Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Hematology RC Editable > Drugs > Flashcards

Drugs Flashcards

(57 cards)

Start Studying
1
Q

Eltrombopag

A

For ITP: 50mg PO daily and titrate to plt>50

For severe AA in triple IST
150mg daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Avatrombopag

A

20mg PO daily, titrate to plt >50
If liver disease for pre-op, 40-60mg PO daily x5 days, finish ~8d prior to the surgery or procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Romiplostim

A

1mcg/kg SC/IV weekly, titrate to plt>50
Max 10mcg/kg/week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rituximab for ITP, WAIHA [off label], TTP [with plex]

A

375mg/m2 weekly x4

*1g q14d x2 doses more for autoimmune [can be later lines of rx or off label though]
- RA, myasthenia, MS, pemphigus, mixed cryoglobulinemia, neuromyelitis optica, IgG4 disease, dermatomyositis/polymyositis

Either dosing in some renal: minimal change disease, membranous nephropathy, lupus nephritis, GPA, MPA, EGPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Gemtuzumab target

A

CD-33

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Inotuzumab target

A

CD-22

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rituximab target

A

CD-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Blinatumumab drug target

A

Bispecific antibody
Anti-CD19 and anti-CD3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Alemtuzumab

A

CD52

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Rituximab Risks

A

Infusion reactions
serum sickness
Hypogammaglobulinemia
Infection risk
Hep B reactivation, strongyloides
Cardiac arrhythmia
Progressive Multifocal Leukoencephalopathy [PML] from JC virus reactivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Steroid Side effects

A

Insomnia
Mood issues
HTN
hyperglycemia
Osteoporosis
Infection risk
PJP
Weight gain, fluid retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fostamatinib

A

Syk inhibitor [spleen tyrosine kinase]
100mg PO BID -> 150mg BID
S/E: HTN, diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anticoag in HIT

A

Argatroban: for HIT, HITT, HIT with PCI
- hepatic clearance, adjust if liver issues to 0.5-1.2 mcg/kg/min
- no adjustment for renal (ARgat, Alright for Renal)
Dose: 1-2mcg/kg/min drip, adjust to PTT

Bivalirudin: for HIT needing PCI
Dose: 0.15 mg/kg/h drip, adjust to PTT.
Lower if renal/liver issues

Danaparoid: for pregnant
IV or subcut. Renal clearance, longer half-life
Dose: 2250 units IV bolus, then 400/300/200 units per hour
Use danaparoid anti-Xa level to monitor
If subcut, dont need to monitor

Fondaparinux: easy
- long half life, not in renal disease [renally cleared], ok in pregnancy
- 5-10mg subcut daily [weight based]

DOACs: not approved for acute HIT [lack of controlled trial data, but clinical experience present] but can be used with pt discussion
- Dose: same as treatment of VTE
- Issue: Has peaks and troughs… Apix BID maybe more stable levels, but Riva has been used more. Dabig not without parenteral first.
- if life threatening thrombosis prob not
- no PTT confounding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tranexamic acid risks

A

Contraindication: hematuria. Risk ureteral clots and obstructive uropathy
Caution in recent/active VTE or atherosclerotic disease
Headache
Abdominal discomfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

TXA MOA

A

Lysine analog, prevents plasminogen from binding lysine residue on fibrin strands -> prevents fibrinolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

UFH heparin issues

A

IV, mostly inpatient
unpredictable, AT level, heparin resistance
Bleeding
Osteoporosis with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

LMWH pros/cons

A

Osteoporosis in long use
renal clearance, careful if CrCl<30
Still small risk of HIT
Can try Protamine if bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fondaparinux pros/cons

A

Long half life, renally cleared
CI if CrCl<30
Caution if CrCl<50
No reversal
OK in HIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Direct Thrombin inhibitors

A

Argatroban, Bivalirudin
Short half lives = drip. Monitor with PTT
Bival off label for HIT

Dabigatran is oral, not for HIT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Danaparoid

A

Indirect Xa inhibitor, IV or subcut
Adjust for renal dysfunction, renally cleared
VTE proph, off label for HIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Risks of Splenectomy

A

Surgical and anesthetic risks
Infection with encapsulated organisms: strep pneumonia, meningococcal, HIB
Post splenectomy sepsis: 3.2%, 1.4% mortality
Need vaccinations. If can’t vaccinate in time, give PCN proph
Thrombosis
Small risk of pulmonary HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ATG side effects

What proph?

A

Infusion reactions: fever, rigours, rash, hypotension, hypertension, third spacing

Serum sickness = fever, rash, joint pain, malaise, B symptoms

Pre-meds: Benadryl, tylenol
Prednisone 1mg/kg x10d then taper rapidly [for serum sickness proph]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Triple IST for severe AA or very severe AA

Study These Flashcards
A

horse ATG [ATGAM] 40mg/kg IV daily x4days [inpatient]

CsA 10 mg/kg/d split BID,. target trough 200-350, 6-12 months then slow taper

Eltrombopag, 150mg daily [75mg daily if east asian or liver disease]. 6 months then taper or stop.

Response 10-12 weeks

24
Q

CsA side effects

Study These Flashcards
A

Hair growth, gingival hyperplasia, renal insufficiency, HTN, neurotoxicity [PRES, sz, PML], magnesium wasting

25
IFN side effects
fatigue, myalgias, influenza like symptoms, mood change, suicidality, optic changes, autoimmunity, neuropathy Less with pegylated IFN Not teratogenic, ok in pregnancy` IFN= influenza-like, fatigue, Neuro (eyes, neuropathy, mood)
26
Ruxolitinib Side effects
Myelosuppression [esp MF], weight gain, high cholesterol, increased skin cancers, increased infections like Zoster
27
In ALL: want proph, but what type cannot be used concurrently with Vincristine?
Potent Azoles: Posa and Vori Increase neurotoxicity with Vincristine Often use Micafungin, then fluconazole later in therapy
28
Drug induced ITP
drug-Ab complex = heparin Hapten = penicillin, cephalosporin Ab binds drug adsorbed on platelet = quinine BM suppression = valproate Abx: B lactam, TMPSMX, vanco anti-epileptic or antipsychotic: valproate, carbamazepine GP2b3a - platelet clumping and thrombocytopenia within hours
29
Caplacizumab dose/duration
11mg subcut x30d
30
Eculizumab dosing/frequency
aHUS 900mg weekly x4, then 1.2g q2weeks PNH 600mg qweekly x4, then 900mg q2 weeks
31
Ravulizumab dosing/loading/frequency
aHUS or PNH [treatment by weight] 60-100kg: 2700mg load, then 3300mg 2 weeks later and then every 8 weeks
32
Drug induced neutropenia
anti-thyroids antibiotics anti convulsants other: Clozapine, Ritux, Sulfasalazine, Deferiprone, Levimasole in drugs
33
What is 7+3?
7 days of Cytarabine 200mg/m2/d over 24h infusion for 7 days 3 days of anthracycline: - Daunorubicin 60-90mg/m2 daily - Idarubicin 12mg/m2 daily
34
What is FLAG-Ida?
Fludarabine 30mg/m2 D1-5 Cytarabine 2g/m2 over 4h D1-5 [high dose] G-CSF 300mcg daily D1-5 Idarubicin 10mg/m2 D1-3
35
GO dosing AML APL
in AML: ALFA 0701 trial, add GO to 7+3 in low/int risk GO 3mg/m2 days 1/3/7. Other option is higher dose on D1 Low risk: 5y OS 77% vs 55% Int risk: 5y OS 40% vs 35% in APL: add in higher risk to ATRA/ATO 9mg/m2 on day 1
36
Midostaurin dosing
RATIFY trial, ITD or TKD [ITD is the inferior/worse one, in 2/3 of FLT3] Dose: 50mg PO BID days 8-21 of 28d cycle Watch for QTC
37
Gilteritinib dose
120mg PO daily Approved for R/R FLT3 positive Is type 1 inhibitor like midostaurin, so works on ITD and TKD Newer trial [MORPHO], in FLT3+ with MRD+ before transplant, benefit of post-transplant Gilteritinib maintenance
38
Special drugs: Oral or IV/subcut: Aza Ven IDH1 IDH2 Glasdegib Midostaurin Gilteritib GO Menin inhibitors
Aza: Subcut or PO [Onureg] Venetoclax: PO IDH1: PO IDH2: PO Glasdegib: PO Midostaurin: PO Gilteritib: PO Quizartinib: type 2 inh of FLT3-ITD only Gemtuzumab Ozogamicin: IV Menin inhibitors: Revumenib PO, Zeftomenib PO
39
Lococo protocol Induction: Consolidation:
For low risk APL [WBC<10] INDUCTION: ATRA: 45mg/m2/d PO split BID ATO: 0.15mg/kg/d IV --Continue until CR with hematologic recovery -- if WBC goes >10 give HU -- maybe DS proph prednisone 0.5mg/kg/d Consolidation [7 cycles of 28d] ATRA: 45mg/m2/d for 15/28d cycle ATO: 0.15mg/kg/d for Mon-Fri (5 doses/wk), 4 weeks on/4 weeks off
40
APML4 Induction Consolidation
ATRA: 45mg/m2/d split BID, D1-36 ATO: 0.15mg/kg/d D9-36 Idarubicin: 12mg/m2 D2/4/6/8 DS proph: Pred 1mg/kg daily D1-10 Alternative: GO + ATRA/ATO Consolidation varies
41
Treatment of HLH Dex Etoposide
Dex 10mg BID Etoposide 150mg/m2 IV - 2x/wk for 2 weeks - 1x/wk for 6 weeks - every 2 weeks after if needed *if not cancer HLH, there is max cumulative dose of etoposide, 2-3g/m2 [~13-20 doses] Is a topoisomerase II inhibitor
42
t-AML latencies for: 1. Alkylators or RT? 2. Topoisomerase inh? How many TP53 mutated?
1. Alkylators: 5-10 years, monsoonal karyotypes [5,7,27], TP53 2. TopoII: 1-5 years, MLL/KMT2A or RUNX1 TP53 mutations in 30-40% CHIP predisposes to therapy associated myeloid neoplasm if have CHIP and get Chemotherapy
43
Blina Dosing? Drug class? Trials/Indications Side effects?
9mcg over 24h D1-7, then 28mcg over 24h D8-28 BiTE for CD19/CD3. Not good for bulky, but gets MRD negative well 1. BLAST: Ph- B-ALL if MRD+ after initial therapy [not overt relapse] 2. TOWER: in R/R Ph- B-ALL, better than standard chemo 3. In Ph+ B-ALL: in older for decreased intensity regimens, for MRD+ after therapy, for R/R Side effects: Neurotoxicity, CRS
44
Meds in ABVD Who can drop the Bleo? Which trial? Neutropenia -> do they get feb neut? G-csf proph?
Adriamycin=doxo Bleo Vinblastine Dacarbazine Drop bleo if PET2 is negative, per RATHL Omit bleo if BLI, underlying lung or renal disease, drop in DLCO or pulm symptoms from treatment, age >70
45
What was the ESCHELON 1 trial?
Phase 3 Advanced stage cHL Brentuximab-AVD vs ABVD 5y mPFS 82 vs 75%
46
Side effects of Brentuximab? MOA of Brentuximab? What proph do they need?
Peripheral neuropathy 30% >gr2 Most over 60 got neutropenia gr3+ Feb neut 20% More infection/hospitalization Anti-cd30 drug antibody conjugate, with MMAE Use G-CSF proph!
47
What is escBEACOPP Outcomes and risks
Bleo Etop Doxo Cyclo Vincristine Procarbazine-> dacarbazine Pred With escalating doses based on tolerance For young and high risk patients HD15: Better control than ABVD but more early and late toxicities, more infertility, more secondary malignancies HD18: neg PET2 -> 4 cycles ok
48
What is BrECADD?
HD21 trial Brentuximab Etop Cyclo Doxo Dacarbazine Dex Vs esc beacopp Advanced stage cHL better 3y PFS 94.9 vs 92.4 Benefit across all subgroups, especially benefit in low IPI Less AE, less TRMB, less TRM PET2 guided 4 vs 6 cycles Better tolerability, less fertility issues
49
Nivo-AVD: who to use it in?
SWOG S1826 Nivo-AVD vs BV-AVD in advanced stage cHL 2y PFS 92 vs 83% Less TRM, better tolerability, much less neuropathy. Less feb neut in older but still present in both More hyper/hypo thyroid. Risk other immune related adverse effects
50
Bleomycin lung toxicity: Risk factors? Mortality? Treatment?
10% get it, 1% die RFs: age >70, higher cumulative dose, renal disease, underlying lung disease Dry cough, SOB CT changes: fibrosis, diffuse alveolar danc damage, NSIP, BOOP, organizing pneumonia PFT: DLCO decreases first RX: Stop Bleo Steroids: pred 1mg/kg or pulse Oxygen to 89-92% (NOT high fiO2 doses) CT to monitor Potentially Abx if infection 2nd line: NAC, imatinib, anti-TNF infliximab
51
What is AETHERA trial
BV maintenance after auto in high risk pts High risk: Primary Refractory Early relapse <1y Extranodal disease at relapse
52
What long term monitoring after HL therapy? RT related? In general?
Relapse Secondary malignancy Cardiac toxicity: cardiomyopathy or CVD Neuropathy (BV) Pulmonary (Bleo) H&P, labs, CXR RT: breast cancer screen (8-10y after chest RT or age 40), lung cancer, TSH if neck RT, CRC screen early if abdo/pelvic RT Bone density Dental Cataract Psychosocial
53
Examples of, Side effects, proph: PIs IMIDs anti-CD38 ab
PIs: Bortezomib, Carfilz, Ixazomib s/e: neuropathy, VZV, low plt, N/V/D, rash, fatigue proph: valtrex IMIDs: Len, Thal, Pomalidomide s/e: thromboemb, cytopenias, rash, fatigue, diarrhea, 2nd malignancies proph: ASA or LMWH or ?DOAC. depends on other RFs for thrombosis Anti-CD38 Ab: Dara, Isatuximab, Elotuzumab s/e: infusion/injection site reaction, hypogammaglobulinemia, infections, shingles proph: Valtrex, +/- IVIG
54
Types of myeloma CAR-Ts
Idecel [KARMMA] Ciltacel [CARtitude] prob better S/e: CRS, ICANs, hypogammaglobulinemia, infection Less grade 3+ CRS than B-ALL or NHL CAR-T though. Grade 1/2 still ~60-75% Valtrex, PJP proph Revaccinate after
55
Myeloma bispecifics, targets, and side effects?
anti-BCMA Teclistimab [majesTIC] Elrenatamab (magnetisMM-3) anti-GPRC5D Talquetamab [monumenTAL] s/e: CRS, hypogammaglobulinemia is common, often need IVIG, infections. Valtrex proph, maybe PJP proph Revaccinate after Maybe CMV monitoring
56
Aza dosing Mono therapy With Ven
75mg/m2 subcutaneous x7d Cycle 3+ can increase to 100mg/m2 if no response so far and tolerating well without cytopenias With Ven 75mg/m2 dose Ven 100->200->400mg day 1/2/3 Ven 20->50->70mg if on Posa
57
Polatuzumab MOA Use?
ADC CD79a and MMAE neuropathy, cytopenias DLBCL Pola-R-CHP (1L DLBCL or HGBL) - POLARIX trial vs RCHOP, better PFS - IPI2+ Pola-BR (RR DLBCL

Hematology RC Editable (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions