ONCOLOGY 2-Misc

Question 1

What degrades asparagine that leukemia cell need to proliferate?

Answer 1

L-asparginas- ADE- Anaphylaxis

Question 2

What steroid is used to treat ALL, CLL, NHL?

Answer 2

Prednison- , fluid retention (RAAS-cortisol INC retention), immune suppression, INC appetite, insomnia

Question 3

What agents are Selective estrogen receptor modulators, block hormonal receptors in some tissues not others

Answer 3

Tamoxifen*-breast cancer

Question 4

What is a selective estrogen receptor down regulator that is antagonist?

Answer 4

Fulvestrant-metastatic breast cancer

Question 5

This aromatase inhibitor prevents androgen from conversion to estrogen?

Answer 5

Anastrozole, Exemestane

Question 6

What SERM have these ADEs: hypercalcemia (osteoporosis), bone pain?

Answer 6

Tamoxifen*-breast cancer

Question 7

What aromatase inhibitor has ADEs of joint pain?

Answer 7

Anastrozole

Question 8

What Aromatase inhibitor has ADE INC appetite?

Answer 8

Exemestane

Question 9

What agents block testosterone receptors preventing uptake in tumor?

Answer 9

Flutamide, Bicalutamide-prostate cancer

Question 10

What gonadotropin releasing hormone agonist that is continuous suppresses LH and FSH, thus DEC steroidogenesis, 1,3, 6 mo implants?

Answer 10

Leuprolide

Question 11

This GRHA has these ADE: HOT flashes, edema pain, GI upset, respiratory d/o, urinary do, weak?

Answer 11

Leuprolide, goserelin

Question 12

What hormonal therapy has liver failure and gynecomastia, loss of libido risk?

Answer 12

Flutamide, Bicalutamide-prostate cancer

Question 13

What agent is selective, irreversible inhibitor of CYP17, dec testosterone precursors?

Answer 13

Abiraterone

Question 14

What are ADe of Abiraterone?

Answer 14

Edema, HYPERtriglyceridemia, HYPOkalemia and Phos. INC LFT and cough

Question 15

What is primary use of Abiraterone?

Answer 15

Metastatic prostate cancer

Question 16

What other agen is for metastatic prostate cancer, inhibits androgen signaling. Major ADE- seizures?

Answer 16

Enzalutamide

Question 17

What are components of immunotherapy?

Answer 17

Cytokines, Antibodies, Antigen, Lymphocytes- biologic antitumor effects by stimulating immune system

Question 18

What are proteins secreted from WBC, used for metastatic renal, w ADE- HYPOTN, edema, thrombocytopenia, confusion. Vascular leak syndrome?

Answer 18

Cytokines-Interleukins-2

Question 19

What agent antitumor by recognizing tumor surface proteins, but is pt on peripheral blood?

Answer 19

Sipuleucel T-well tolerated

Question 20

What agent bind to CTLA-4 activated T-cell and proliferation?

Answer 20

Ipilimumab-monoclonal antibody

Question 21

What are the ADEs of ipilimumab?

Answer 21

GI-colitis EMERGENT

Question 22

What PD-1 inhibitor is a checkpoint that downregulate T-cell activation to reduce immune attack on normal tissues?

Answer 22

Pembrolizumab, Nivolumab- melanoma, NSC Lung Ca, lymphoma, Head

Question 23

What are PD-1 inhibitor SE?

Answer 23

Colitis, pancreatitis endocrine, rash, Arthralgia

Question 24

What agents target molecules w/in cancer cells that inhibit cancer growth, new approach, selective, and less ADE?

Answer 24

Bevacizumab- block VEGF- vascular endothelial growth factor- inhibits angiogenesis in tumor

Question 25

What Molecular targeted therapy affect cancer cell that overexpress human epidermal growth factor receptor 2 (HER2)?

Answer 25

Trastuzumab- metastatic breast cancer

Question 26

What MTT used for colorectal cancer blocks extracellular epidermal growth factor receptor with Skin and GI ADE?

Answer 26

Cetuximab

Question 27

What MTT is used for KRAS wild type colorectal cancer?

Answer 27

Panitumumab

Question 28

What are MTT for Non small cell lung cancer?

Answer 28

Gefitinib-EGFR, Erlotinib-Tyrosine Kinase

Question 29

What is indicated for B-cell NHL?

Answer 29

Rituximab- hypersensitivity, Ibritumomab

Question 30

Which agent is Renal Cell CA?

Answer 30

Sunitinib, Pazopanib, Temsirolimus

Question 31

What agent block BCR-ABL oncogene that is found in CML?

Answer 31

Imatinib- monitor for response to therapy

Question 32

What BREK and MEK inhibitors are used in NSCLC?

Answer 32

Vemurafenib, Trametinib

Question 33

These agents are indicated for ALK in NSCLC, MOA is inhibits tyrosine kinase and anaplastic lymphoma kinase?

Answer 33

Alec, Ceri, Crizotinib. ADE; hyperglycemia, HYPOK and CA; GI, LFTs

Question 34

What are risk factors for chemically induced nausea and vomiting?

Answer 34

Poor control previous cycle. Female, Young, Low ETOH

Question 35

What is key to CINV?

Answer 35

Prention 1. DDX- bowel obstruction, Gastroparesis, Brain tumors, Electrolytes, Ascites CA, Drug combos w/ opioids, Psyche

Question 36

What are the high emesis chemo agents?

Answer 36

Carboplatin, Cisplatin, cyclophosphamide, Doxorubicin, Ifosfamide

Question 37

What agent can be HIGH emesis w/ HIGH Dose?

Answer 37

Methotrexate

Question 38

Which antiemetic agent are Neurokinin-1 (NK-1) antagonist give 30 min prior to chemo?

Answer 38

: Aprepitant (Emend®) Fosaprepitant (Emend

Question 39

What antibiotic is antagonist to serotonin receptors in GI tract, combine w/ corticosteroid, ADE- Headache?

Answer 39

Serotonin (5-HT3) antagonists -ESTRON

Question 40

Which antiemetic agent are Neurokinin-1 (NK-1) antagonist give 30 min prior to chemo?

Answer 40

Corticosteroids -DEXA, decadron. ADE- euphoria, insomnia, INC appetit.

Question 41

What drug IV administration warning with corticosteroids?

Answer 41

vaginal anal burning

Question 42

What should be avoid with steroids and other chemo agents?

Answer 42

AVOID PD-1 checkpoint inib-mabs- BC will not be effective if steroid used

Question 43

What is antagonist to serotonin receptors in GI tract, combine w/ corticosteroid, ADE- Headache?

Answer 43

METOCLOPRAMIDE-Benzamide analogs- explosive diarrhea, NA retention-HTN, impotence, Extrapyramidal renx

Question 44

What other agen block dopamine for delayed emesis?

Answer 44

Prochlorperazine-Phenothiazine

Question 45

What benzo is used for emesis to prevent anticipatory n/v, anterograde amnesia, DEC anxiety, DEC akathisia?

Answer 45

Lorazepam

Question 46

What agent is used for breakthrough n/v, inhibit prostaglandins, with euphor, ataxia, drowsy, hallucinations ADE?

Answer 46

Dronabinol-Cannabinoid

Question 47

Which chemo are the worse mucositis?

Answer 47

MTX, 5FU- TX - magic mouthwash: lidocaine, diphenhydramine, Al, MG

Question 48

When should chemo be administered with concerns of bone marrow suppression?

Answer 48

WBC >3k or ANC >1.5k AND platelets .100K.(absolute neutrophil count=WBC x % granulocytes (cell + (%segmented neut + bands%)

Question 49

What COLONY STIMULATING FACTOR RX can be used to treat febrile neutropenia and neutropenia?

Answer 49

Filgrastim and Pegfilgrastim, Sargramostim IV BBW- may promote growth in LEUKEMIA. AVOID IN ALL, CLL, CML, AML.

Question 50

When can the CSF grastims be used?

Answer 50

OK for Breast cancer and Small cell lung Cancer w/ Topotecan.

Question 51

What is discontinued d/t anemia ADE of chemo?

Answer 51

ESA- erythropoietin stimulating agents-darbepoetin, Epoetin

Question 52

What is ok to treat anemia in Cancer?

Answer 52

Transfuse only if symptoms of anemia. DEC RBC, DEC Hgb <10

Question 53

What agents can be used to DEc pain in chemo?

Answer 53

Bisphosphonates- Pamidronate, zoledronic acid- USe breast and prostate, multiple myeloma- ADE- osteonecrosis of jaw

Question 54

What are other agents for pain?

Answer 54

Amitriptyline-SSRI, Anticonvulsant-Gabapentin, Corticosteroids, Benzodiazepines-Diazepam, Lorazepam

Question 55

What is a chemoprotectant that DEC anthracycline induced free radical damage used in combo with Doxorubicin?

Answer 55

Dexrazoxane- slow IV, breast cancer

Question 56

What is used for fluorouracil and capecitabine OD?

Answer 56

Uridine triacetate