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Pharmacy Drugs > 416 Exam 6 Cancer > Flashcards

416 Exam 6 Cancer Flashcards

1
Q

Trt for neutropenia

A

Filgrastim 5mcg/kg
Pegfilgrastim 6mg
SE: Bone pain- premedicate w/APAP or Claritin

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2
Q

Neutropenic fever (pseudomonas) trt

A

Cefepime, Ceftazidime, Carbapenems, Zosyn
add Aminoglycoside or Cipro
add Vanco
Fungal: caspofungin

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3
Q

Trt for anemia

A 
Epoetin alpha (Epogen, Procrit) 
Darbepoetin (Aranesp)
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4
Q

Thrombocytopenia trt and prevention

A

Transfusion

Prevention: Oprelvekin 50mcg/kg (non-myeloid malignancy)

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5
Q

Mucositis trt and prevention

A

Trt: oral hygiene, pain relief (magic mouthwash, lidocaine)
Prevention: oral hygiene, chlorhexidine, Palifermin (severe mucositis)

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6
Q

Diarrhea trt

A

Hydration
Loperamide
Octreotide

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7
Q

Extravasation trt

A

Stop injection
Admin Totect for anthracyclines
Cold compresses

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8
Q

Peripheral neuropathy trt

A

Duloxetine

Gabapentin

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9
Q

Breast cancer- neoadjuvant therapy (pre/postmenopause, node+, >1cm)

A

Chemo + surgery + radiation (+/- Trastuzumab, Tamoxifen)

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10
Q

Breast cancer trt pre/postmenopause, ER/PR-

A

Surgery + chemo +/- Trastuzumab (NO endocrine)

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11
Q

Breast cancer trt premenopause, ER/PR+

A

Surgery + chemo + Tamoxifen 20mg + LHRH agonist (goserelin) +/- Trastuzumab

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12
Q

Breast cancer trt postmenopause, ER/PR+

A

Surgery + chemo + AI inhibitor (anastrozole 1mg/letrozole 2.4mg/exemetane 25mg) +/- Tamoxifen +/- Trastuzumab

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13
Q

Breast cancer stage IV trt premenopause ER/PR-

A

Chemo

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14
Q

Breast cancer stage IV trt premenopause ER/PR+

A

Tamoxifen +/- LHRH agonist (goserelin) +/- Trastuzumab

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15
Q

Breast cancer stage IV trt ER/PR+ postmenopause

A

AI inhibitor (anastrozole 1mg) +/- CDK inhibitor (Palbociclib) +/- Trastuzumab OR Lapatinib
OR
Fulvestrant +/- CDK inhibitor (Palbociclib) +/- Trastuzumab

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16
Q

Ovarian cancer trt

A

Surgery + chemo (paclitaxel + cisplatin)

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17
Q

Ovarian cancer trt Cisplatin resistant (recurrence <6months)

A

Chemo: docetaxel or gemcitabine or paclitaxel +/- pazopanib

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18
Q

Ovarian cancer trt when failed chemo >3 times BRCA-mutated

A

PARP inhibitor: Olaparib

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19
Q

Ovarian cancer trt when failed chemo >3 times (NOT BRCA specific)

A

PARP inhibitors: Niraparib, Rucaparib

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20
Q

Prostate cancer initial trt <10yrs life expectancy

A

Observation or radiation

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21
Q

Prostate cancer trt >10yr life expectancy AND localized disease

A

Prostatectomy

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22
Q

Prostate cancer initial trt >10yr life expectancy

A

Prostatectomy or Radiation +/- ADT (LHRH agonist: goserelin, leuprolide OR LHRH antagonist: degarelix)

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23
Q

Prostate cancer trt progressing castrate sensitive metastatic disease

A

ADT + bilateral orchidectomy OR LHRH agonist +/- antiandrogens (Flutamide, Nilutamide) OR LHRH agonist + docetaxel

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24
Q

Prostate cancer trt castrate resistant with PSA doubling time <10months

A

Androgen receptor inhibitor: Apalutamide

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25
Q

Prostate cancer trt castrate resistant metastatic asymptomatic

A

Sipuleucel-T (vaccine)

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26
Q

Prostate cancer trt castrate resistant metastatic No visceral Mets

A

Enzalutamide OR Abiratenone +prednisone

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27
Q

Prostate cancer trt castrate resistant metastatic with visceral Mets

A

Docetaxel + prednisone (continue to progress: cabazitaxel)

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28
Q

Renal cell carcinoma trt stage I

A

Partial nephrectomy OR active surveillance

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29
Q

Renal cell carcinoma trt stage II

A

Radical nephrectomy

30
Q

Renal cell carcinoma trt Stage III

A

Radical nephrectomy + VEGF inhibitor (Sunitinib)

31
Q

Renal cell carcinoma trt Stage IV

A

Radical nephrectomy + IL-2 or Targeted therapy
Options:
Bevacizumab + IFN 2
mTOR inhibitor: Temsirolimus

32
Q

SCLC limited stage trt

A

Radiation + chemo (cisplatin + etoposide)

33
Q

SCLC extensive stage trt

A

Chemo (cisplatin or carboplatin + etoposide)

34
Q

NSCLC stage I trt

A

Surgery + observation

35
Q

NSCLC stage II trt

A

Surgery + chemo (cisplatin)

36
Q

NSCLC stage III trt

A

Surgery + chemo (cisplatin) +/- radiation OR targeted therapy

37
Q

NSCLC stage IV trt negative biomarker non-squamous

A

Chemo:
PS 0-1: cisplatin/premetrexed +/- Bevacizumab
PS 2: carboplatin/paclitaxel
PS 3: best supportive care

38
Q

NSCLC stage IV trt negative biomarker squamous

A

Chemo:
PS 0-1: cisplatin/gemcitabine (NO Bevacizumab)
PS 2: carboplatin/gemcitabine
PS 3: best supportive care

39
Q

NSCLC stage IV trt EGFR + biomarker

A

EGFR inhibitors: Gefitinib or Erlotinib

Osimertinib for T790M mutation

40
Q

NSCLC stage IV trt EML4-ALK + biomarker

A

ALK inhibitors: Alectinib

Or Brigatinib, ceritinib, crizotinib

41
Q

NSCLC stage IV trt ROS1+ biomarker

A

ALK inhibitors: Crizotinib

or Ceritinib

42
Q

NSCLC stage IV trt PDL1+ biomarker

A

PDL1 inhibitors: Pembrolizumab

or Nivolumab, Atexolizumab

43
Q

NSCLC stage IV trt BRAF+ biomarker

A

BRAF V600E inhibitors: Dabrafenib, Trametinib

44
Q

Acute CINV

A

5HT3: Ondansetron 16-24mg PO, 8-16mg IV; Palonsetron 0.25mg IV; Dolansetron 100mg PO
NK1: Aprepitant 125mg, 80mg, 80mg PO; Fosaprepitant 150mg IV; Rolapitant
Steroids: Dexamethasone 12mg then 4-8mg x3days
Olanzapine 10mg QD

45
Q

Delayed CINV

A

5HT3: Palonsetron 0.25mg IV
NK1: Aprepitant 125mg, 80mg, 80mg PO; Fosaprepitant 150mg IV; Rolapitant
Steroids: Dexamethasone 12mg then 4-8mg x3days
Olanzapine 10mg QD

46
Q

Breakthrough CINV

A

DA: Prochlorperazine 12.5-25mg q4-6h; Promethazine 10mg q6h
GABA: Lorazepam 1-2mg q4-6h
Steroids: Dexamethasone 12mg then 4-8mg x3days
Olanzapine 10mg QD
5HT3: Ondansetron 16-24mg PO, 8-16mg IV; Palonsetron 0.25mg IV; Dolansetron 100mg PO

47
Q

Refractory CINV

A 
Dronabinol 
ADH cocktail (Ativan, Diphenhydramine,Haloperidol)
48
Q

HD stage I-IV favorable OR unfavorable nonbulky OR unfavorable bulky

A

ABVD +/- radiation

Doxorubicin, Bleomycin, Vinblastine, Dacarbazine

49
Q

HD relapse <12months of ABVD

A

Stem cell transplant

50
Q

HD fail stem cell transplant

A

Brentuximab + AVD

51
Q

HD fail Brentuximab

A

PDL1: Nivolumab or Pembrolizumab

52
Q

Non-HD indolent trt

A

Radiation +/- chemo

53
Q

Non-HD aggressive trt (DLBCL)

A

Chemo + radiation

RCHOP: rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone

54
Q

ALL remission induction trt

A

Vincristine + Dexamethasone + L-asparaginase

High risk: + daunorubicin

55
Q

ALL CNS prophylaxis

A

Intrathecal cytarabine + hydrocortisone + MTX

56
Q

ALL maintenance trt

A

Mercaptopurine + MTX + Dexamethasone + Vincristine

Ph+ add bcr-abl inhibitor

57
Q

AML remission induction and consolidation trt

A

7 + 3
7 days of Cytarabine
3 days daunorubicin or idarubicin
Consolidation= 7 + 3 higher doses

58
Q

AML M3 induction trt

A

ATRA + idarubicin or arsenic trioxide

59
Q

AML M3 consolidation trt

A

Arsenic + Cytarabine + Daunorubicin

60
Q

AML M3 maintenance trt

A

ATRA +/- 6MP + MTX

61
Q

CML chronic/accelerated trt

A

Bcr-abl inhibitors:
Imatinib 400mg, Dasatinib 100mg, Nilotinib 300mg, Bosutinib 400mg
t315i mutation: Panatinib

62
Q

CLL trt

A

Watch and wait (asymptomatic)
Ibrutinib
FCR (young pts): Fludarabine, Cyclophosphamide, rituximab

63
Q

Colon cancer stage I

A

Surgery (no chem, no adjuvant)

64
Q

Colon cancer stage II

A

Surgery + chemo (ONLY if high risk)

65
Q

Colon cancer stage III

A

Surgery + adjuvant chemo (FOLFOX: 5FU, oxaliplatin, leucovorin)

66
Q

Colon cancer stage IV

A

Surgery + adjuvant chemo (FOLFOX +/- Bevacizumab)

5FU, Oxaliplatin, Leucovorin

67
Q

Melanoma trt

A

Surgery +/- adjuvant (Nivolumab)

No role for chemo

68
Q

Melanoma metastatic BRAF-

A

Checkpoint inhibitors: Pembrolizumab, Nivolumab

69
Q

Melanoma metastatic BRAF+

A

BRAF inhibitors: Dabrafenib + Trametinib

70
Q

Melanoma metastatic CNS penetration

A

Temozolamide

71
Q

Non-melanoma (basal or squamous cell) trt

A

Surgery +/- radiation +/- topical 5FU or Imiquimod

No role for chemo

72
Q

Non-melanoma last line trt

A

Hedgehog: Vismodegib or Sonidegib

Pharmacy Drugs (37 decks)

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