Chemotherapy V Flashcards Preview

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Flashcards in Chemotherapy V Deck (40):
1

Tyrosine Kinase Inhibitors

Small molecule (2)
Monoclonal Antibodies (3)

Small molecule: Imatinib, Erlotinib

Monoclonal Ab: Trastuzumab, cetuximab, bevacizumab

2

Imatinib MOA

Binds and blocks BCR-ABL

3

Where is Imatinib metabolized

LIVER- avoid coadministration with inducers/inhibitors of CYP3A4

4

Imatinib SE

SUPERFICIAL EDEMA
nausea
MUSCLE CRAMPS
Abdominal pain
Rash
Diarrhea
Anemia
Neutropenia, thrombocytopenia

5

What should you monitor in patients taking Imatinib?

TSH level
(Increases clearance of thyroid hormone)

6

Imatinib Indications

CML

GI stromal tumors

7

Other drugs like Imatinib?

Dasatanib
Nilotinib

8

Cetuximab MOA

Monoclonal antibody to EGFR (transmembrane TK)

Sensitizes cell to chemo and radiation

9

Cetuximab Indication

Metastatic lung, colon cancer
Head, neck cancers (+radiation)

10

Cetuximab SE

Rash
Diarrhea
HYPOMAGNESEMIA
Infusion reaction
Skin toxicity
Trichomegaly

11

What must you treat patients taking Cetuximab with?

IV therapy for hypomagnesemia

12

What type of mutational analysis should you perform on a patient with COLORECTAL cancer to determine if they will respond to Cetuximab?

KRAS
NRAS

Wildtype: respond to Cetuximab
Mutated: no response

13

Erlotinib MOA

Small molecule inhibitor of the TK associated with EGFR

14

How is erlotinib metabolized?

CYP3A4

15

Erlotinib SE

Rash, nausea, anorexia, fatigue, paronchia (nailbed pain)

16

Perform mutational analysis on non-small cell lung cancers for ____ activating mutations

EGFR

17

Bevacizumab

Monoclonal Ab, binds to VEGF, prevents signaling for new blood vessel formation

18

Bevacizumab Indication

Metastatic colorectal cancer
Metastatic lung cancer

*significant prolongation or survival!

19

Bevacizumab SE

HTN, proteinuria, arterial clots, colon perf, bleeding, reversible posterior leukoencephalopathy syndrome, infusion reactions

20

Small molecule VEGF receptor TK inhibitors

Sorafenib, Pazopanib, Sunitinib

21

Small molecule VEGF receptor TK inhibitors metabolism

CYP3A4

22

Small molecule VEGF receptor TK inhibitors SE

Similar to bevacizumab +
Hand foot syndrome
Congestive heart failure

23

Small molecule VEGF receptor TK inhibitors Indication

All 3 - renal cell cancer (clear cell)

Sunitnib- pancreatic neuroendocrine cancer, GI stromal tumor

Sorafenib- unresectable hepatocellular cancer

24

Trastuzumab MOA

Monoclonal Ab to extracellular domain of EGFR receptor, HER-2 Neu

25

Trastuzumab SE

CARDIAC TOXICITY

fever, n/v/d, cough, HA, SOB, back pain, rash, myalgia

26

The greatest risk of cardiac toxicity is in patients taking Trastuzumab and this other drug

Anthrcycline

27

What should you monitor in a patient taking Trastuzumab?

Cardiac ejection fraction

28

Trastuzumab Indication

Breast cancer (Her2/neu+)
Stomach and gastroesophageal junction cancer (Her2/neu+)

29

When should you use trastuzumab?

when Her2/neu is overexpressed

30

Crizotinib Indication

Pts with ALK-anaplastic lympoma kinase rearrangements in adenocarcinoma of lung

31

Vemurafenib Indication

Melanoma with V600E mutation in BRAF (activating mutation)

32

L-asparaginase MOA

Depletes asparagine pools rapidly

Leukemia cells lack asparagine synthetase and cannot synthesize asparagine

decrease in protein synthesis

33

L-asparaginase SE

CLOTTING (decreased antithrombin 3)

34

L-asparaginase Indication

Acute lymphoblastic leukemia

35

Hydroxyurea MOA

Inhibits DNA synthesis by inhibiting ribonucleotide reductase

36

Hydroxyurea Indication

Acute myelogenous leukemia

37

All-trans retinoic acid MOA

Induces terminal differentiation of leukemic cells

38

All-trans retinoic acid Indication

Acute promyelocytic leukemia (APL)

39

Arsenic Trioxide Indication

Treatment of relapsed APL

40

Arsenic Trioxide SE

QT prolongation