Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

TOP 300 drugs - NAPLEX > Oncology > Flashcards

Oncology Flashcards

(100 cards)

Start Studying
1
Q

External factors causing cancer

A

Chemical
Radiation
Bacteria
Viruses

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

Internal factors causing cancers

A

Genetic mutations
Hormones
Sunlight exposure
Tobacco use
Excessive EtOH intake
Obesity
Older age
Poor diet
Low physical activity

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

Warning signs of cancer

A

CAUTION
Change in bowel or bladder habits
A sore throat that does not heal
Unusual bleeding/discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in wart or mole
Nagging cough or hoarseness

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

Breast cancer screening

A

Begin yearly mammograms at age 45–54
Mammograms every 2 years or annually at ages ≥ 54 yrs

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

Cervical cancer screening

A

Pap smear every 3 years
HPV DNA test every 5 years
PAP smear + HPV DNA test every 5 years
For years 25-65 years

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

Colorectal cancer screening

A

Stool-based tests (if +, f/u with colonoscopy): FIT yearly, gFOBT yearly, or MT-sDNA every 3 years

Visual exams: colonoscopy every 10 years, CT colonography every 5 years, FSIG every 5 years

For M/F ≥ 45 yrs old

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

Lung cancer screening

A

Annual CT scan if all of the following:
1. 20 pack-year+ smoking history
2. Still smoking or quit smoking in the past 15 years
For F/M ≥ 50 years

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

Prostate cancer screening

A

If a patient chooses to be tested:
- PSA blood test with/without DRE

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

Bleomycin: dosing considerations

A

Lifetime cumulative dose: 400 units
Pulmonary toxicity

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

Doxorubicin: dosing considerations

A

Lifetime cumulative dose: 450-550 mg/m2
Cardiotoxicity

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

Cisplatin: dosing considerations

A

Dose per cycle not to exceed 100 mg/m2
Nephrotoxicity

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

Vincristine: dosing considerations

A

Single dose “capped” at 2 mg
Neuropathy

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

Medication given to prevent cardiotoxicity from doxorubicin

A

Dexrazoxane

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

Chemotherapy agents that don’t cause myelosuppression

A

Bleomycin
Vincristine
Asparaginase

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

Chemotherapies MOST known to cause N/V

A

Cisplatin
Ifosfamide
Cyclophosphamide

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

Chemotherapies MOST known to cause Mucositis

A

Fluorouracil
Methotrexate

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

Chemotherapies MOST known to cause Cardiotoxicity

A

Anthracyclines
HER2 inhibitors
Arsenic Trioxide
Many TKIs

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

Chemotherapies MOST known to cause pulmonary toxicity

A

Bleomycin
Busulfan
Carmustine/Lomustine
Methotrexate & MAbs (pneumonitis)

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

Chemotherapies MOST known to cause Nephrotoxicity

A

Cisplatin
Methotrexate (high doses)

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

Chemotherapies MOST known to cause constipation

A

Vincristine

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

Chemotherapies MOST known to cause diarrhea

A

Irinotecan
Capecitabine/5-FU
Methotrexate

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

Chemotherapies MOST known to cause neuropathy

A

Vinca alkaloids
Platinums
Taxanes

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

Chemotherapies MOST known to cause clotting

A

SERMs
Aromatase inhibitors
Immunomodulators

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

Chemotherapies MOST known to cause Hepatotoxicity

A

Anti-androgens (bicalutamide, flutamide, nilutamide)
Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Drug to give prophylactically with cisplatin to prevent nephrotoxicity
Amifostine (Ethyol) **Also, maintain adequate hydration and do not exceed max dose of 100 mg/m2/cycle**
15
Nadir: defination
Lowest point that WBCs & RBCs reach
15
WBC/platelet nadir | How many days after chemotherapy?
7-14 days after chemotherapy
16
RBC nadir
Much later, usually months d/t long lifespan of RBCs (~120 days)
16
How long does it generally take for WBCs & platelets to recover?
3-4 weeks post-treatment
17
Neutropenia & severe neutropenia definitions
Neutropenia: < 1,000 cells/mm3 Severe neutropenia: < 500 cells/mm3
18
Filgrastim (Neupogen) side effects
Bone pain, fever
19
Febrile neutropenia diagnosis requirements
Fever of > 38.3 degrees Celsius and ANC < 500 cells/mm3
20
Issues with ESAs and cancer
Can shorten survival and inc tumor progression. For this reason, they are NOT recommended in a patient pursuing curative intent
21
When to initiate ESAs
Hgb < 10 mg/dL Use the lowest dose needed to avoid RBC transfusions
22
When to initiate platelet transfusions for thrombocytopenia
PLT count < 10,000 or < 30,000 and active bleeding is present
23
Droperidol: issue
QTc prolongation
24
Cannabinoids (e.g. dronabinol, nabilone) side effects
Inc. appetite Sedation Dysphoria Euphoria
25
Aprepitant & dexamethasone DI
Aprepitant is an CYP3A4 inhibitor **decrease dexamethasone dose
26
Max dose of Loperamide under medical supervision
16mg/day
27
Hand-foot syndrome management
Limit daily activities to reduce friction and heat exposure to hands/feet Avoid prolonged exposure to hot water Avoid use of dishwashing gloves Avoid inc. pressure on the soles of feet & palm of hands
28
TLS complications
Hyperkalemia (arrhythmias) Hypercalcemia (anorexia, nausea, seizures) Hyperuricemia (Uric acid crystallizes, causing acute renal failure)
29
TLS treatment
Hyperuricemia: allopurinol, rasburicase for high-risk patients, and NS for all Hypercalcemia: mild (hydration), moderate-severe (IV hydration with NS, IV bisphosphonates (Zometa), and calcitonin (up to 2 days) for severe cases. Xgeva for hypercalcemia refractory to bisphosphonates
30
Major vesicants
anthracyclines & vinca alkaloids
31
Anthracyclines extravasation management
Dexrazoxane or dimethyl suloxide plus cold compresses
32
Vinca alkaloids: Extravasation treatment
Hyaluronidase plus warm compresses
33
Warning signs of melanoma skin cancer
ABCDE Asymmetry Border Color Diameter Evolving
34
Klinefelter syndrome
When males have 1 Y chromosome and 2+ X chromosomes **Males with this genetic condition have a higher risk of breast cancer**
35
Adjuvant treatment for breast cancer in a premenopausal women
Tamoxifen, SERM, antagonist in the breast cells GnRH agonist (gosereline or leuprolide) to induce menopause **IF this then AI is a reasonable option**
36
Adjuvant treatment for breast cancer in a postmenopausal women
Aromatase inhibitors (anastrozole) Raloxifene **for breast cancer prevention in post-menopausal females**
37
Raloxifene: issues
Blood clots & hot flashes
38
Oncogene
Protein that turns a normal cell into a cancer cell (e.g. HER2)
39
What supplements to take with tamoxifen (soltamax)
Ca/Vit D
40
Tamoxifen metabolism
Prodrug, metabolized by CYP2D6 **why venlafaxine is preferred for hot flashes instead of fluoxetine & paroxetine**
40
Prostate cancer treatments
41
GnRH antagonists: examples
Degarelix (Firmagon) Relugolix (Orgovyx)
42
GnRH agonists: examples
Leuprolide (Lupon, Depot) Gosereline (Zoladex)
43
Anti-androgens (first-generation): examples
Bicalutamide (Casodex) Flutamide Nilutamide (Nilandron)
44
Antiandrogen (2nd generation) examples
Apalutamide (Erleada) Darolutamide (Nabeqa) Enzalutamide (Xtandi)
45
Which prostate chemo drugs can cause an initial surge in testosterone (Tumor flare), and thus must be given with an anti-androgen for several weeks?
GnRH agonists
45
Androgen deprivation therapy (ADT) side effects
Impotence Weakness Hot flashes Loss of bone density
46
Mesna (Mesnex) use
Given prophylactically with ifosfamide and high doses of cyclophosphamide to prevent hemorrhagic cystitis
46
Platinums: issues
Peripheral sensory neuropathy Ototoxicity Nephrotoxicity
47
Carboplatin dosing
Use the Calvert formula (Target AUC) * (GFR + 25)
48
Oxaliplatin: unique issues
Cold sensitivity QT prolongation
49
Topoisomase I example
Irinotecan Topotecan
49
Mtoxantrone: discoloration
Blue
50
Topoisomase II examples
Etoposide Bleomycin
50
Etoposide IV concerns
Infusion-related hypotension (infuse over atleast 30-60 minutes) Prepare concentration to ≤ 0.4mg/mL to avoid precipitation
51
Vinca alkaloids concerns (all)
peripheral sensory and autonomic neuropathies (constipation)
52
Vinca alkaloid most associated with CNS toxicity
Vincristine
53
Vincaalkaloids most associated with BMS
Vinblastine Vinorelbine
53
Vincristine: DI
Major substrate of CYP3A4 Caution with Azole antifungals
54
Taxanes: DI
Elimination reduced when given after cisplatin/carboplatin. Give taxanes BEFORE platinum-based compounds
54
Taxanes: common side effects
Peripheral sensory neuropathies HSR and fatal anaphylaxis Require adjustment for hepatic impairment
55
Paclitaxel: premedication
Benadryl, steroid, H2RA
56
Docetaxel: premedication
Premedicate with steorids for 3 days, starting 1 day prior to docetaxel
57
Docetaxel: unique concern
severe fluid retention
57
Abraxane: characteristics
Paclitaxel bound to albumin No need to premedicate
58
Pyrimidine Analog Antimetabolites: MOA
active metabolite (F-UMP) is incorporated into RNA to replace uracil & inhibit cell growth while another active metabolite (5-dUMP) inhibits thymidylate synthetase
59
Capecitabine Boxed Warning/Contraindication
BW: Significant increase in INR during and up to 1 month after treatment C/I: CrCl < 30 mL/min
60
What is given with fluorouracil to increase efficacy?
Leucovorin
61
Dihydropyrimidine dehydrogenase (DPD) deficiency increases toxicity from which drugs?
Capecitabine Fluorouracil
62
What drug is the active form of folic acid?
Leucovorin
63
What is given to rapidly lower MTX levels in patients with MTX-induced AKI & delayed clearance?
Glucarpidase (Voraxane)
64
If given intrathecally, what formulation of MTX must be used?
Preservative-free
65
Lenalidomide: Boxed warning
Severe birth defects Thrombosis
66
Common characteristics of MAbs
All given as IV infusions Most associated with infusion related reactions Agents conjugated to cytotoxic drugs are associated with additional side effects d/t the conjugate Agents that activate the immune system can be associated with life-threatening autoimmune-mediated side effects
67
Bevacizumab/Ramucirumab: MoA + common toxicities
MoA: inhibits blood vessel growth HTN, leading to proteinuria, hemorrhage, thrombosis, impaired wound healing
68
Cetuximab/Panitumumab: MoA + common toxicities
EGFR antagonist, inhibits growth factor binding to the surface of tumor cells. EGFR > Epidermis > Skin toxicity (acneform rash) **Rash = working!**
69
Trastuzumab/Pertuzumab: MoA + common toxicity
HER2 receptor antagonist. Cardiotoxicity
70
Rituximab/Brentuximab: MoA + common toxicities
Bind to antigens (CD20, CD30, etc) expressed in specific hematopoietic cells & cause cell death. BMS, inc. risk of viral infection reactivation
71
Ipilimumab/Pembrolizumab: MoA + common toxicities
Increases immune recognition of tumor antigens. Over-active immune system = colitis, hepatotoxicity, thyroid dysfunction, myocarditis
72
Bevacizumab (Avastin): unique concerns
Impairs wound healing: do not administer 28 days before or after surgery
73
Trastuzumab (Herceptin): monitoring
LVEF (using ECHO or MUGA) at baseline and during treatment Pharmacogenomics: test for HER2 gene expression
74
Cetuximab: genomics
Test for EGFR gene expression and KRAS mutation. Must be KRAS wild-type to use in colorectal cancer.
75
Rituximab: unique concerns
MUST premedicate with Benadryl, Tylenol & steroid. Must be CD20 positive to use Hep B reactivation and PML are boxed warnings **Check Hep B panel prior to administration**
76
TKI examples
Imatinib (Gleevic) All end in "nib"
77
TKI common characteristics
Require pharmaogenomic testing Oral bioavailability may be altered with food
78
TKI: common toxicities
Hypothyroidism QT prolongation Rash **Correlated with efficacy** Hepatic toxicity Diarrhea Those that are multi-targeted may cause HTN, hand-foot syndrome d/t interference with growth of blood vessels (VEGF)
79
Which oral chemo drugs should be taken with meals or within 1 hour after food?
Imatinib Capecitabine

TOP 300 drugs - NAPLEX (12 decks)

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