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Phamacology Summer > Antineoplastic/ Chemotherapy Agents Part 1: General Class Wide Effects > Flashcards

Antineoplastic/ Chemotherapy Agents Part 1: General Class Wide Effects Flashcards

1
Q

 Rescue agent: Mesna

a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab

A

d. Cyclophosphamide

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2
Q

 Rescue Agent: Leucovorin

a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab

A

e. Methotrexate

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3
Q
  • Anti-HER2
    a. Cisplatin
    b. Vincristine
    c. Doxorubicin
    d. Cyclophosphamide
    e. Methotrexate
    f. Trastuzumab
A

f. Trastuzumab

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4
Q

Platinum Compound

a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab

A

a. Cisplatin

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5
Q

Vinca Alkaloids-

a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab

A

b. Vincristine

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6
Q

Anthracyclines

a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab

A

c. Doxorubicin

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7
Q

Nitrogen Mustard

a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab

A

d. Cyclophosphamide

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8
Q

Antimetabolites

a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab

A

e. Methotrexate

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9
Q

Monoclonal Antibody-

a. Cisplatin
b. Vincristine
c. Doxorubicin
d. Cyclophosphamide
e. Methotrexate
f. Trastuzumab

A

f. Trastuzumab

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10
Q

BADGOATS 1
-BONE MARROW SUPPRESSION
 ADMINISTRATION CONCERNS
which is the above

  1. Neutropenia- Infection Risk/Safety
  2. Anemia- S/S and Management
  3. Thrombocytopenia- S/S and Management
  4. Infiltration/Extravasation- S/S and Management
  5. Disposal and PPE
A
  • BONE MARROW SUPPRESSION
    1. Neutropenia- Infection Risk/Safety
    2. Anemia- S/S and Management
    3. Thrombocytopenia- S/S and Management

 ADMINISTRATION CONCERNS

  1. Infiltration/Extravasation- S/S and Management
  2. Disposal and PPE
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11
Q

BADGOATS 2
 GI TRACT CONCERNS
 OTHER PATIENT SAFETY CONCERNS
which is the above

  1. Nausea/Vomiting
  2. Oral Care, GI irritation/ulceration
  3. Alopecia
  4. Tumor Lysis Syndrome
  5. Sexual/Reproductive
A 
 GI TRACT CONCERNS
1. Nausea/Vomiting
2. Oral Care, GI irritation/ulceration
 OTHER PATIENT SAFETY CONCERNS
3. Alopecia
4. Tumor Lysis Syndrome
5. Sexual/Reproductive
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12
Q

 Neutropenia

Low point called ?

A

“Nadir”

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13
Q 
NEUTROPENIA
 PATIENT SAFETY PRECAUTIONS
which is true ?
Limit unnecessary procedures
 Live vaccines NOT recommended
 LIMIT visitors
 Do NOT allow sick/ill visitors
 risk for infection
 Do NOT allow flowers/potted plants
 Micro-organisms
 COOK and CLEAN fruits and vegetables
 No RAW fruits/veggies – risk of infection
A

all

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14
Q

“I will avoid crowds to keep from infecting others.“- WHAT IS WRONG WITH THIS
STATEMENT?

A

Large crowds can infect the immune compromised.

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15
Q

Which true about Reducing Bleeding Risk
 Bleeding Gums- soft bristle tooth brush
 Electric Razor
 Limit activities that could cause a bleed (no rugby)
 Rugby is safe

A

 Bleeding Gums- soft bristle tooth brush
 Electric Razor
 Limit activities that could cause a bleed (no rugby)

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16
Q

Thrombocytopenia
Infiltration put in order.
 3) STOP THE INFUSION AND REMOVE THE CATHETER
 1) Warm or cold compress- DEPENDS ON WHAT INFILTRATED
 4) Elevate Extremity and encourage range of motion
 2) Check with provider- how much drug did patient get? Need new
dose?

A

 3) STOP THE INFUSION AND REMOVE THE CATHETER
 4) Elevate Extremity and encourage range of motion
 1) Warm or cold compress- DEPENDS ON WHAT INFILTRATED
 2) Check with provider- how much drug did patient get? Need new
dose?

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17
Q

PREVENTION:
 Careful site selection, monitoring and securing of catheter

Extravasation or INFILTRATION

A

INFILTRATION

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18
Q

 PREVENTION:
 Use a central line
 Chemotherapy certified nurses only give chemotherapy
 Use infusion pump, monitor IV site

Extravasation or INFILTRATION

A

Extravasation

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19
Q

Thrombocytopenia
Extravasation put in order.
 1) Try to withdraw any solution from the IV access
 3) STOP THE INFUSION!
 2) Keep catheter in place- you may need to infuse an antidote
 4) Elevate Extremity and follow hospital protocol

A

 3) STOP THE INFUSION!
 1) Try to withdraw any solution from the IV access
 2) Keep catheter in place- you may need to infuse an antidote
 4) Elevate Extremity and follow hospital protocol

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20
Q

 ? Spill- Contact Occupational Safety and Health Administration (OSHA)

Large or Small Spill

A

Large

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21
Q

 ? Spill- Chemotherapy Spill Kits

Large or Small Spill

A

Small Spill

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22
Q

Goggles, mask, protective clothing, shoe covers, absorbent pads, detergent cleansers,
chemotherapy waste disposal bags

Large or Small Spill

A

Small Spill

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23
Q

Which is true about
 CHEMOTHERAPY INDUCED NAUSEA/VOMITING –

 Don’t eat if nauseated
 Limit fluids prior to chemotherapy (reduce nausea)
 Eat foods at ROOM temperature (Hot Foods Increase Nausea)
 Do NOT drink extra fluids (can cause over-distention)
 Do NOT eat extra unsaturated fats (don’t break down as well)
 Patients will typically experience weight loss

A

all

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24
Q

 Oral Hygiene is Essential

 Flossing once daily (ATI has wrong answer of 4 times daily)
 AVOID Alcohol based mouthwash ( No alcohol!)
 Run toothbrush in dishwasher weekly (not monthly- ATI distractor)
 Use soft bristle tooth brush
 Magic Mouthwash- antifungal, lidocaine, antihistamine
 BLAND DIET- No hot (temperature), Avoid spicy foods, etc.
 Report Ulcers, blood in stool, etc.

A

all

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25
Treatment? ALLOPURINOL Alopecia Tumor Lysis Syndrome Sexual Health-
Tumor Lysis Syndrome
26
``` USED TO TREAT-  Wide array of cancers a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
c. Doxorubicin
27
``` ADVERSE EFFECTS:  BAD GOATS a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
c. Doxorubicin
28
c. Doxorubicin Alopecia  Starts ? days when beginning treatment  Can last ? months after end of treatment
Alopecia  Starts 7-10 days when beginning treatment  Can last 2 months after end of treatment
29
``` ADVERSE EFFECTS Cardiac Toxicity Ruby red a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
c. Doxorubicin
30
c. Doxorubicin  Harmless red discoloration of bodily fluids? Cardiac Toxicity Ruby red
Ruby Red
31
c. Doxorubicin LIFE TIME LIMIT! Cardiac Toxicity Ruby red
Cardiac Toxicity
32
Monitor EKG and Echocardiogram a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
c. Doxorubicin
33
```  USED TO TREAT-  Wide array of cancers Derived from vinca rosea plant (periwinkle plant) a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
b. Vincristine
34
```  MECHANISM:  Mitotic Inhibitor a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
b. Vincristine
35
``` MECHANISM:  Believed to inhibit Topoisomerase II, which inhibits production of DNA and RNA a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
c. Doxorubicin
36
``` ADVERSE EFFECTS:  BAD GOATS  Peripheral Neuropathy a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
b. Vincristine
37
``` Nearly ALL patients will have  Decreased reflexes  Weakness  Sensory Loss  Paresthesias (numbness/tingling)  30-50% of patients have autonomic nerve damage  Constipation  Urinary hesitancy/retention ``` a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
b. Vincristine
38
``` USED TO TREAT-  Wide array of cancers  Includes acute lymphomas; solid  tumors (head, neck, ovary and breast cancers); Hodgkin’s  and non-Hodgkin’s lymphomas; and multiple myeloma a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
d. Cyclophosphamide
39
``` MECHANISM:  Kills rapid growing cells by alkylation of DNA and RNA synthesis a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
d. Cyclophosphamide
40
``` ADVERSE EFFECTS:  BAD GOATS  Acute Hemorrhagic Cystitis a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
d. Cyclophosphamide
41
``` Increase fluids to 3 Liters/Day  Monitor for blood in urine a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
d. Cyclophosphamide
42
``` Watch out for electrolyte abnormalities  hyperkalemia a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
d. Cyclophosphamide
43
Commonly given with Mesna (uro-protectant) a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
d. Cyclophosphamide
44
```  USED TO TREAT-  Wide array of cancers  Includes bladder, testicular, and ovarian cancers a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
a. Cisplatin
45
``` MECHANISM:  Kills rapid growing cells by alkylation of DNA and RNA synthesis a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
a. Cisplatin
46
``` ADVERSE EFFECTS:  BAD GOATS  Highly Emetogenic  Renal Toxicity  Hearing Loss  Paresthesia's a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
a. Cisplatin
47
``` USED TO TREAT-  Solid Tumors (breast/lung)  Lymphomas/Leukemia  Rheumatoid Arthritis  Ectopic Pregnancy a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
e. Methotrexate
48
``` MECHANISM:  Rheumatoid Arthritis (?): Mechanism isn’t 100% understood, but it does function as anti-inflammatory and immunomodulator a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
e. Methotrexate LOW DOSE
49
MECHANISM: CANCER (?): inhibits dihydrofolate reductase, stops cells from utilizing folic acid for DNA synthesis (this means fast acting cells….like cancer!!!) a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
e. Methotrexate (HIGH DOSE
50
``` MECHANISM:  Suppresses S-phase specific cell reproduction a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
e. Methotrexate
51
``` The Good: Kills Cancer or stops overactive immune system a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
e. Methotrexate
52
 The Bad (high dose therapy): BAD GOATS! a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
e. Methotrexate
53
``` CANCER: When destroying tumors, they release DNA byproduct. Result=hyperuricemia a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate ```
e. Methotrexate
54
``` Patients can have extreme turnover of DNA byproduct: Tumor Lysis Syndrome This can cause nephrotoxicity! a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate ```
e. Methotrexate
55
Result=hyperuricemia a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
56
 This medication is Pregnancy Category X a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
57
 This medication is associated with SCAR (SJS/TEN) a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
58
 This medication can cause photosensitivity a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
59
 This medication can cause liver toxicity a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
60
 PROTECT FROM SUNLIGHT a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
61
```  NOTABLE DRUG-DRUG CONCERNS:  INCREASED EFFECTS:  NSAIDS (including aspirin)  Antibiotics like penicillin and sulfamethoxazole can increase ? toxicity a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate ```
e. Methotrexate
62
```  Leucovorin Rescue (sort of an antidote) a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate ```
e. Methotrexate
63
```  In the hospital we can check ? levels (we then dose the leucovorin based on the levels) a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate ```
e. Methotrexate
64
Oral versions are given ONCE WEEKLY, if you see ONCE DAILY, BE CAREFUL!!! You could kill someone a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate
e. Methotrexate
65
```  USED TO TREAT-  HER2+ Breast Cancer a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
f. Trastuzumab
66
? is a monoclonal antibody which binds to the extracellular domain of the human epidermal growth factor receptor 2 protein (HER-2); it mediates antibody-dependent cellular cytotoxicity by inhibiting proliferation of cells which overexpress HER-2 protein. a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
f. Trastuzumab
67
``` ADVERSE EFFECTS:  TWO BOXED WARNINGS: CARDIOMYOPATHY  INFUSION REACTIONS AND PULMONARY TOXICITY a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
f. Trastuzumab
68
```  Stop immediately if dyspnea or significant hypotension a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab ```
f. Trastuzumab
69
Highly Emetogenic a. Cisplatin b. Vincristine c. Doxorubicin d. Cyclophosphamide e. Methotrexate f. Trastuzumab
a. Cisplatin

Phamacology Summer (48 decks)

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