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Flashcards in This stuff right here Deck (100):
1

High Emetic Risk Drugs

Streptozosin
Mechlorethamine
Darcarbazine
Cyclophosphamide >1.5gm/m2
Carboplatin AUC >6
Cisplatin
Doxorubicin + Cyclophosphamide

2

High Risk Antiemesis Combo regimen

5HT3 + NK + Steroid (and/or Benzo)

3

Antiemesis Rescue Tx

Something not already in use; D2A common for breakthrough

4

Febrile Neutropenia Empiric Coverage

Antipseudomonal Beta-Lactam (cephalosporin)

5

When to use gCSF

When patient is becoming neutropenic (>20% risk)

6

What to do as secondary prophylaxis if pt has history of Febrile Neutropenia and/or previous gCSF use

Add gCSF, if previously used then Reduce chemo or change Tx

7

What labs/levels are high risk for TLS?

Uric Acid (>8) Potassium >6; Phosphorous >6.5 and Calcium <7 or >14

8

Tx for Uric Acid abnormalities in TLS

Allopurinol (also can be used prophylaxis)
Rasburicase

9

Tx for Hyperkalemia in TLS

Regular Insulin in D50W (if BG <250)
Nebulized Albuterol + Sodium Bicarbonate
Furosemide
SPS (sodium exchange)
Patiromer (Ca exchange)

10

Tx for Hyperphosphatemia if no Hypercalcemia

Calcium Carbonate
Calcium Acetate
Aluminum Hydroxide

11

Tx for Hyperphosphatemia if Hypercalcemia

Renagel
Renvela
Lanthanum Carbonate
Ferric CItrate
Sucroferric Oxyhydride

12

Tx for Hypercalcemia

Hydrate First
Bisphosphanates
Calcitonin
* if refractory w/ Bisphosphanates may add denosumab

13

Strongest Mutation correlated with Breast Cancer

BRCA (1 and 2)
- also at higher risk for ovarian/prostate

14

Breast Cancer Tx if ER/PR (+) and HER-2 (+/-)

Hormone Tx
- Tamoxifen or LHRH (premenopausal)
- Aromatase inhibitor (postmenopausal)

15

Breast Cancer Tx if ER/PR (-) and HER2 (+)

Trastuzumab +/- (Carboplatin + Docetaxel)

16

Breast Cancer Tx if ER/PR (-) and HER2 (-)

Cyclophosphamide + Doxorubin + Taxane

17

Breast Cancer Emetogenic Regimen

Fosaprepitant + Dexmethasone + Ondansetron
PRN prochloperazine and Ativan
+ Olanzapine if refractory

18

Breat Cancer Trastuzumab adjunctive

Pentuzumab ( only w/ Trastuzumab)

19

Neratinib

Used in HER2 (+)
TKI; prevents formation of HER2 epitopes
Diarrhea major side effect

20

Lapatinib

Used in HER2 (+)
TKI; inhibits EGFR & HER2;

21

Pablociclib

Used in HER2(-) ER/PR (+)
Cyclin Depende Kinase inhibitor
Inhibits CDK4/6 by blocking retinoblastoma hyperphosphorylation

22

Androgen Deprivation Therapy Options

1. Oriechiectomy (Castration)
2. Medical Androgen Deprivation (Chem Cast)

23

LHRH Agonist Place in therapy

Suppresses LH an FSH/Testosterone Production
Leuprolide
Goreselin
Triptorelin
- See initial disease flare up to 2 weeks; Use anti-androgens prior to Tx for 1-2wks

24

LHRH Antagonists

Use if high tumor burden
Binds to GNRH receptor in pituitary, directly suppresses androgen production
Degarelix agent of choice

25

AntiAndrogens

Used in combo w/ LHRH for androgen deprivation
Bicalutamide agent of choice

26

Abiraterone

Androgen Biosynthesis inhibitor binds CYP17, blocking androgen synthesis in testes, adrenal and tumors
Significant DDIs: 3A4, 2C8, 2D6, 1A2

27

Chemo Tx in Prostate Cancer

used if metastazing
- Docetaxel or Cabazitaxel

28

Enzalutamide

Pure androgen blocker,
More Hormonal side effects than bicalutamide
Decreases seizure threshold

29

Limited Stage SCLC Tx

Cisplatin + Etoposide (EP) and Radiation

30

Extensive Stage SCLC Tx

Etoposide + Cisplatin
Etoposide + Carboplatin
Cisplatin + Irinotecan (Asians?)

31

Extensive SCLC Single Agent Tx

Topotecan
Irinotecan
Gemcitabine
Paclitaxel
Docetaxel
Vinorebine
Etoposide

32

Extensive SCLC 2nd line Combo

Cyclphosphamide + Doxorubicin + Vincrisitine (CAV)
Nivolumab or Ipilumumab
Combos increase toxicity

33

Mutation free NSCLC SCC

Platinum Doublet (No pemetrexed)

34

Mutation Free NSCLC LCC

Platinum Doublet with Pemetrexed
Carboplatin + Paclitaxel + Bevacizumab
Carboplatin + Pemtrexed + Pembroluzumab

35

EGFR Mutation NSCLC

Afatinib, Erlotnib, getfitinib

36

ALK Mutation NSCLC

Alectinib, Crizotinib, Ceritnib

37

ROS1 Mutation NSCLC

Crizotinib
Ceritnib

38

BRAF v600 Mutation NSCLC

Dabrafenib + Trametinib

39

PD-li Mutation NSCLC

Pembrolizumab

40

Gynecologic Malgnancies Stage Ic-III Tx

Platinum/Taxan Combo (IV or IP)
(Ic = OV)
(III = IP)
NO Oxaliplatin

41

Calvert Equation

Dose = AUC x (GFR +25)
Max GFR = 125
Used for Carboplatin Dosing

42

Plt Resistant Recurrent Gyne Malig Tx

Single agent (non platinum) +/- Bevacizumab

43

Recurrent Gyne malig Tx (plt sensitive)

Platinum doublet +/- Bevacizumab

44

Recurrent (>2) gyne malig tx

Parp Inhibitors
Olaparib
Rucaparib
Niraparib

45

Colon Cancer Stage III Category 1 tx

FOLFOX
or CAPEOX

46

Colon Cancer Stage IV Tx

FOLFIRI (inc mortality except in stage IV)
FOLFOX
CAPEOX

47

Colon Cancer Tx w/ KRAS/NRAS wild type

Cetuximab
Panitimumab

48

Colon Cancer EGFR inhibitor Major Toxicity

Skin Toxicity
- Papulopoustular Skin Rash
- Xenosis
- Fissures
- Alopecia

49

Non-Mismatch Repair Deficient Colon Cancer Tx

Nivolumab
Pembrolizumab

50

ALL Induction Tx

Vincristine + Prednisone + Daunorubucin + L-Aasparaginase

51

ALL CNS Chemo Tx

Intrathecal Chemo
- Methotrexate
- Cytarabine

52

ALL Consolidation Tx

Non-universal combo tx
Daunorubicin, Vincristine, Prednisone, Asparaginase, Methotrexate, Cytaraine, Doxorubicin, Mercaptopurine, Thioguanine

53

ALL maintenance Tx

Decreasing doses of
- Mercaptopurine
- Methotrexate
- Vincristine
- Prednisone

54

ALL w/ Philadelphia Mut Tx

BCR-ABL Tyrosine Kinase Inhibitors
- Dasatninb, Imatinib, Nilotinib

55

ALL Salvage Tx for anti-CD19

Blinatumomab
Tisagenlecleucel

56

ALL Salvage Tx for anti CD22

Inotuzumab

57

Blinatumomab MoA

CD-19 dicted CD3 T-cell engager, forms cytolytic synapse between cytotoxic T cell and cancer target B-cell. Mediates the production of cytolytic proteins, release of inflammatory cytokines and proliferation of T cells, resulting in lysis of CD 19 + cells

58

ALL CNS prophylaxis measures

Do not do with Kids (mental Retardation alert)

59

AML/ANLL Induction Tx

Anthracycline x 3 days Cytarabine x7 days (3 and 7)

60

AML/ANLL Consolidation Tx

high doses of Cytarabine

61

APL Induction Tx

Tretinoin PO + Arsenic (low risk)
Anthracycline +/- Cytarabine (High Risk)

62

Pre AHSCT Tx

Busulfan and Cyclophosphamide

63

CLL Chemo Immuno Tx

Fludarabine + Cyclophosphamide + Rituximab (FCR)
Pentostatin + Cyclophosphadmie + Rituximab (PCR)
Bendamustine + Rituximab (BR)

64

CLL P13-K Delta inhibitor Tx

Idelalisib

65

CLL Bruton's Tyrosine Kinase Inhibitor

Ibrutinib

66

CLL Selective BCL02 inhibitor

Venetoclax

67

CLL tx w/ adjuvant Chlorambucil

Ofatumumab
Obinutuzumab

68

CLL CD52 inhibitor

Alemtuzumab

69

HSV/VZV Infection Prophylaxis

Acyclovir/Valacyclovir

70

PCP infection prophylaxis

SMX/TMP
Dapson
Atovaquone
Pentamidine

71

Hepatitis B Infection Prophylaxis

Entecavir, Tenofovir and Lamivudine

72

CMV Infection Prophylaxis

Serial PCRs
Valganciclovir

73

Hypogammaglobulinemia Tx

IV Ig

74

Autoimmune Hemolytic Anemia Tx

High dose steroids
Rituximab
Alemtuzumab

75

Immune Thrombocytopenia

High Dose steroids
IV Ig, Rituximab, Rho Ig, Immunosuppressants
Romiplostim, Eltrombopag

76

Richter Syndrome Tx

Combination Chemo

77

CML Acute Frontline Tx

Hydroxyurea
TLS prophylaxis w/ Allopurinol

78

CML Primary Tx

Imatinib, Dastatinib or Nilotinib
D or N if high risk

79

CML Tx after TKI failure

Bosutinib
Ponatinib
Omacetaxine

80

MM Clinical Manifestation

CRAB
Calcium elevation
Renal Insufficiecy
Anemia
Bone Disease

81

MM low/Int Induction Tx

VRD
Bortezomib, Lenalidomide and Dexamethasone

82

MM High risk Induction Tx

KRD
Carfilzomib, Lenalidomide and Dexamethasone

83

MM Elder/Frail Tx

RD
Lenalidomide and Dexamethasone

84

Immunomodulators used in MM

Lenalidomide
Thalidomide

85

Immunomodulator ADRs

Teratogenicity
VTE
Myelosuppression
Peripheral Neuropathy

86

Proteasome inhibitors and target

Bortezomib (26S)
Carflizomib (20S)
Ixasomib (20s, reversible)

87

MM Maintenance Tx

Lenalidomide or Bortezomib

88

MM Salvage Tx

Daratumumab
Elotuzumab

89

Osteo Support in MM

Bisphosphonates
Pamidronate
Zoledronic Acid

90

Elotuzumab MoA

(SLAMF7) Direction activation of NK cells

91

Daratumumab target

(CD38)

92

"B Symptoms"

Fever
Drenching Night Sweats
Weight Loss >10% Body weight

93

Hodgkin Chemo Tx Standards

ABVD
Stanford V
BEACOPP

94

ABVD

ABVD
Doxorubicin
Bleomycin
Vinblastine
Dacarbazine

95

Stanford V

Doxorubicin
Vinblastine
Mechlorethamine
Vincristine
Bleomycin
Etoposide
Prednisone

96

BEACOPP

Bleomycin
Etoposide
Doxorubicin
Cyclophosphamide
Vincristine
Procarbazine
Prednisone

97

Hodgkin Salvage Tx

AutoSCT --> Brentuximab, Nivolumab, Prembrolizumab

98

Non-Hodgkin Diffuse Large C CEll Tx

RCHOP or R-Bendamustine
Rituximab, Cyclphosphamide, Doxorubicin, Vincristine, Prednisone
Rituximab + Bendamustine

99

Non-Hodgkin Follicular Tx

Bendamustine + Rituximab
Bendamustine + Obintuzumab

100

Burkitts Lymphoma Tx

RCHOP