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July > 8.7.2013(pharm-anticancer Drugs) 60 > Flashcards

8.7.2013(pharm-anticancer Drugs) 60 Flashcards

0
Q

Most susceptible atom to Alkylating agents

A

N7 of guanine

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1
Q

Gompertzian model

A

Growth fraction peaks when tumor is approx 37% of its maximum size

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2
Q

Mesna

A

Mercaptoethane sulfonic acid

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3
Q

Mechlorethamine is used in

A

Hodgkin lymphoma

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4
Q

Adverse effects of cyclophosphamide

A

Cardiac dysfunction
Pulmonary toxicity
SIADH

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5
Q

Anticancer drugs that cause delayed neutropenia

A

Nitrsoureas

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6
Q

Adverse effects of busulfan

A

Adrenal insufficiency
Pulmonary fibrosis
Skin hyperpigmentation
Hyperuricemia

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7
Q

CNS side effects of procarbazine

A

Hypnosis

Vivid dreams

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8
Q

Drug used for CLL

A

Chlorambucil

As it spares myelocytes

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9
Q

Cisplatin nephrotoxicity can be prevented by

A

Chloride diuresis

Doesnot help against ototoxicity

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10
Q

Cisplatin is inactivated by

A

Aluminium

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11
Q

Drug that can be given to prevent cisplatin induced nephrotoxicity

A

Amifostine

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12
Q

Electrolyte abnormalities associated with cisplatin

A 
Reduces all ions 
Hypomagnesimia 
Hypokalemia
Hypophosphatemia
Hypocalcemia
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13
Q

Anticancer drugs with strong vesicant properties

A

Nitrosoureas

Mechlorethamine

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14
Q

Alkylating agent with less chance of secondary leukemia

A

Cyclophosphamide

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15
Q

Anticancer drugs causing veno occlusive disease

A

All Alkylating agents in high doses

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16
Q

Alkylating agents causing pulmonary fibrosis

A

All Alkylating agents

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17
Q

Mechanisms of MTX resistance

A 
Decreased MTX transporter
Decreased formation of MTX polyglutamate
Increased levels of DHFR due to GENE AMPLIFICATION 
altered DHFR
Increased drug efflux transporter
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18
Q

Enzyme required for activation of MTX and pemetrexed

A

Folylpolyglutamate synthase

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19
Q

MTX is DOC for

A

Choriocarcinoma

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20
Q

Pemetrexed is approved for treatment of

A

Mesothelioma

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21
Q

Citrovorum factor

A

N10 formyl THF

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22
Q

Rx of MTX toxicity

A

Citrovorum factor
Alkalinisation of urine
Dialysis
Glucarpidase

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23
Q

Glucarpidase

A

MTX cleaving enzyme

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24
Q

Pralatrexate is used for Rx of

A

Peripheral T cell lymphoma

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25
Q

Adverse effects of MTX

A

Hepatotoxicity
Pulmonary infiltrates and fibrosis
Bone marrow supression
Mucositis

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26
Q

DOC for CLL

A

Fludarabine

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27
Q

Purine analogs

A

6MP
6TG
Cladribine
Fludarabine

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28
Q

DOC for Hairy cell leukemia

A

Cladribine(resistant to degradation by ADA)

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29
Q

Drug that must be given to longterm purine analog users

A

Cotrimoxazole for PCP prophylaxis as long term purine analog use leads to Immunosuppression

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30
Q

Dose of which anti metabolites should be reduced when given along with allopurinol

A

6-MP

azathioprine

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31
Q

Pyramidine analogs

A 
5FU
cytarabine
Capecitabine
Gemcitabine
5-azacytidine
Decitabine
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32
Q

Single most effective agent for induction of remission in AML

A

Cytarabine

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33
Q

Anticancer drug eliminated by lungs

A

5FU

converted to CO2

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34
Q

Adverse effect of capecitabine

A

Hyperbilirubinemia

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35
Q

Metabolism of thiopurines

A

TPMT

thiopurine methyl transferase

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36
Q

5FU is catabolised by

A

Dihydropyramidine dehydrogenase

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37
Q

5FU action is augmented by

A

Leukovorin

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38
Q

DOC for pancreatic cancer

A

Gemcitabine

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39
Q

Adverse effect of thiopurines

A

Hepatotoxicity

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40
Q

Adverse effects of 5FU

A

Neurotoxicity

Hand foot syndrome

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41
Q

Side effect of fludarabine

A

Arthralgia

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42
Q

Side effect of gemcitabine

A

Diarrhoea

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43
Q

Marrow sparing cytotoxic drugs

A

Vincristine
Bleomycin
L-asparaginase

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44
Q

Diff btw vincristine and vinblastine

A

Vinblastine causes bone marrow supression

Vincristine has bone marrow sparing effect but dose limiting neurotoxicity

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45
Q

Use of vinblastine

A

Metastatic testicular tumors

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46
Q

Use of vincristine

A

Induction of remission in childhood leukemias

Pediatric solid tumors-Wilms,neuroblastoma,rhabdomyosarcoma

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47
Q

Taxanes that causes hypersensitivity reactions

A

Paclitaxel

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48
Q

Taxanes that don’t cause hypersensitivity reactions

A

Docetaxel

Nabpaclitaxel(protein bound paclitaxel)

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49
Q

Adverse effect of Taxanes

A

Bone marrow suppression

Neurotoxicity

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50
Q

Taxanes drug interactions

A

Cisplatin decreases paclitaxel clearance

Paclitaxel decreases doxorubicin clearance

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51
Q

Use of Cabazitaxel

A

Rx of refractory metastatic prostate cancer in combination with prednisone

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52
Q

MOA of action of Ixabepilone

A

Microtubule stabilisation

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53
Q

Estramustine is combination of

A

Estrogen and Mechlorethamine

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54
Q

Use of estramustine

A

Prostatic Ca

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55
Q

Side effects of estramustine

A

Gynacomastia

Impotence

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56
Q

MOA of camptothecins

A

Inhibits topoisomerase 1

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57
Q

Elimination of camptothecins

A

Irinotecan eliminated in bile

Topotecan eliminated by renal route

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58
Q

Rx of choice for advanced colorectal carcinoma

A

Irinotecan+5FU

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59
Q

Dose limiting toxicities of camptothecins

A

Irinotecan-diarrhoea

Topotecan- neutropenia

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60
Q

Adverse effects of irinotecan

A

Diarrhoea
Myelosuppression
Cholinergic syndrome(inhibits acetyl choline esterase)

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61
Q

MOA of etoposide and teniposide

A

Inhibit topoisomerase 2

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62
Q

Use of etoposide

A

Testicular Ca
Prostate Ca
Small cell Ca of lung

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63
Q

Etoposide induced secondary leukemia

A

Develops at short interval
Not preceded by myelodysplasia
It’s acute non lymphocytic type

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64
Q

Toxicity of etoposide

A

Hepatotoxicity

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65
Q

All anti tumor antibiotics are obtained from

A

Streptomyces

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66
Q

Cardiotoxicity of anthracyclins can be reduced by

A

Alpha tocopherol

Dexrazoxane

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67
Q

MOA of anthracyclins

A

Inhibits topoisomerase 2

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68
Q

Less cardiotoxic anthracyclin

A

Mitoxantrone

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69
Q

Radiation recall reaction is seen with

A

Anthracyclins

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70
Q

Use of Mitoxantrone

A

Hormone resistant prostate cancer
AML
SPMS(secondary progressive MS)

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71
Q

Leukemia caused by Mitoxantrone

A

Acute promyelocytic leukemia

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72
Q

Use of valrubicin

A

BCG refractory urinary bladder Ca insitu

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73
Q

Radiosensitizers

A 
Hydroxy urea
Gemcitabine
Metronidazole
5FU
dactinomycin
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74
Q

Use of dactinomycin

A

Solid tumors in children

75
Q

Nature of Bleomycin

A

Glycopeptide

76
Q

Earliest indicator of adverse effect of Bleomycin

A

Decreased DLco

77
Q

Adverse effects of Bleomycin

A 
Cutaneous
  Hyperpigmentation
  Hyperkeratosis 
  Erythema
  Ulcers
Pneumonitis
Pulmonary fibrosis
Hypersensitivity
78
Q

Bleomycin is metabolised by

A

Bleomycin hydrolase

It’s concentration is less in skin and lungs

79
Q

Bleomycin toxicity is ________ dependant

A

Oxygen

80
Q

Hypoxic tumor cells can be killed by

A

Mitomycin

81
Q

Adverse effect of mitomycin

A

HUS

delayed bronchospasm

82
Q

Use of mitomycin

A

Superficial Bladder Ca
Anal Ca
Tracheal and laryngeal stenosis

83
Q

Adverse effects of docetaxel

A

Peripheral neuropathy

Fluid retention

84
Q

Imatinib is the drug of choice for

A

CML

GIST

85
Q

MOA of Imatinib

A

Competitive inhibitor of ATP binding of the abl kinase

86
Q

Erlotinib pharmacokinetics

A

Food increases absorption by 100%

Metabolised by CYP3A4

87
Q

Adverse effects of erlotinib

A

Skin rash
Diarrhoea
Anorexia
Fatigue

88
Q

Erlotinib is effective in

A 
Women
Non smokers
Asians
Non small cell lung Ca
Adenocarcinoma 
Bronchioalveolar Ca
89
Q

Use of erlotinib

A

Non small cell lung cancer with EGFR receptor mutation
KRAS mutation cancers don’t respond to it
Pancreatic Ca

90
Q

Use of sorafenib and sunitinib

A

Sunitinib- RCC,GIST

sorafenib-RCC,HCC

91
Q

Adverse effects of sorafenib and sunitinib

A

Hypertension

92
Q

Route of administration of tyrosine kinase inhibitors

A

Oral

93
Q

Use of lapatinib

A

Ca breast

Inhibits TK associated with her2/neu

94
Q

Use of pazopanib

A

Advanced RCC

Multi targeted TK inhibitor against VEGF,PDGF,c kit

95
Q

Drug that inhibits TK activated by JAK

A

Tofacitinib

96
Q

Tofacitinib is used against

A

rheumatoid arthritis

97
Q

Tyrosine kinase inhibitors used in medullary Ca of thyroid

A

Vandetanib(VEGFR,EGFR)

Cabozantinib(c-MET,VEGFR-2)

98
Q

TK inhibitor used in Rx of malignant melanoma

A

Vemurafenib(BRAF)

99
Q

TK inhibitor used in myelofibrosis

A

Ruxolitinib(JAK1,2)

100
Q

TK inhibitors used in CML

A 
Bosutinib
Dasatinib
Imatinib
Nilotinib
Ponatinib
101
Q

TK inhibitor used in colorectal cancer

A

Regorafenib(VEGFR2,TIE2)

102
Q

TK inhibitors used in non small cell carcinoma of lung

A

Crizotinib(cMET,ALK)
Erlotinib(EGFR)
Gefitinib(EGFR)

103
Q

TK inhibitors used in advanced RCC

A

Axitinib(VEGFR1,2,3)
Pazopanib(VEGFR1,2,3;PDGFR A,B;cKIT)
Sorafenib
Sunitinib

104
Q

TK inhibitors used in pancreatic Ca

A

Sunitinib

Erlotinib

105
Q

Dose limiting toxicity of transtuzumab

A

Cardiotoxicity

106
Q

CD52 antagonist

A

Alemtuzumab(low grade lymphomas and CLL)

107
Q

Monoclonal Ab against EGFR

A

Cetuximab
Panitumumab
EGFR positive metastatic colorectal Ca

108
Q

CD33 Antagonist

A

Gemtuzumab ozogamycin

CD33 positive AML

109
Q

CD 20 antagonists conjugated with radioisotopes

A

I131-tositumomab
Y90-ibritumomab tiuxetan
Used for relapsed lymphomas

110
Q

Recombinant IL-2 with diphtheria toxin

A

Denileukin diftitox

Used for recurrent cutaneous T cell lymphoma

111
Q

Adverse effects of cetuximab

A

Rash
Hypomagnesimia
ILD

112
Q

Rituximab is used against

A 
CLL
AIHA
ITP
NHL
RA

CHINA

113
Q

Use of cetuximab

A

Colorectal Ca

Head and neck cancer

114
Q

Advantage of panitumumab

A

Fully human Mab

No rash

115
Q

Adverse effects of bevacizumab

A

Hypertension
Thromboembolism
Impaired wound healing
GIT perforation

116
Q

Use of bevacizumab

A 
Colorectal
Breast
Glioblastoma 
Metastatic RCC
non small cell lung Ca
117
Q

Adverse effects of flutamide

A

Hot flushes
Gynacomastia
Hepatic dysfunction

118
Q

Complete androgen blockade

A

AR blockers

GnRH agonists

119
Q

MOA of abiraterone

A

17 A hydroxylase inhibitor

Prostate Ca

120
Q

Drugs that inhibit 17 A hydroxylase

A

Etomidate

Abiraterone

121
Q

Drugs that inhibit 11 B hydroxylase

A

Metyrapone

Etomidate

122
Q

SERD

A

Selective estrogen receptor downregulator

Fulvestrant

123
Q

Aromatase inhibitors

A 
1G-Aminoglutethimide
2G
Formestane
Fadrozole
Rogletimide
3G
Exemestane
Anastrazole
Letrozole
Vorozole
124
Q

Adverse effects of aminoglutethemide

A

Adrenal insufficiency
Myelosupression
Rash

125
Q

Adverse effects of L asparaginase

A

Severe hypersensitivity reactions
Acute pancreatitis
CVT

126
Q

Asparaginase is used in treatment of

A

Leukemias

Lymphomas

127
Q

MOA of pentostatin

A

Inhibits ADA

128
Q

Use of Plicamycin

A

Hypercalcemia of malignancy

Metastatic testicular Ca

129
Q

Hydroxy urea is DOC for

A

Sickle cell anemia
Essential thrombocytosis
Polycythemia Vera

130
Q

Second drug of choice in essential thrombocytosis

A

Anagrelide

131
Q

Route of administration of hydroxy urea

A

Oral

132
Q

Adverse effects of tretinoin

A

Vit A toxicity- headache,dryness,rash,pruritis,conjunctivitis
Retinoic acid syndrome- pleural or pericardial effusion,pulmonary infiltrates,fever
Hypercholesterolemia
Hypertriglyceridemia
Abdominal pain and diarrhoea

133
Q

Adverse effects of arsenic trioxide

A

Hyperglycaemia

Prolonged QT interval

134
Q

Adverse effects of thalidomide

A 
Teratogenicity
Constipation
Peripheral neuropathy
Rash
Hypothyroidism
Increased risk of DVT
135
Q

IMiD and selCID

A

Immunomodulatory derivatives of thalidomide

Selective cytokine inhibitory drugs

136
Q

MOA of thalidomide

A 
Inhibition of angiogenesis 
Inhibition of TNF A
Increased production of IL-10
Reduces phagocytosis
Alteration of adhesion molecule expression
137
Q

Use of thalidomide

A 
MM
ENL
skin manifestations of SLE
HIV associated wasting 
Crohn
Conditioning before stem cell transplantation
MDS
kaposi sarcoma
Primary brain malignancies
Recurrent aphthous ulcers
TB
GVHD
138
Q

Histone deacetylase inhibitors

A

Vorinostat

Romidepsin

139
Q

Use of histone deacetylase inhibitors

A

Cutaneous T cell lymphoma

140
Q

Recombinant IL-2

A

Aldesleukin

141
Q

Use of aldesleukin

A

RCC

malignant melanoma

142
Q

Use of neoadjuvant chemotherapy

A 
Bladder
Breast
Colorectal
Stomach
Esophagus
Lung
143
Q

Recombinant IL-11

A

Oprelevkin

Used to prevent thrombocytopenia

144
Q

Rx for radiation induced xerostomia

A

Pilocarpine

Palifermin

145
Q

Induction Rx for ALL

A 
Intrathecal MTX
asparaginase
Daunorubicin
Prednisolone
Vincristine

MAD PV

146
Q

Drugs used during consolidation phase of ALL

A 
Hyper CVAD alternated with cytarabine+MTX
cyclophosphamide 
Vincristine
Adriamycin
Dexamethasone
147
Q

Rx of choice for AML

A

Cytarabine+Daunorubicin/idarubicin

148
Q

Rx of choice for CLL

A

Fludarabine
Cyclophosphamide
Rituximab

FCR

149
Q

Rx of choice for Hodgkin

A 
ABVD
adriamycin
Bleomycin
Vinblastine
Dacarbazine
150
Q

Rx of choice for non hodgkin lymphoma

A 
R-CHOP
Rituximab
Cyclophosphamide 
Hydroxydaunorubicin(doxorubicin)
Oncovin(vincristine)
Prednisone
151
Q

Rx of choice for multiple myeloma

A

Bortezomib
Dexamethasone
Lenalidomide

152
Q

Rx of choice for waldenstrom macroblobinemia

A

FCR

153
Q

Rx of choice for non small cell lung Ca

A

Cisplatin

Vinorelbine+/- bevacizumab

154
Q

Rx of choice of small cell lung Ca

A

Cisplatin+etoposide

155
Q

Rx of choice of mesothelioma

A

Cisplatin+pemetrexed

156
Q

Rx of choice for head and neck cancer

A

Cisplatin+5FU

157
Q

Rx of choice for esophageal Ca

A

Cisplatin+5FU

158
Q

Rx of choice of ovarian cancer

A

Paclitaxel+carboplatin

159
Q

Rx of choice cervical Ca

A

Paclitaxel+cisplatin

160
Q

Adjuvant chemotherapy for Ca breast

A

Doxorubicin
Cyclophosphamide
Docetaxel

161
Q

Rx of choice of uterine cancer

A

Progestin/tamoxifen/Aromatase inhibitors

Cisplatin+doxorubicin+paclitaxel

162
Q

Rx of choice for choriocarcinoma

A

MTX/dactinomycin

163
Q

Rx of choice of testicular Ca

A

BEP

Bleomycin+etoposide+cisplatin

164
Q

Rx of choice for kidney cancer

A

Sunitinib

165
Q

Rx of choice for bladder cancer

A

Gemcitabine+cisplatin

166
Q

Rx of choice for astrocytoma/GBM

A

Temozolamide

167
Q

Rx of choice for neuroblastoma

A

Cyclophosphamide
Doxorubicin
Cisplatin
Etoposide

168
Q

Rx of choice for thyroid Ca

A

I131

Sorafenib

169
Q

Rx of choice for stomach cancer

A

Epirubicin
Cisplatin
5FU

170
Q

Rx of choice for pancreatic Ca

A

Gemcitabine

Gemcitabine+cisplatin/erlotinib

171
Q

Rx of choice for colon cancer

A

FOLFOX6+/- bevacizumab
FOLFIRI+/- bevacizumab
FOLinic acid+5FU+OXaliplatin
FOLinic acid+5FU+IRInotecan

172
Q

Rx of choice for rectal cancer

A

Radiotherapy

5FU

173
Q

Rx of choice for anal Ca

A

RT+5FU+mitomycin C

174
Q

Rx of choice for insulinoma

A

Interferon/Streptozocin

175
Q

Rx of choice for osteosarcoma

A

Doxorubicin
Cisplatin
Ifosfamide
High dose MTX

Any two of above drugs

176
Q

Rx of choice for soft tissue sarcoma

A 
MAID
Mesna
Adriamycin
Ifosfamide 
Dacarbazine
177
Q

Rx of choice for melanoma

A

Dacarbazine/temozolamide/IL2

178
Q

Rx of choice for HCC

A

Sorafenib

179
Q

Rx of choice for kaposi sarcoma

A

Liposomal doxorubicin/Daunorubicin

180
Q

Rx of choice for adrenal Ca

A

Mitotane

181
Q

Rx of choice for carcinoid

A

Streptozocin+5FU

182
Q

Other name for Amifostine

A

Ethyol

183
Q

Dose limiting side effect of Amifostine

A

Hypotension

184
Q

Route of administration of Amifostine

A

SC

185
Q

OER

A

Oxygen enhancement ratio

Amount of radiation dose required before and after radiation

July (7 decks)

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