Flashcards in CTX not in sketchy Deck (105)
What are the indications for cyclophosphamide in cancer?
What about for ifosphamide?
Soft tissue carcinoma (sarcomas)
What drug is an analogue of cyclophosphamide?
What type of drug is temozolomide? (MoA?)
Monofunctional alkylating agent: spontaneous hydrolysis of DNA-active species and methylates DNA.
What is the indication for temozolomide?
Brain tumors (GBM)
What are the toxicities for temozolomide?
N/V, hair loss
What drug helps prevent hematuria (and hemorrhagic cystitis) w/ifosphamide administration? (and rarely w/cyclophosphamide)?
Which of the platinum agents have the same indications?
Cisplatin + carboplatin
What are the indications for cisplatin + carboplatin?
What is the indication for oxaliplatin?
Testicular cancer (curative!)
Lung, ovary, head/neck, bladder cancers
Colorectal cancer (doubles survival)
Which of the platinum agents can cause neuropathy?
Which of the platinum agents can cause myelosuppression?
(*cisplatin does NOT cause myelosuppression)
Which of the platinum agents can cause ototoxicity?
Which of the platinum agents can cause nephrotoxicity?
How can it be prevented?
Administer with hydration and mannitol diuresis (chloruresis)
Dose reduction for renal insufficiency
Describe the types of neuropathy that can seen w/oxaliplatin.
- Acute cold-induced neuropathy (begins immediately)
- Chronic sensory neuropathy (mild, rarely disabling and slowly resolves)
Which of the platinum cmpds can cause hypomagnesemia?
Which of the platinum cmpds is a vein irritant?
What are the indications for vincristine?
What are the indications for vinblastine?
Acute lymphoblastic leukemia
Lung & breast cancer
What are the indications for paclitaxel?
Non-small cell lung cancers
Which of the vinca (plant) alkaloids are vesicants?
All (vincristine, vinblastine, taxanes)
What is the major reason to adjust dose for the vinca alkaloids?
Dose reduction in presence of jaundice (order bili)
What are some SE's of paclitaxel besides neuropathy, myelosuppression, and being a vesicant?
How can you avoid an infusion rxn w/paclitaxel?
Premedicate with steroids
Which drug categories are cross-resistant due to MDR?
The intercalating and non-intercalating topoisomerase II inhibitors and the tubulin inhibitors (vinca alkaloids)
What are the indications for etoposide?
Small cell lung cancer
(small testicular lymphoma)
What specific type of cancer can etoposide cause?
What other minor SE's does it cause (besides hair loss, myelosuppression)?
Are any of the platinum cmpds emetogenic? Which?
Oxaliplatin causes N/V as well
When would you adjust your dose w/etoposide?
Dose reduce for hepatic or renal dysfunction
What are the indications for ironotecan?
GI tract (eg colon) cancers
What are the 2 types of diarrhea seen w/ironotecan?
How would you treat each?
Early cholinergic diarrhea treated with atropine
Late secretory diarrhea (treated w/imodium & hydration)
When would you adjust your dose w/ironotecan?
Dose reduction for jaundice (order bili)
Pts w/Gilbert’s syndrome should not be given what chemo drug?
UGT1A1*28 (decreases glucuronidation and increases myelosuppression and diarrhea, mutation in 9% of Caucasian and African population)