1. Anthracyclines

Question 1

Anthracyclines MOA

Answer 1

–Intercalation into DNA, interfering with DNA and RNA synthesis
–Inhibition of topoisomerase II, preventing the fragmentation and repair of DNA
–Creating oxygen-free radicals that damage cells

Question 2

DOXOrubicin (brand, indication)

Answer 2

Adriamycin

Breast cancer, metastatic cancers, disseminated neoplastic conditions

Question 3

DAUNOrubicin (brand, indication)

Answer 3

Cerubidine

Acute lymphoid and myeloid leukemia

Question 4

EPIrubicin (brand)

Answer 4

Ellence
Breast cancer (off-label: gastroesophageal cancer)

Question 5

IDArubicin (brand)

Answer 5

Idamycin

Acute myeloid leukemia

Question 6

VALrubicin (brand)

Answer 6

Valstar

Carcinoma in situ of bladder

Question 7

Non-liposomal anthracyclines are potent ____

Answer 7

vesicants (tissue necrosis if extravasated)

Question 8

Non-liposomal anthracyclines cause ____ urine discoloration

Answer 8

red

Question 9

Doxorubicin: DNE __-__ mg/m2 total lifetime cumulative dose

Answer 9

450-550

Question 10

dexrazoxane (brands, indication)

Answer 10

Totect: antidote used for accidental doxorubicin extravasation
Zinecard: for cardio-protection at higher doses (doxo >300 mg/m2)

Question 11

Non-liposomal anthracyclines BBWs (6)

Answer 11

Myocardial toxicity, vesicant, myelosuppression, hepatotoxicity, secondary malignancy
Renal impairment (dauno, ida)

Question 12

Non-liposomal anthracyclines CIs

Answer 12

Pre-existing myocardial insufficiency, severe hepatic impairment

Question 13

DOXOrubicin liposomal (brand)

Answer 13

Doxil

Question 14

DAUNOrubicin liposomal (brand)

Answer 14

DaunoXome

Question 15

Liposomal anthracyclines BBWs (4)

Answer 15

Myocardial toxicity, infusion-related reactions, myelosuppression
Hepatotoxicity (dauno liposomal)

Question 16

Liposomal anthracyclines ADR

Answer 16

hand-foot syndrome

Question 17

mitoXANtrone (brand)

Answer 17

Novantrone

an anthracenedione, related to anthracyclines

Question 18

mitoXANtrone is _____ with vesicant-like properties

Answer 18

irritant

Question 19

mitoXANtrone causes ____ urine discoloration

Answer 19

blue

Question 20

mitXANtrone BBWs (4)

Answer 20

myocardial toxicity, myelosuppression, secondary malignancy

Question 21

Anthracycline DDIs

Answer 21

CYP3A4 and Pgp inhibitors and inducers, cholchicine, clozapine, mercaptopurine, warfarin, live vaccines

Question 22

Anthracycline monitoring

Answer 22

During each cycle: tumor response, CBC, hepatic function tests, electrolyte abnormalities, myelosuppression (infection)

Question 23

VALrubicin contains polyoxyethylated castor oil, known to cause ____ of diethylhexylphthalate (DEHP), and shold be stored in ___ or ____ containers or in _____ bags and administered through non-DEPH containing administration sets.

Answer 23

leaching; glass; polypropylene; plastic