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Flashcards in CTX not in sketchy Deck (105)
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1

What are the indications for cyclophosphamide in cancer?

What about for ifosphamide?

Breast cancer
Non-Hodgkin's lymphoma

Testicular cancer
Soft tissue carcinoma (sarcomas)

2

What drug is an analogue of cyclophosphamide?

Ifosfamide

3

What type of drug is temozolomide? (MoA?)

Alkylating agent
Monofunctional alkylating agent: spontaneous hydrolysis of DNA-active species and methylates DNA.

4

What is the indication for temozolomide?

Brain tumors (GBM)

5

What are the toxicities for temozolomide?

Myelosuppression
*Pneumocystic PNA
N/V, hair loss

6

What drug helps prevent hematuria (and hemorrhagic cystitis) w/ifosphamide administration? (and rarely w/cyclophosphamide)?

Mesna

7

Which of the platinum agents have the same indications?

Cisplatin + carboplatin

8

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)

9

Which of the platinum agents can cause neuropathy?

(Cisplatin)

Oxaliplatin (dose-limiting)

10

Which of the platinum agents can cause myelosuppression?

(*cisplatin does NOT cause myelosuppression)
Carboplatin
Oxaliplatin

11

Which of the platinum agents can cause ototoxicity?

Cisplatin

12

Which of the platinum agents can cause nephrotoxicity?

How can it be prevented?

Cisplatin

Administer with hydration and mannitol diuresis (chloruresis)
Dose reduction for renal insufficiency

13

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)

14

Which of the platinum cmpds can cause hypomagnesemia?

Cisplatin

15

Which of the platinum cmpds is a vein irritant?

Oxaliplatin

16

What are the indications for vincristine?

What are the indications for vinblastine?

Lymphoma
Hodgkin's disease
Acute lymphoblastic leukemia

Lung & breast cancer

17

What are the indications for paclitaxel?

Ovarian cancer
Breast cancer
Gastroesophageal cancer
Non-small cell lung cancers

(OBG N)

18

Which of the vinca (plant) alkaloids are vesicants?

All (vincristine, vinblastine, taxanes)

19

What is the major reason to adjust dose for the vinca alkaloids?

Dose reduction in presence of jaundice (order bili)

20

What are some SE's of paclitaxel besides neuropathy, myelosuppression, and being a vesicant?

How can you avoid an infusion rxn w/paclitaxel?

Stomatitis, arthralgias/myalgias.

Premedicate with steroids

21

Which drug categories are cross-resistant due to MDR?

The intercalating and non-intercalating topoisomerase II inhibitors and the tubulin inhibitors (vinca alkaloids)

22

What are the indications for etoposide?

Small cell lung cancer
Testicular cancer
Lymphoma

(small testicular lymphoma)

23

What specific type of cancer can etoposide cause?

What other minor SE's does it cause (besides hair loss, myelosuppression)?

Leukemogenic

N/V

24

Are any of the platinum cmpds emetogenic? Which?

Cisplatin

Oxaliplatin causes N/V as well

25

When would you adjust your dose w/etoposide?

Dose reduce for hepatic or renal dysfunction

26

What are the indications for ironotecan?

GI tract (eg colon) cancers

27

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)

28

When would you adjust your dose w/ironotecan?

Dose reduction for jaundice (order bili)

29

Pts w/Gilbert’s syndrome should not be given what chemo drug?
Why?

Ironotecan

UGT1A1*28 (decreases glucuronidation and increases myelosuppression and diarrhea, mutation in 9% of Caucasian and African population)

30

What are the toxic SE's for cyclophosphamide and ifosfamide besides myelosuppression and hematuria/hemorrhagic cystitic?

What other unique SE's can ifosfamide have at high doses?

Both: N/V, hair loss

Ifosfamide: lethargy and confusion