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Renal > 05.21 - Drug Tx of Renal Cancer (Sweatman) > Flashcards

05.21 - Drug Tx of Renal Cancer (Sweatman) Flashcards

1
Q

Admin of IFN-alpha 2b

A

SC 3 x weekly

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1
Q

Coca Cola urine =

A

Rhabdomyolysis

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2
Q

Toxicity of Cyclophosphamide

A

Meylo; Hemorrhagic Cystitis (mesna)

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3
Q

Maculopapular rash, mucositis, anemia, fatigue

A

Rapamycins

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4
Q

IFN-alpha 2b is used off label to treat

A

Clear Cell RCC

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5
Q

Adminstration of high dose IL-2 is akin to

A

Induction of controlled state of septic shock

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5
Q

Pharmacologic support for patients taking Aldesleukin

A

Abx, Dopamine for GFR, Phenylephrine for BP support, Fever and Chills, PPI for hyperacidity

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6
Q

Destructive metastic RCC sites

A

Lung Liver Bone

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7
Q

Axitinib

A

Only approved as follow tx after failur of initial drugs

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7
Q

Black box warnings for Bevacizumab

A

Hemm, GI perforations, Wound healing complications

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8
Q

Patients with Bilateral RAS are dependent on ___ to maintain renal perfusion

A

RAAS

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8
Q

Action of Insulin on K levels

A

Na/H exchanger –> Drives K from blood into cells –> Serum K drops

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9
Q

Drug that causes Hypotension

A

Bevacizumab

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9
Q

Patients taking Aldesleukin have high potential for

A

Sepsis

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10
Q

Spironolactone causes what in men

A

Gynecomastia (similar structure to steroids)

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11
Q

Dactinomycin Toxicity

A

Myelo; Hepatic Dysfuncion, Infection

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12
Q

Toxicity of Carboplatin

A

Myelo; Infection

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13
Q

mTOR blockers

A

Everolimus, Temsirolimus

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13
Q

Cockroft-Gault Formula

A

accounts for age and sex

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15
Q

Standard chemo agents for Wilm’s post nephrectomy

A

Vincristine, Dactinomycin, Doxorubicin (Cyclo, Etoposide)

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15
Q

Mesna

A

Antidote to Cyclophosphamide and Ifosfamide

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16
Q

Black box warnings for IFN-alpha 2b

A

Neuropsych, AI, Ischemic and Infectious disorders

17
Q

3 causes of Hyperkalemia mention by sweatman

A

Lysis, Statins, Crush injury

18
Q

Most common adverse effects of IFN-alpha 2b

A

Fatigue, fever, flu-like symptoms; Leukopenia, Neutropenia

20
Q

Etoposide Toxicity

A

Hematologic Toxicity; BP instability

21
Q

Sign of Rhabdomyolysis

A

Coca Cola urine

22
Q

Effect of Insulin on heart

A

Cardiotonic, independent of Beta1

23
Q

__ are contraindicated in Bilateral RAS

A

ACEi’s and ARB’s

24
Q

Tx of BB or CCB overdose

A

Insulin + Glucose

26
Q

Bilateral sensory “stocking-glove”

A

Vincristine

27
Q

In fit patients with mets at dx and minimal symptoms, what provides the best survival strategy

A

Nephrectomy followed by IFN-alpha

29
Q

Only approved as follow up therapy after failure of initial drug

29
Q

How does HypoMg cause HypoK

A

Doesn’t allow K to exit ROMK channel, just enter

31
Q

Most common metastatic site for RCC

A

Lymph Nodes

32
Q

Route of Temsirolimus vs Everolimus

A

Weekly IV vs Daily Oral

33
Q

Ifosfamide Toxicity

A

Hemorrhagic Cystitis (mesna)

34
Q

At physiological Mg concentrations,

A

Mg occludes ROMK channel, preventing K from exiting cell

35
Q

2 CYP substrates

A

TKIs, Rapamycins

36
Q

Patients taking this drug have high potential for sepsis

A

Aldesleukin

37
Q

Renal fxn in men vs women

A

Higher in men

38
Q

Most drugs for adult RCC target

A

VEGF due to etiology from vHL mutations

40
Q

Cytotoxic chemo in Adult vs Pediatric RCC

A

Ineffective in adults

41
Q

Chronic NSAID tx is not good for

A

elderly patients, especially if taking anti-HTN

43
Q

Results of clinical trials with low dose intermittent pulse IL-2

A

Disappointing

44
Q

Hepatic Dysfunction Tox

A

Dactinomycin

45
Q

Admin of Aldesleukin

A

IV to hospitalized patients

46
Q

Endogenous IFN activation results in transcriptional upregulation of

A

Genes responsible for Anti-viral, Anti-proliferative, and Anti-tumor activities

48
Q

Low dose infusion of IL-2 leads to selective expansion of

A

A subset of NK cells that overexpress high affinity IL-2 receptor

49
Q

Patients with recurrent Clear Cell Sarcoma involving brain respond to

A

ICE: Ifosfamide, Carboplatin, Etoposide

50
Q

Resistance to the Rapamycins (-limus)

A

Second mTOR complex

51
Q

Sorafenib blocks

A

VEGFR, PDGFR, KIT, RAF

52
Q

Pulmonary Infiltrates

A

Temsirolimus and Everolimus

53
Q

Fatigue, Fever, Flu-Like symptoms

A

IFN-alpha 2b

54
Q

Aldesleukin (IL-2) and IFN-alpha are used in treatment of

A

Clear Cell RCC

Renal (31 decks)

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