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Intro To Drugs > antineoplastic agents > Flashcards

antineoplastic agents Flashcards

1
Q

Cancer Pathophysiology

A

Dysregulation of cell cycle
Continuous growth and division
Imbalance between oncogene expression and tumor suppressor gene expression
Tumor development

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2
Q

antineoplastic agents MOA

A

Stop or slow growth of cancer cells, which grow and divide quickly
Also affect healthy cells that grow quickly
Bone marrow cells
Cells of the gastrointestinal (GI) tract including cells that line the mouth and intestines
Hair

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3
Q

antineoplastic agents adverse effects

A

Bone marrow suppression (BMS)/myelosuppression
Neutropenia, anemia, thrombocytopenia
Nausea, vomiting, diarrhea, mucositis
Alopecia

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4
Q

antineoplastic agents counseling

A

Watch for fever, malaise, sore mouth or throat

May cause hair loss

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5
Q

antineoplastic agents interactions

A

Vaccines:
Inactivated
Live

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6
Q

antineoplastic agents key points

A 
Monitor for signs of BMS and infection
Often give antiemetics for N/V
Dosing:
Body surface area (BSA)
Adjustments
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7
Q

Cyclophosphamide Alkylating Agents MOA

A

Forms strong covalent bonds with DNA inhibiting replication and causing bond breaks and cell death.

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8
Q

Cyclophosphamide Alkylating Agents uses

A

Cancers, autoimmune disorders

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9
Q

Cyclophosphamide Alkylating Agents dosing

A

Dosage forms: injection, tablets
Usual doses: 400-1800 mg/m2 IV x 1 dose that may be repeated at 2-4 week intervals, 50-100 mg/m2 PO daily for up to 14 continuous days

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10
Q

Cyclophosphamide Alkylating Agents adverse effects

A

BMS, N/V/D/mucositis, alopecia, hemorrhagic cystitis

Amenorrhea, sterility, secondary malignancies

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11
Q

Cyclophosphamide Alkylating Agents Hemorrhagic cystitis

A

Acrolein metabolite binds to bladder wall
Cystitis with tissue edema, ulceration, local hemorrhage
Painful urination, hematuria
Prevention:
Hydration
Mesna

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12
Q

Cyclophosphamide Alkylating Agents counseling

A

Drink plenty of fluids
Take oral doses early in the day
Report painful urination, discolored or bloody urine

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13
Q

Cyclophosphamide Alkylating Agents key points

A

Hydration ± Mesna to prevent hemorrhagic cystitis

Give antiemetics to prevent N/V

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14
Q

Doxorubicin Anthracyclines MOA

A

Inhibition of DNA and RNA synthesis by intercalation of DNA base pairs and inhibition of DNA repair by topoisomerase

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15
Q

Doxorubicin Anthracyclines uses

A

Cancers

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16
Q

Doxorubicin Anthracyclines dosing

A

Dosage forms: injection
Usual doses: 60-75 mg/m2 per dose every 3-4 weeks; 20-30 mg/m2 per day for 3 days every 4 weeks; 60 mg/m2 per dose every 2 weeks (dose dense

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17
Q

Doxorubicin Anthracyclines adverse effects

A

BMS, N/V/D/mucositis, alopecia, cardiotoxicity
Extravasation
Amenorrhea, sterility, secondary malignancies

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18
Q

Doxorubicin Anthracyclines cardiotoxicity

A 
Measure ejection fraction (EF) prior to starting therapy
Echocardiogram
Limit cumulative lifetime dose
550 mg/m2 
Dexrazoxane
Chemoprotectant 
Liposomal doxorubicin (Doxil)
19
Q

Doxorubicin Anthracyclines extravasation

A

Leakage of vesicants into surrounding tissue leading to tissue necrosis
Central access preferred
Dimethylsulfoxide and cold compresses
Dexrazoxane

20
Q

Doxorubicin Anthracyclines interactions

A

Trastuzumab

21
Q

Doxorubicin Anthracyclines counseling

A

Watch for pain or swelling at injection site

22
Q

Doxorubicin Anthracyclines key points

A

Cardiotoxicity
Extravasation
Give antiemetics to prevent N/V

23
Q

Cytarabine, 5-Fluorouracil, Capecitabine, Methotrexate, Antimetabolites MOA

A

Similar in structure to naturally occurring compounds

Incorporate themselves into DNA leading to cell death

24
Q

Cytarabine, 5-Fluorouracil, Capecitabine, Methotrexate, Antimetabolites uses

A

Cancers

Methotrexate – psoriasis, rheumatoid arthritis, ectopic pregnancy, Chron’s disease

25
Q

Cytarabine, 5-Fluorouracil, Capecitabine, Methotrexate, Antimetabolites adverse effects

A

All: BMS, N/V/D, mucositis
Cytarabine: tumor lysis syndrome, CNS toxicity, conjunctivitis
5-Fluorouracil and Capecitabine: photosensitivity, palmar-plantar erythrodysesthesias (hand-foot syndrome), eye irritation/lacrimation
Methotrexate: neurotoxicity, hepatotoxicity, nephrotoxicity

26
Q

Cytarabine adverse effects

A 
!!Tumor lysis syndrome!!
Caused by tumor cell lysis
Release of intracellular contents
Potassium, phosphate, nucleic acids/uric acid
Acute renal failure
27
Q

5-Fluorouracil adverse effects

A

Palmar-plantar erythrodysesthesias

28
Q

Methotrexate adverse effects

A

neurotoxicity, hepatotoxicity, nephrotoxicity

29
Q

Cytarabine, 5-Fluorouracil, Capecitabine, Methotrexate, Antimetabolites counseling points

A

Cytarabine: stay well hydrated, report changes in mental status, steroid eye drops
5-Fluorouracil and Capecitabine: Avoid sunlight exposure and use sunscreen when exposure cannot be avoided, may cause painful rash on the hands and feet
Methotrexate: watch for fever, malaise, bleeding, bruising, flank pain, leucovorin rescue

30
Q

Carboplatin, Cisplatin. Platinum Compounds MOA

A

form strong covalent bonds with DNA inhibiting replication and causing cell death

31
Q

Carboplatin, Cisplatin. Platinum Compounds uses

A

cancers

32
Q

Carboplatin, Cisplatin. Platinum Compounds adverse effects

A

BMS, N/V, peripheral neuropathies, alopecia, ototoxicity
Carboplatin – hypersensitivity
Cisplatin – nephrotoxicity, ELYTE losses (K, Mag)

33
Q

Carboplatin, Cisplatin. Platinum Compounds interactions

A

Aminoglycosides

34
Q

Carboplatin, Cisplatin. Platinum Compounds counseling

A

Drink plenty of fluids, contact your healthcare provider if you are unable to keep fluids down, or if there is any hearing loss

35
Q

Carboplatin, Cisplatin. Platinum Compounds key points

A

Cisplatin nephrotoxicity

36
Q

Docetaxel, Paclitaxel- Taxanes MOA

A

Promote assembly and preventing depolymerization, leading to stabilization of microtubule bundles and inhibition of cell replication

37
Q

Docetaxel, Paclitaxel- Taxanes uses

A

: cancers

38
Q

Docetaxel, Paclitaxel- Taxanes counseling

A

Peripheral neuropathies can occur with continued use

39
Q

Docetaxel, Paclitaxel- Taxanes adverse effects

A

BMS, peripheral neuropathy, myalgia, arthralgia, alopecia
Docetaxel – fluid retention syndrome, skin and nail changes
Paclitaxel – hypersensitivity

40
Q

Docetaxel, Paclitaxel- Taxanes key points

A

Docetaxel – premedicate with corticosteroid to reduce fluid retention
Paclitaxel – premedicate with a corticosteroid, diphenhydramine, and histamine-2 blocker to prevent hypersensitivity

41
Q

Imatinib (Gleevec), Rituximab (Rituxan), Trastuzumab (Herceptin) MOA

A 
Target abnormal genetic signaling proteins specific to the cancer
Imatinib (Gleevec)
Targets Philadelphia fusion gene
Rituximab (Rituxan)
Targets CD-20 antigen on B-cells
Trastuzumab (Herceptin)
Targets HER2/neu oncogene
Breast Cancer
42
Q

NCI Toxicity Rating

A

0: no toxicity
4: life threatening toxicity

43
Q

Chemotherapeutic Agents are ISMP High-Alert Medications

Methods to prevent medication errors

A

Double-check orders
Specialist prescribers
Protocol adherence

Intro To Drugs (13 decks)

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