avoid green tea*)
64
mTOR Inhibitors
Mammalian target of rapamycin (mTOR) inhibitors: block angiogenesis by preventing the release of vascular endothelial growth factor (VEGF) and platelet- derived growth factor (PDGF), thus blocking tumor cell proliferarion and causing cell death Ex. Temsirolimus (Torisel), Everolimus (affinitor)
65
Proteasome Inhibitors (think MM)
Inhibit breakdown of intracellular proteins and disrupt the proteasome pathway Ex. Bortezomib (Velcade- MM, mantle cell lymphoma)
66
BRAF Inhibitors
target the mutant form of BRAF protein Ex. Vemurafenib (Zelboraf)
67
Bevacizumab (Avastin)
mColorectal cancer, NSCLC, mBreast, glioblastoma, mrenal cell cancer generalized weakness, pain, abdominal pain, N, V, reduced appetite, upper respiratory infection, low white cell count
68
Lenalidomide (Revlimide)
Ubiquitin E3 Ligase cereblon- interacts with and targets this enzyme to degrade Ikaros transcription factors IKZF1 and IKZF3. Inhibits angiogenesis, tumor secreted cytokines, and tumor proliferation MM, mantle cell lymphoma, MDS N, V, C, D, rash, tiredness, fever, itching
69
Thalidomide (Thalomid)
Mechanism not fully understood- inhibits tumor angiogenesis and pro-inflammatory tumor secreted cytokines (TNF- a, IL1B, IL-6) MM, RCC, glioblastoma multiforme headache, dizziness, drowsiness, weakness, anxiety, agitation, confusion, tremors, muscle weakness, wt gain or loss, rash, dry skin
70
Nonspecific Immunotherapy
stimulates broad immune response fatigue, N, V, D, flu- like symptoms, fever, chills, headache, arthralgias/ myalgias Ex. Interferon- A, Interleukin-2
71
Chimeric Antigen Receptor T-cell Therapy (CAR-T)
Collects patients own T-cell lymphocytes and uses them to treat cancer. Obtained through apheresis, genetically modded in a lab to have a CAR site on surface so they can recognize antigens on targeted tumor cells S/E: cytokine release syndrome (N, headache, chills fatigue) and neuro symptoms like confusion, aphasia, weakness and seizures
72
Hormone Therapy
AKA endocrine therapy is used to treat horomone sensitive cancers - stopping or reducing the body's ability to produce hormones - interfering with or blocking hormone receptors - substituting chemically similar agents for active hormones but that can't be used by the tumor
73
Selective Estrogen Receptor Modulators (SERMs)
nonsteroidal antiestrogen agents that compete with estrogen for binding to estrogen receptors Ex: Tamoxifen citrate (Novaldex), Toremifene (Fareston), raloxifene (Evista)
74
SERM indications and side effects
Tamoxifen/ Toremifene: breast cancer Raloxifene: osteoporosis or post- meno atrisk for breast cancer Menstrual symptoms (hot flashes, sweating, nausea, menstrual irregularities, mood changes, dec libido, fatigue), thromboembolic complications, skin changes, rash, joint aches and pains fluid retention and peripheral edema wt gain
75
Aromatase Inhibitors
Block production of estrogen by inhibiting conversion of adrenal androgens to estrogen. primarily used in post menopausal women because pre-menopausal produce too much aromatase to block. used for breast cancer ex anastrozole (arimidex), letrozole (femara), exemaestane (Aromasin)
76
Aromatase inhibitor side effects
hot flashes, arthralgias, mild N/V, asthenia, thromboembolic events, HTN (letrozole), fever, malaise, myalgias
77
Progesterones
possess antiestrogenic effects and inhibit the stability, availability and turn over of estrogen receptors Ex. Megace (megesterol acetate) Used in breast, endometrial, renal cell cancers Prescribed as an app stimulant in cancer and HIV/ AIDS
78
Progesterone side effects
Wt gain (fluid retention) thromboembolic events N/V menstrual bleeding, hot flashes, sweating and mood change hyperglycemia
79
Antiandrogens
These bind to androgen receptors and block the effects of testosterone in androgen- sensitive cancer cells Ex. Bicalutamide (casodex), Flutamide (Eulexin) used to treat prostate cancer
80
Antiandrogen side effects
Wt gain hot flashes, fatigue decreased libido, impotence bone pain
81
What are Luteinizing Hormone-releasing Hormone (LHRH) agonists
synthetic proteins which are similar to naturally occurring LHRH and signal the pituitary to stop producing luteinizing hormone. This results in the suppression of testosterone to manage the growth and spread of prostate cancer. Can also be used to suppress ovarian function by interfering with ovarian signals to the pituitary to produce estrogen Ex. Leuprolide acetate (Lupron) and goserelin (Zoladex)
82
LHRH agonist side effects
hot flashes, fatigues, headaches bone pain, muscle weakness decreased libido, impotence gynecomastia

CSO Exam 2022 (9 decks)

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