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Drug List Flashcards

(188 cards)

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1
Q

Abiraterone

Class of drug

A

Anti-androgen

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2
Q

Abiraterone

Mechanism of action

A

Selective CYP17 inhibitor

  • -> inhibit androgen production in testes/prostate/adrenal glands
  • -> inhibit testosterone-stimulated growth in prostatic tumours
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3
Q

Abiraterone

Indication

A

Prostate cancer

Only if androgen-specific

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4
Q

Abiraterone

Why this over another DRUG/CLASS? (Place in therapy)

A

INCOMPLETE FLASHCARD

Combination with prednisone

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5
Q

Abiraterone

Important cautions (2)/contraindications (1)/interactions (1)

*include bracketed numbers if applicable

A

CAUTIONS

  • Use condoms
  • Pregnant women use gloves when handling

CONTRAINDICATIONS
- Pregnancy & breastfeeding

INTERACTIONS
- Dexamethasone –> increased hypokalaemia/torsade de pointes risk

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6
Q

Abiraterone

Monitoring (4)

A

BP
K+
Fluid balance
Liver function

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7
Q

Abiraterone

Side effects (4)

A

Hypertension
Hypokalaemia
Peripheral oedema
UTI

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8
Q

Amikacin

Class of drug

A

Aminoglycoside

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9
Q

Amikacin

Mechanism of action

A

Irreversibly bind to 30S ribosome subunit

  • -> alter cell membrane permeability
  • -> inhibit protein synthesis (bactericidal)
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10
Q

Amikacin

Indication

A

SERIOUS gram-negative infections resistant to gentamicin (1st-line aminoglycoside)

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11
Q

Amikacin

Why this over another drug? (Place in therapy)

A

Last resort: if resistant to gentamicin/other aminoglycosides

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12
Q

Amikacin

Important cautions (1)/contraindications (2)/interactions

*include bracketed numbers if applicable

A

CAUTIONS
- Dehydration

CONTRAINDICATIONS

  • Myasthenia gravis
  • Ototoxicity with previous aminoglycoside use
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13
Q

Amikacin

Monitoring (3)

A

Renal function
Hearing
Serum concentration

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14
Q

Amikacin

Side effects (2)

A

Nephrotoxicity

Ototoxicity (irreversible)

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15
Q

Anastrozole

Class of drug

A

Anti-oestrogen

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16
Q

Anastrozole

Mechanism of action

A

Aromatase inhibitor

  • -> inhibits oestradiol production via aromatase enzyme in postmenopausal women
  • -> reduce turnover of breast tissue cells
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17
Q

Anastrozole

Indication

A

Breast cancer in postmenopausal women

only if oestrogen receptor specific

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18
Q

Anastrozole

Why this over another drug? (Place in therapy)

A

First-line or after 2-3 years of tamoxifen therapy

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19
Q

Anastrozole

Important cautions (2)/contraindications (2)/interactions

*include bracketed numbers if applicable

A

CAUTIONS

  • Susceptible to osteoporosis (may further weaken bones)
  • Severe liver/renal impairment

CONTRAINDICATIONS

  • Premenopausal women
  • Pregnancy & breastfeeding
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20
Q

Anastrozole

Monitoring (2; generalised)

A
  • Mammogram

- Breast examination –> physically feeling for abnormalities/lumps

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21
Q

Anastrozole

Side effects (6)

A 
Musculoskeletal aches/pains
Numb/tingling fingers
Hot flushing
Vaginal dryness
Hair loss/thinning
Stomach upset
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22
Q

Aprepitant

Class of drug

A

Antiemetic –> neurokinin receptor antagonist

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23
Q

Aprepitant

Mechanism of action

A

NK1 receptor antagonist in brain (neurokinin)

  • -> in combination: augments other antiemetic activity
  • -> inhibit emesis/vomiting
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24
Q

Aprepitant

Indication

A

Nausea & vomiting due to chemotherapy/post-operation

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25
Aprepitant Why this over another DRUG/CLASS? (Place in therapy)
In combination with other antiemetics eg. steroids
26
Aprepitant Important cautions (2)/interactions (2) *include bracketed numbers if applicable
CAUTIONS - Liver impairment - Two forms of contraception INTERACTIONS - CYP3A4 --> increase half-life of 3A4-metabolised drugs/increase effect - Fentanyl --> prolonged sedation, increased risk of respiratory depression
27
Aprepitant Monitoring (1)
Liver function
28
Aprepitant Side effects (4)
Decreased appetite Hiccups Asthenia (decreased muscle strength) ALT increased
29
Bicalutamide Class of drug
Anti-androgen
30
Bicalutamide Mechanism of action
Gonadorelin analogue - -> inhibits androgen receptors - -> deterioration of prostate tumours
31
Bicalutamide Indication
Prostate cancer
32
Bicalutamide Why this over another DRUG/CLASS? (Place in therapy)
Combination with another gonadorelin analogue (if monotherapy-resistant) or surgical castration
33
Bicalutamide Important cautions (3)/contraindications (1)/interactions (1)
CAUTIONS - Liver impairment - Photosensitivity - QT prolongation CONTRAINDICATIONS - Women & children INTERACTIONS Domperidone --> QT prolongation
34
Bicalutamide Monitoring (2)
Liver function | QT prolongation --> ECG
35
Bicalutamide Side effects (6)
``` Constipation Abdominal pain Nausea Flatulence Jaundice Oedema ```
36
Bisacodyl Class of drug
Stimulant laxative
37
Bisacodyl Mechanism of action
Stimulates peristalsis of colon/large intestine - -> promotes water accumulation & electrolytes - -> softens stool & reduces transit time *does not act on small intestine*
38
Bisacodyl Indication
Constipation; preparation for surgery/diagnostic procedures
39
Bisacodyl Why this over another DRUG/CLASS? (Place in therapy)
**INCOMPLETE FLASHCARD**
40
Bisacodyl Important cautions (1)/contraindications (5)/interactions *include bracketed numbers if applicable
CAUTIONS - Prolonged/excessive use --> dehydration, hypokalaemia CONTRAINDICATIONS - Acute IBD - Acute abdominal surgery - Severe dehydration - Intestinal obstruction - Abdominal pain associated with nausea & vomiting
41
Bisacodyl Monitoring
Electrolytes
42
Bisacodyl Side effects (6)
``` Abdominal pain Diarrhoea Nausea & vomiting Dizziness Syncope/fainting Rectal burning ```
43
Capecitabine Class of drug
Antimetabolite
44
Capecitabine Mechanism of action (3 points)
Prodrug --> tumour-activated into fluorouracil False nucleotide incorporated into DNA & RNA --> prevent normal cell division esp. S-phase Inhibition of thymidylate synthetase --> inhibit DNA & RNA synthesis
45
Capecitabine Indication (4 cancers)
Breast Colon Colorectal Oesophago-gastric
46
Capecitabine Why this over another DRUG/CLASS? (Place in therapy)
Breast: combination therapy, or monotherapy if combo not indicated Colon: combination therapy, or monotherapy if combo not indicated Colorectal: 1st-line if metastatic Oesophago-gastric: 1st-line if advanced; combo with Pt-based chemo
47
Capecitabine Important cautions (3)/contraindications (3)/interactions (1) *include bracketed numbers if applicable
CAUTIONS - Liver impairment - Renal impairment --> reduce dose - Pregnancy --> proper cytotoxic procedures CONTRAINDICATIONS - Dihydropyrimidine dehydrogenase deficiency - Severe liver impairment - Breastfeeding INTERACTIONS - Capecitabine --> increased myelosuppression risk; separate filgrastim 1 day before & after capecitabine treatment
48
Capecitabine Monitoring (3)
Liver function Renal function Electrolytes (if experience diarrhoea)
49
Capecitabine Side effects (4)
Mucositis (sore mouth) Nausea & vomiting Diarrhoea Alopecia
50
Carboplatin Class of drug
Platinum-based antineoplastic
51
Carboplatin Mechanism of action
Alkylating-type agent - -> does DNA cross-linking & interrupt structure (NOT cell-cycle phase specific) - -> inhibit DNA, RNA & protein synthesis - -> prevent cell replication
52
Carboplatin Indication (2 cancers)
Ovarian | Lung
53
Carboplatin Why this over another DRUG/CLASS? (Place in therapy)
Less likely severe nausea & vomiting than cisplatin
54
Carboplatin Important cautions (1)/contraindications (2)/interactions (2) *include bracketed numbers if applicable
CAUTIONS - Renal impairment --> reduce dose CONTRAINDICATIONS - Pregnancy (1st trimester) & breastfeeding - Severe renal impairment INTERACTIONS - Filgrastim --> increased myelosuppression risk; separate treatments by 1 day - Gentamicin --> increase risk of renal impairment
55
Carboplatin Monitoring (3)
Renal function Neurological tests Hearing tests
56
Carboplatin Side effects (7)
``` Thrombocytopenia (low platelet count) Neurotoxicity Ototoxicity Mucositis (sore mouth) Nausea & vomiting Diarrhoea Alopecia ```
57
Ceftriaxone Class of drug
3rd-generation cephalosporin
58
Ceftriaxone Mechanism of action
Attach to penicillin-binding proteins in bacteria - -> interrupt cell wall biosynthesis - -> bacterial cell lysis & death (bactericidal)
59
Ceftriaxone Indication (3 serious infections +1)
Septicaemia Pneumonia Meningitis Surgical prophylaxis
60
Ceftriaxone Why this over another DRUG/CLASS? (Place in therapy)
Widest spectrum --> most active against gram-negative Half-life allows for OD dosing
61
Ceftriaxone Important cautions (1)/contraindications (1)/interactions (2) *include bracketed numbers if applicable
CAUTIONS - Severe liver & renal impairment CONTRAINDICATIONS - Cephalosporin allergy INTERACTIONS - Concomitant parenteral nutrition containing calcium --> precipitation - Warfarin --> increased INR & anticoagulant activity
62
Ceftriaxone Monitoring (2)
Liver function | Renal function
63
Ceftriaxone Side effects (2)
GI upset | Thrush (vaginal/oral)
64
Cefuroxime Class of drug
2nd-generation cephalosporin
65
Cefuroxime Mechanism of action
Attach to penicillin-binding proteins in bacteria - -> interrupt cell wall biosynthesis - -> bacterial cell lysis & death (bactericidal)
66
Cefuroxime Indication
Surgical prophylaxis
67
Cefuroxime Why this over another DRUG/CLASS? (Place in therapy)
Less susceptible than 1st-gen (cefazolin etc.) to beta-lactamase inactivation --> greater activity against H. influenzae Preferred in dialysis
68
Cefuroxime Important cautions (1)/contraindications (1)/interactions (2) *include bracketed numbers if applicable
CAUTIONS - Renal impairment --> reduce dose CONTRAINDICATIONS - Cephalosporin allergy
69
Cefuroxime Monitoring (1)
Renal function
70
Cefuroxime Side effects (2)
GI upset | Thrush (vaginal/oral)
71
Cisplatin Class of drug
Platinum-based antineoplastic
72
Cisplatin Mechanism of action
Alkylating-type agent - -> does DNA cross-linking & interrupt structure (NOT cell-cycle phase specific) - -> inhibit DNA, RNA & protein synthesis - -> prevent cell replication
73
Cisplatin Indication (BOTH CL cancers)
Bladder Ovarian Testes Head/neck UNAPPROVED Cervical Lung
74
Cisplatin Why this over another DRUG/CLASS? (Place in therapy)
Less likely for severe thrombocytopenia (low platelet count) than carboplatin
75
Cisplatin Important cautions (1)/contraindications (1)/interactions (2) *include bracketed numbers if applicable
CAUTION - Renal impairment --> alternative preferred CONTRAINDICATIONS - Pregnancy (1st trimester) & breastfeeding INTERACTIONS - Filgrastim --> increased myelosuppression risk; separate treatments by 1 day - Cisplatin --> increased risk of renal impairment & ototoxicity
76
Cisplatin Monitoring
Renal function Neurological tests Hearing tests
77
Cisplatin Side effects
``` Nausea & vomiting Neurotoxicity Ototoxicity Mucositis (sore mouth) Diarrhoea Alopecia ```
78
Cyclizine Class of drug
1st-generation antihistamine
79
Cyclizine Mechanism of action
Histamine H1 receptor antagonist - -> may inhibit midbrain area emetic centre - -> reduce vomiting Anticholinergic activity - but no marked sedating effect
80
Cyclizine Indication
Nausea & vomiting
81
Cyclizine Why this over another DRUG/CLASS? (Place in therapy)
Vomiting associated with breast cancer radiotherapy --> does not elevate prolactin levels Preferred if less sedation wanted
82
Cyclizine Important cautions (3)/contraindications (1)/interactions (1) *include bracketed numbers if applicable
CAUTIONS - GI obstruction - Angle-closure glaucoma (high-risk of) - Severe heart failure CONTRAINDICATIONS - Severe liver impairment INTERACTIONS - Alcohol --> increase sedating effects
83
Cyclizine Monitoring (1)
Liver function
84
Cyclizine Side effects (6)
``` Drowsiness Dry mouth/nose/throat Blurred vision Tachycardia Urinary retention Constipation ```
85
Cyclophosphamide Class of drug
Alkylating agent | Immunosuppressant
86
Cyclophosphamide Mechanism of action
Alkylating agent - -> does DNA cross-linking & interrupt structure - -> inhibit DNA, RNA & protein synthesis - -> prevent cell replication; immunosuppression
87
Cyclophosphamide Indication
Leukaemia Lymphoma Some solid tumours Rheumatoid arthritis
88
Cyclophosphamide Why this over another DRUG/CLASS? (Place in therapy)
**INCOMPLETE FLASHCARD**
89
Cyclophosphamide Important cautions (2)/contraindications (2)/interactions *include bracketed numbers if applicable
CAUTIONS - Liver impairment --> reduce dose - Renal impairment --> reduce dose CONTRAINDICATIONS - Haemorrhagic cystitis (bladder UTI) - Pregnancy (1st trimester) & breastfeeding
90
Cyclophosphamide Monitoring (2)
Liver function | Renal function
91
Cyclophosphamide Side effects (4)
Myelosuppression Nausea & vomiting Alopecia Bladder toxicity (haemorrhagic cystitis)
92
Dexamethasone Class of drug
Glucocorticoid
93
Dexamethasone Mechanism of action
1. Reduce expression of pro-inflammatory genes 2. Increase expression of anti-inflammatory genes 3. Decrease synthesis of cytokines - -> suppress inflammation - -> immunosuppression due to direct inhibition of lymphocyte proliferation & function
94
Dexamethasone Indication
Nausea & vomiting with chemotherapy/palliative care
95
Dexamethasone Why this over another DRUG/CLASS? (Place in therapy)
Added if metoclopramide & domperidone not sufficiently effective Before starting docetaxel chemo
96
Dexamethasone Important cautions (4)/contraindications (1)/interactions (1) *include bracketed numbers if applicable
CAUTIONS - Hypertension - Hypothyroidism - Liver impairment - Glaucoma CONTRAINDICATIONS - Systemic infections UNLESS antimicrobial also given INTERACTIONS - Abiraterone --> increased hypokalaemia/torsades de pointes risk
97
Dexamethasone Monitoring
Liver function | Renal function
98
Dexamethasone Side effects
- Hypertension - Fluid retention - Diabetes - Osteoporosis
99
Docetaxel Class of drug
Antineoplastic Taxane
100
Docetaxel Mechanism of action
Promote assembly of tubulin into stable microtubules & inhibit disassembly - -> decreases free tubulin - -> disrupts cell microtubular network - -> disrupts mitotic & interphase cell functions
101
Docetaxel Why this over another DRUG/CLASS? (Place in therapy)
Breast: locally-advanced/metastatic with failed previous chemo Non-small cell lung: locally-advanced/metastatic with failed Pt-based chemo Ovarian: after failure of previous chemo, may combine with Pt-based chemo Head/neck: combo with cisplatin & fluorothiouracil Prostate: androgen-independent/hormone refractory
102
Docetaxel Why this over another DRUG/CLASS? (Place in therapy)
Breast: locally-advanced/metastatic with failed previous chemo Non-small cell lung: locally-advanced/metastatic with failed Pt-based chemo Ovarian: after failure of previous chemo, may combine with Pt-based chemo Head/neck: combo with cisplatin & fluorothiouracil Prostate: androgen-independent/hormone refractory
103
Docetaxel Important cautions (3)/contraindications (1)/interactions (1) *include bracketed numbers if applicable
CAUTIONS - Pregnancy - Oedema --> pre-treat with dexamethasone - Liver impairment --> reduce dose CONTRAINDICATIONS - Breastfeeding INTERACTIONS - CYP3A4 inhibitors --> increase docetaxel half-life
104
Docetaxel Monitoring (2)
Liver function | CBC
105
Docetaxel Side effects (4)
Neutropenia (low neutrophils) Oedema Alopecia Musculoskeletal pain
106
Docusate Class of drug
Stool softeners
107
Docusate Mechanism of action
Increases amount of water absorbed by stool in gut - -> softens stool - -> facilitates passing
108
Docusate Why this over another DRUG/CLASS? (Place in therapy)
**INCOMPLETE FLASHCARD**
109
Docusate Why this over another DRUG/CLASS? (Place in therapy)
**INCOMPLETE FLASHCARD**
110
Docusate Important cautions (2)/contraindications (3)/interactions *include bracketed numbers if applicable
CAUTIONS - Prolonged/excessive use - Haemorrhoids, anal fissures CONTRAINDICATIONS - Intestinal obstruction - Undiagnosed rectal bleeding - Appendicitis
111
Docusate Side effects (4)
Abdominal cramps Diarrhoea Nausea Rash
112
Docusate Side effects (4)
Abdominal cramps Diarrhoea Nausea Rash
113
Domperidone Class of drug
Antiemetic (peripheral)
114
Domperidone Mechanism of action
1. Stimulates GI peristalsis 2. Lowers oesophageal sphincter pressure 3. Dopamine receptor antagonist in chemoreceptor trigger zone
115
Domperidone Indication
Nausea & vomiting
116
Domperidone Why this over another DRUG/CLASS? (Place in therapy)
**INCOMPLETE FLASHCARD**
117
Domperidone Important cautions (3)/contraindications (3)/interactions (3) *include bracketed numbers if applicable
CAUTIONS - Electrolyte disturbances - Renal impairment --> reduce frequency - Pregnancy & breastfeeding CONTRAINDICATIONS - Prolactinoma - Intestinal obstruction, GI haemorrhage - Liver impairment INTERACTIONS - CYP3A4 inhibitors --> QT prolongation - Bicalutamide --> QT prolongation - Epirubicin --> QT prolongation - Goserelin --> Qt prolongation
118
Domperidone Monitoring (3)
ECG Liver function Renal function
119
Domperidone Side effects (1)
Dry mouth
120
Epirubicin Class of drug
Anthracycline cytotoxic antibiotic | like doxorubicin [not in drug list]
121
Epirubicin Mechanism of action (3)
Intercalate DNA base pairs - -> modify DNA structure - -> inhibit DNA & RNA synthesis; cause DNA fragmentation Interfere with action of topoisomerase II - -> promote DNA cleavage & inhibit repair - -> inhibit DNA & RNA synthesis; cause DNA fragmentation React with iron --> generate free radicals --> cellular damage NOT cell cycle specific
122
Epirubicin Indication (4)
Breast cancer Non-Hodgkin's lymphoma Soft tissue sarcoma Superficial bladder cancer
123
Epirubicin Why this over another DRUG/CLASS? (Place in therapy)
Better cardiotoxicity threshold over doxorubicin --> allows for higher dosing
124
Epirubicin Important cautions (4)/contraindications (6)/interactions (3) *include bracketed numbers if applicable
CAUTIONS - When handling --> irritant to tissues - Cardiotoxicity --> determined max. dose - Liver impairment --> reduce dose - Severe renal impairment --> reduce dose CONTRAINDICATIONS - Severe myocardial insufficiency - Recent myocardial infarction - Severe arrhythmia - Previous treatment with max. dose of other anthracycline - Severe liver impairment - Pregnancy (1st trimester) & breastfeeding INTERACTIONS - Domperidone --> QT prolongation - Filgrastim --> increased myelosuppression (decreased bone marrow) - Pegfilgrastim --> increased myelosuppression (decreased bone marrow)
125
Epirubicin Monitoring (2)
Liver function --> bilirubin | Renal function
126
Epirubicin Side effects (2)
Hyperpigmentation of skin, nails, oral mucosa | Red-coloured urine
127
Exemestane Class of drug
Aromatase inhibitor
128
Exemestane Mechanism of action
Irreversibly inhibits aromatase enzyme in peripheral tissues - -> no androgen conversion into oestrogen - -> reduce proliferation of breast tissue - -> helps control & manage breast tumours
129
Exemestane Indication
Breast cancer | only if oestrogen receptor-specific
130
Exemestane Why this over another DRUG/CLASS? (Place in therapy)
- Early breast cancer after 2-3 years of tamoxifen | - Advanced breast cancer after other failed treatments
131
Exemestane Important cautions (3)/contraindications (2)/interactions (1) *include bracketed numbers if applicable
CAUTIONS - Susceptibility to osteoporosis - Menopause --> lab test to confirm - Liver & renal impairment CONTRAINDICATIONS - Premenopausal women - Pregnancy & breastfeeding INTERACTIONS - Hormone replacement therapy, tamoxifen, tibolone --> effects cancel out
132
Exemestane Monitoring (1)
Bone mineral density
133
Exemestane Side effects (8)
``` Nausea, vomiting Abdominal pain Dyspepsia Constipation Dizziness, fatigue, headache Depression Hot flushes, sweating Alopecia ```
134
Fentanyl Class of drug
Opioid agonist
135
Fentanyl Mechanism of action
Bind to opiate receptors in CNS - -> inhibit ascending pain pathway signals - -> alter pain perception & response
136
Fentanyl Indication
Chronic cancer pain
137
Fentanyl Why this over another DRUG/CLASS? (Place in therapy)
Pain ladder in reverse for cancer pain | Breakthrough pain when on other opioids for chronic cancer pain
138
Fentanyl Important cautions (3)/contraindications (2)/interactions (1) *include bracketed numbers if applicable
CAUTIONS - Pupil assessments --> affect responses vital for neurological assessment - Impaired respiratory function eg. asthma - Obstructive or inflammatory bowel disorders - Dose titration --> needs to be gradual - Liver & renal impairment --> reduce dose CONTRAINDICATIONS - Acute respiratory depression - Comatose patients - COPD INTERACTIONS - Aprepitant --> increased fentanyl activity
139
Fentanyl Monitoring
Liver & renal function
140
Fentanyl Side effects
Nausea, vomiting Abdominal pain Constipation Drowsiness, dizziness, confusion
141
Filgrastim Class of drug
Recombinant human granulocyte-colony stimulating factor (rhG-CSF)
142
Filgrastim Mechanism of action
Stimulate production & release of functional neutrophils from blood precursor cells in bone marrow --> increase neutrophil count & reverse neutropenia
143
Filgrastim Indication
Neutropenia --> reduction in duration
144
Filgrastim Why this over another DRUG/CLASS? (Place in therapy)
**INCOMPLETE FLASHCARD**
145
Filgrastim Important cautions (3)/contraindications (1)/interactions (5) *include bracketed numbers if applicable
CAUTIONS - Premalignant/malignant myeloid conditions - Sickle-cell anaemia - Osteoporosis CONTRAINDICATIONS - Severe congenital neutropenia INTERACTIONS - Capecitabine --> increased myelosuppression risk; separate filgrastim 1 day before & after capecitabine treatment - Carboplatin --> increased myelosuppression risk; separate treatments by 1 day - Cisplatin --> increased myelosuppression risk; separate treatments by 1 day - Epirubicin --> increased myelosuppression risk; separate treatments by 1 day - Fluorouracil --> increased myelosuppression risk; separate treatments by 1 day
146
Filgrastim Monitoring
Bone mineral density | CBC
147
Filgrastim Side effects
``` Nausea, vomiting Generalised weakness Headache Constipation, diarrhoea Anorexia Chest pain Alopecia ```
148
Fluorouracil Class of drug
Antimetabolite --> pyrimidine analogue
149
Fluorouracil Mechanism of action
False nucleotide incorporated into DNA & RNA --> prevent normal cell division esp. S-phase Inhibition of thymidylate synthetase --> inhibit DNA & RNA synthesis
150
Fluorouracil Indication (3)
GI tract cancers Breast cancer Skin cancer (topical)
151
Fluorouracil Why this over another DRUG/CLASS? (Place in therapy)
Only when other methods have failed Combination with antineoplastics eg. capecitabine Combination with folinic acid/calcium folinate in colorectal cancer
152
Fluorouracil Important cautions (2)/contraindications (1)/interactions (4) *include bracketed numbers if applicable
CAUTIONS - When handling --> irritant to tissues - Over 70yo CONTRAINDICATIONS - Pregnancy (1st trimester) & breastfeeding INTERACTIONS - Filgrastim --> increased myelosuppression risk; separate filgrastim 1 day before & after fluorouracil treatment
153
Fluorouracil Monitoring (2)
Platelet count | WBC
154
Fluorouracil Side effects (4)
Nausea, vomiting Alopecia Confusion Soreness in mouth, dysphagia, ulceration
155
Flutamide Class of drug
Anti-androgen
156
Flutamide Mechanism of action
Inhibit nuclear binding of androgen - -> inhibit androgen uptake in prostate - -> reduce tumour
157
Flutamide Indication
Advanced prostate cancer | only if androgen-specific
158
Flutamide Why this over another DRUG/CLASS? (Place in therapy)
Monotherapy Combination with LHRH (luteinising hormone-releasing hormone)
159
Flutamide Important cautions (5)/contraindications (1)/interactions (1) *include bracketed numbers if applicable
CAUTIONS - Cardiac disease --> oedema - Excessive alcohol consumption --> liver cirrhosis - Diabetes - Osteoporosis - Women --> may be teratogenic CONTRAINDICATIONS - Severe liver impairment INTERACTIONS - Domperidone --> QT prolongation
160
Flutamide Monitoring
Liver function Bone mineral density Respiratory symptoms
161
Flutamide Side effects (12)
``` Jaundice Hepatic encephalopathy Hepatic necrosis Hot flushes Decreased libido Impotence Diarrhoea Nausea & vomiting Gynaecomastia (man boobs) Drowsiness Depression Anxiety, nervousness ```
162
Folic acid Mechanism of action
Synthetic folate pathway coenzyme - -> important for erythropoiesis - -> important for producing/maintaining new cells
163
Folic acid Indication
Megaloblastic anaemia (if folate-deficient) Prevention of methotrexate side effects Rheumatic disease
164
Folic acid Why this over another DRUG/CLASS? (Place in therapy)
Megaloblastic anaemia & methotrexate
165
Folic acid Important cautions (1)/contraindications (1) *include bracketed numbers if applicable
CAUTIONS - Simultaneous administration with methotrexate CONTRAINDICATIONS - Monotherapy for pernicious anaemia (poor vit B12 uptake)/vit B12 deficiency --> increased risk of neurological conditions
166
Folic acid Side effects (1)
GI disturbances
167
Folic acid Class of drug
Synthetic B vitamin
168
Folinic acid/calcium folinate Class of drug
Synthetic B vitamin
169
Folinic acid/calcium folinate Mechanism of action
Derivative of folic acid
170
Folinic acid/calcium folinate Important contraindications (1) *include bracketed numbers if applicable
CAUTIONS - Avoid simultaneous administration of methotrexate CONTRAINDICATIONS - Intrathecal injection (into spinal canal) - Pernicious anaemia (poor vit B12 uptake)/vit B12 deficiency --> increased risk of neurological conditions
171
Folinic acid/calcium folinate Why this over another DRUG/CLASS? (Place in therapy)
Combo with fluorouracil in colorectal cancer Only methotrexate, not megaloblastic anaemia Better for folic acid antagonists -> those inhibit folic acid conversion into folinic acid, but not folinic acid itself
172
Folinic acid/calcium folinate Important cautions (1)/contraindications (2)/interactions (1) *include bracketed numbers if applicable
CAUTIONS - Avoid simultaneous administration of methotrexate CONTRAINDICATIONS - Intrathecal injection (into spinal canal) - Pernicious anaemia (poor vit B12 uptake)/vit B12 deficiency --> increased risk of neurological conditions INTERACTIONS - Capecitabine --> reduced tolerated dose of capecitabine
173
Folinic acid/calcium folinate Monitoring
Methotrexate levels if applicable --> determine dose & duration of folinic acid
174
Folinic acid/calcium folinate Side effects (2; rare)
Insomnia | Agitation
175
Gentamicin Class of drug
Aminoglycoside
176
Gentamicin Mechanism of action
Irreversibly bind to 30S ribosome subunit - -> alter cell membrane permeability - -> inhibit protein synthesis (bactericidal)
177
Gentamicin Indication
Empirical treatment of febrile neutropenia in chemo Gram-negative infections
178
Gentamicin Why this over another DRUG/CLASS? (Place in therapy)
1st-line aminoglycoside for gram-negative infections, febrile neutropenia in chemo
179
Gentamicin Important cautions (3)/contraindications (2)/interactions (2) *include bracketed numbers if applicable
CAUTIONS - Dehydration - Elderly - Renal impairment CONTRAINDICATIONS - Myasthenia gravis - Ototoxicity with previous aminoglycoside use INTERACTIONS - Carboplatin --> increased risk of renal impairment - Cisplatin --> increased risk of renal impairment & ototoxicity
180
Gentamicin Monitoring (3)
Renal function Hearing Serum concentration
181
Gentamicin Side effects (2)
Nephrotoxicity | Ototoxicity (irreversible)
182
Goserelin Class of drug
Gonadorelin analogue | Hormone antagonist
183
Goserelin Mechanism of action
Initial phase of stimulation Continued use followed by downregulation of GnRH receptors (gonadotrophin-releasing hormone receptors) --> reduces release of gonadotrophins (FSH, LH) --> inhibit androgen & oestrogen production
184
Goserelin Indication (2)
Breast cancer Prostate cancer (more not in oncology)
185
Goserelin Why this over another DRUG/CLASS? (Place in therapy)
Breast cancer: premenopausal & perimenopausal women
186
Goserelin Important cautions (7)/contraindications (1)/interactions (3) *include bracketed numbers if applicable
CAUTIONS - Depression - Hypertension - Metabolic bone disease --> risk of decrease bone mineral density) - PCOS - Diabetes - Risk of ureter obstruction & spinal cord compression in men (tumour 'flare') - Risk of cardiovascular events in men CONTRAINDICATIONS - Pregnancy & breastfeeding INTERACTIONS - Domperidone --> QT prolongation - Bisacodyl --> increased risk of hypokalaemia -->monitor - Haloperidol --> QT prolongation
187
Goserelin Monitoring (3)
``` Abdominal haemorrhage Blood glucose (if diabetes) Potassium levels (if also on bisacodyl ```
188
Goserelin Side effects (5)
``` Injection site injury --> pain, haemorrhage Hot flushes, sweating Sexual dysfunction Gynaecomastia, changes in breast size Initial worsening of symptoms of cancer ```

411 Oncology (9 decks)

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