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Flashcards in Chemotherapy Deck (18)
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1
Q

Which chemotherapy agents are associated with SIADH?

A

Vincristine

Cyclophosphamide

2
Q

Name 2 uses of ATRA.

A
  • Neuroblastoma

- APML

3
Q

What is the mechanism of action of asparaginase?

A

Asparagine depletion; tumor cells lack asparagine synthetase

4
Q

What is the mechanism leading to hearing loss with cisplatin?

A

Production of reactive oxygen species, leading to cell death and damage to several areas of the cochlea

5
Q

Mechanisms of action of rituximab

A

Monoclonal antibody against CD20; leads to depletion of CD20 cells in blood in lymph nodes, i.e. benign and malignant mature B-lymphocytes

6
Q

Nelarabine: non-hematological toxicity

A

Neurological side effects, including: altered mental state, CNS toxicity, peripheral neuropathies, including demyelination (ascending neuropathy, GBS-like)

Risk seems increased if prior radiation therapy or intrathecal chemotherapy

7
Q

Brentuximab vedotin:

  • What is the target?
  • List 2 diseases where it has been used
A

CD-30

Hodgkin lymphoma, ALCL

8
Q

Describe the interaction between asparaginase and cytarabine/methotrexate

A
  • Decrease the effect of cytarabine or MTX if given PRE

- Enhance the effect of cytarabine or MTX if given POST

9
Q

Name 5 drugs interacting with HD methotrexate

A
  • PPI
  • Penicillin
  • Penems
  • PCP prophylaxis (Septra)
  • Acyclovir
  • Fluoroquinolones
  • NSAIDs
10
Q

List 5 chemotherapy agents considered as vesicants

A
  • Vinca alkaloids: VCR, vinblastine, vinorelbine
  • Anthracyclines, e.g. doxorubicine
  • Paxels: docetaxel, paclitaxel
  • Nitrogen mustard
  • Epipodophyllotoxins
  • Other: dactinomycin, mitomycin
11
Q

Which antidotes exist in case of a vesicant?

A
  • Hyaluronidase (vinca alkaloids)
  • DMSO (doxorubicin)
  • Sodium thiosulfate (nitrogen mustard)
12
Q

When treating infiltration of a vesicant, it is usually recommended to use cold compresses. However, it is contraindicated with 2 types of substances. Which ones?

A
  • Vinca alkaloids

- Epipodophyllotoxins

13
Q

Thiotepa:

  • Name 2 indications
  • Name class
A

Indications: bladder cancer, malignant, meningeal neoplasms
Class: alkylating agent

14
Q

What is bortezomib?

Indications?

A
  • Proteasome inhibitor

- Refractory/relapsed B or T cell ALL

15
Q

What is blinatumomab?

A
  • Bispecific T-cell engager antibody, targeting CD19

- Refractory/relapsed precursor B-cell ALL

16
Q

Name serious side effects (2) of blinatumomab

A

Cytokine release syndrome

Neurologic events, e.g. seizures, confusion, delirium, etc.

17
Q

Name common symptoms of cytokine release syndrome

A
  • Fever
  • Organ dysfunction: encephalopathy, hepatic dysfunction, ARDS, cardiac dysfunction, acute kidney injury
  • Hyperferritinemia
18
Q

What is the management of cytokine release syndrome?

A

Prevention: dexamethasone given at time of infusion
Management:
- Supportive care
- Consider IL6 inhibitor (tocilizumab) is severe
- Steroids