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Neoplasm 2 Flashcards

1
Q

How are fixed chemotherapeutic doses determined?

A

finalized based on body surface area (BSA), weight, creatinine clearance, or other adjustments made for each patient

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2
Q

What happens to a tumor’s growth fraction over time?

A

It decreases

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3
Q

Why are CCS and CCNS drugs given together?

A

CCS drugs reduce the tumor growth factor and CCNS drugs help to reduce the tumor burden

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4
Q

Tx combination for Hodgkins lymphoma

A

ABVD

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5
Q

Tx combination for non-Hodgkins lymphoma

A

CHOP +/- R

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6
Q

Tx combination for colorectal CA

A

FOLFOX

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7
Q

Tx combination for small cell CA

A

ICE-V

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8
Q

Tx combination for breast CA

A

TAC

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9
Q

ABVD drugs

A

(doxorubicin) + Bleomycin + Vinblastine + Dacarbazine

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10
Q

CHOP +/- R drugs

A

Cyclophosphomide + Doxorubicin + Oncovin (vincristine) + Prednisone ± Rituximab

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11
Q

FOLFOX drugs

A

5-Flourouracil + Leucovorin + Oxaliplatin

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12
Q

ICE-V drugs

A

Ifosfamide + Carboplatin + Etoposide + Vincristine

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13
Q

TAC drugs

A

Taxotere (docetaxel) + Adriamycin (doxorubicin) + Cyclophosphamide

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14
Q

What determines the type of vascular access devices (VADs) chosen for chemo?

A

based on determining the length of time it will be needed

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15
Q

Midline cath length of use

A

Used when peripheral IV cannot be used, intermediate length of therapy

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16
Q

PICC line use length

A

Several wks or longer

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17
Q

Tunneled central catheter

A

Surgically placed in a large central vein, with a catheter tunneled under the skin

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18
Q

Implantable port

A

a catheter surgically placed under the skin of the chest or arm in a large or central vein

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19
Q

When is intravesical chemo given?

A

Early stage bladder CA - placement of a urinary catheter to give the drug into the bladder

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20
Q

When is Intrapleural and intraperitoneal chemo used?

A

useful for some with mesothelioma, ovarian cancer that has spread to the peritoneum, and lung or breast cancers that have spread to the pleura

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21
Q

Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

A

Involves cutting all visible cancer out of the abdomen and then flooding the cavity with heated chemotherapy drugs

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22
Q

What is HIPEC used in?

A

Used to treat peritoneal metastases resulting from several primary cancers, including colon cancer

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23
Q

How to treat CNS CA?

A

Intrathecal - Most chemotherapy drugs that are given IV are unable to cross the blood-brain barrier

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24
Q

What are irritant drugs?

A

Irritants: drugs that can cause a short-lived and localized/limited cellular damage to a vein

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25
What are vesicant drugs?
Vesicants: drugs that cause severe redness, blistering, and severe tissue damage (chemical cellulites) at an injection site
26
Examples of vesicants
5-FU doxorubicin paclitaxel vinblastine vincristine vinorelbine
27
What can be used to tx extravasation caused by Cisplatin?
Local injection of sodium thiosulfate
28
What can be used to tx extravasation caused by anthracyclines?
Systemic administration of dexrazoxane or topical dimethyl sulfoxide
29
What can be used to tx extravasation caused by Vinca alkaloids, paclitaxel, ifosfamide?
Local injection of hyaluronidase
30
Why do cytotoxic drugs damage bone marrow stem cells?
Because the cells of the bone marrow are almost always in some phase of cell division
31
What is myelosuppression?
Depressed bone marrow function is called myelosuppression
32
Effects of myelosuppression?
Anemia Leukopenia Thrombocytopenia
33
When are transfusions of packed RBCs needed?
Low hematocrit and Hgb - May be required until the bone marrow has recovered its normal ability to produce more blood cells
34
When are transfusions of packed RBCs needed?
Low hematocrit and Hgb - May be required until the bone marrow has recovered its normal ability to produce more blood cells
35
When is erythropoietin used to tx anemia?
Usually reserved for those with long-standing anemia
36
If neutropenia is severe, what can be done?
Abx are given as a preventative measure
37
When is neutropenia most severe with chemo?
Neutropenia is most severe with the use of cell cycle–specific drugs, particularly those that are active in the S and M phases
38
Neutropenia + fever tx
Cancer patients with neutropenia (ANC <500 or expected to be so within 24 hours) and a fever (>38.5°C or 101.5°F ) are usually treated with broad-spectrum antibiotics and colony-stimulating factors
39
Examples of granulocyte colony stimulating factors (G-CSF)
Filgrastim (Neupogen) Pegfilgrastim (Neulasta)
40
Which drugs can worsen platelet count when combined with chemo?
acetylsalicylic acid (aspirin) or NSAIDS can worsen the potential for thrombocytopenia while increasing the risk of GI bleeding
41
What can be done in pts with platelet counts are very low (<10,000) or if a person with moderately low counts has greater than normal bleeding?
Transfusion OR platelet growth factor
42
Examples of platelet growth factors
Romiplostim (Nplate) - SQ Eltrombopag (Promacta, Revolade) - PO Avatrombopag (Doptelet) - PO
43
What determines hair loss with chemo?
The extent of hair loss depends on which drugs are given, drug doses, and the length of treatment
44
Chemo hair loss time line?
Hair loss usually begins within 2 weeks after chemotherapy begins After chemotherapy is completed, hair regrowth may take 3-5 months
45
What is a radiation recall rxn?
Radiation recall reactions (radiation recall dermatitis) is an inflammatory reaction that occurs in a previously irradiated area precipitated by certain drugs
46
Radiation recall rxn sxs
Symptoms: skin reddening, blistering, hyperpigmentation, edema, exfoliation, and ulceration
47
Which meds are associated with radiation recall rxn?
bleomycin, cytarabine, doxorubicin, daunorubicin, idarubicin, hydroxyurea, methotrexate, paclitaxel, and vinblastine
48
Which drugs cause acral eruthema?
cytarabine, methotrexate, 5-fluorouracil
49
What is "hand foot syndrome"?
Acral Erythema - burning, swelling, tingling, and a rash (erythema) on the palms and fingers of the hands and the soles of the feet
50
Drugs used to tx anorexia in chemo pts?
Dexamethasone Prednisolone Methylprednisolone Megestrol (Megace) Canabinoids - not routinely recommended d/t limited data
51
Stomatitis from chemo can lead to what?
The tongue may be coated and swollen, leading to difficulty swallowing, eating, and talking
52
Which drugs cause stomatitis?
Common drugs associated with stomatitis: antimetabolites (5-fluorouracil and methotrexate) and antitumor antibiotics (doxorubicin)
53
What is used to tx stomatitis?
Magic mouthwash
54
Why does chemo cause N/V?
Occur because drugs irritate the lining of the stomach and duodenum and stimulate nerves that lead to the vomiting center in the brain
55
Drugs notorious for causing N/V
cisplatin, carboplatin
56
Which pts are at higher risk of N/V with chemo?
Younger patients, females, and those prone to motion sickness
57
N/V related to chemo tx
Behavioral approaches include guided imagery, relaxation, hypnosis, and distraction Zofran
58
Which chemo drugs cause constipation?
vinca alkaloid drugs, vincristine and vinblastine, opioids given for pain relief, and antiemetics (serotonin receptor antagonists)
59
Which chemo drugs cause diarrhea?
5-fluorouracil, methotrexate, and docetaxel
60
Which chemo drug is notorious for causing cardiotoxicity?
Doxorubicin associated with causing cardiotoxicity
61
What is the max lifetime dose of docxorubicin?
the maximum lifetime dose of doxorubicin is 550 mg/m2
62
What drug may be combined with doxorubicin to avoid cardiotoxicity?
dexrazoxane
63
Use of which chemo drugs increases the risk of neurotoxicity?
vinca alkaloids
64
Which drugs cause pulm damage?
bleomycin, busulfan
65
Which drugs are nephrotoxic?
ifosfamide, cyclophosphamide, cisplatin, and methotrexate
66
How will direct kidney damage from dysfunction present?
Increased Cr
67
What is Amifostine used for?
Amifostine is a cytoprotective agent used to reduce potential renal toxicity associated with cumulative doses of platinum-containing medications such as cisplatin.

Pharm Exam 3 (7 decks)

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