Antineoplastic Therapy

Question 1

gemcitabine (Gemzar)

Answer 1

Class: Antimetabolite

Cell Cycle: S

Indication: Pancreatic CA, lung CA (w/cisplatin), breast CA (w/paclitaxel), ovarian CA (w/carboplatin)

Toxicity: myelosuppression

Question 2

methotrexate

Answer 2

Class:Antimetabolite

Cell Cycle:S

Indication: ALL, lymphomas, sarcomas, breast/lung/head/neck CA

Toxicity:myelosuppression

Precautions: Urine needs to be alkanized before and after treatment. Leucovorin is given after high dose treatment to reduce bone marrow toxicity.

SE: hair loss, mouth sores, photosensitivity

Question 3

5-Fluorouracil (5-FU)

Answer 3

Class:Antimetabolite

Cell Cycle:S

Indication: GI malignancies, pancreas, head, neck, breast, prostate, skin, and liver cancers

Toxicity: stomatitis and diarrhea, myelosuppression

Precautions: Avoid exposure to direct sunlight

SE: anorexia, photosensitivity, alopecia, fatigue, hand/foot syndrome

Question 4

Floxuridine (FUDR)

Answer 4

Class:Antimetabolite

Cell Cycle:S

Indication: liver, biliary, pancreatic, orval cavity, and breast cancers

Route: interarterially into the hepatic artery. When given intravenously, transformed to 5-FU.

Toxicity:stomatitis and diarrhea

SE: alopecia , dermititis, hand/foot syndrome

Question 5

fludarabine (Fludara)

Answer 5

Class:Antimetabolite

Indication: chronic B-cell lymphocytic leukema,mycosis fungoides, low-grade lymphomas,

Toxicity: myelosuppression, tumor lysis syndrome

Precautions:

SE: anorexia, diarrhea, fever, chills, rash, myalgia, fatigue, weakness, GI bleeding, visual disturbances, and UTIs.

Question 6

cytarabine

Answer 6

Class:Antimetabolite

Cell Cycle:S

Indication: acute nonlymphocytic leukemia, acute llymphocytic leukemia, acute myelogenous lleukemia, chronic myelocytic leukemia, and meningeal leukemia.

Toxicity:myelosuppression

Precautions: Corticosteroid eyedrops are usually started before treatment to prevent conjunctivitis

SE: anorexia, diarrhea, anal ulceration, alopecia, hand/foot syndrome

Question 7

pentostatin (Nipent)

Answer 7

Class:Antimetabolite

Cell Cycle: non specific

Indication: refractory hairy cell leukemia

Toxicity:myelosuppression

Precautions:

SE: anorexia, nausea, vomiting, stomatits, abdominal pain, diarreha, headache, fatigue, rashes, chills, fever, pain, depression, and nervousness

Question 8

pemetrexed (Alimta)

Answer 8

Class:Antimetabolite

Cell Cycle:

Indication: malignant pleural mesothelioma, non-small cell lung cancer

Toxicity: myelosuppression

Precautions: The antitumor effect is dependent upon the size of the celluar folate pools, so oral folic acid must be concurrently administered to increase the efficacy and minimize toxicity. Patients also receive B₁₂ injections every three treatment cycles.

SE: anorexia, stomatitis, diarrhea

Question 9

Reversal

Class: Antimetabolite

Cell Cycle: S

Indication: Pancreatic CA, lung CA (w/cisplatin), breast CA (w/paclitaxel), ovarian CA (w/carboplatin)

Toxicity: myelosuppression

Answer 9

gemcitabine (Gemzar)

Question 10

Reversal

Class:Antimetabolite

Cell Cycle:S

Indication: ALL, lymphomas, sarcomas, breast/lung/head/neck CA

Toxicity:myelosuppression

Precautions: Urine needs to be alkanized before and after treatment. Leucovorin is given after high dose treatment to reduce bone marrow toxicity.

SE: hair loss, mouth sores, photosensitivity

Answer 10

methotrexate

Question 11

Reversal

Class:Antimetabolite

Cell Cycle:S

Indication: GI malignancies, pancreas, head, neck, breast, prostate, skin, and liver cancers

Toxicity: stomatitis and diarrhea, myelosuppression

Precautions: Avoid exposure to direct sunlight

SE: anorexia, photosensitivity, alopecia, fatigue, hand/foot syndrome

Answer 11

5-Fluorouracil (5-FU)

Question 12

Reversal

Class:Antimetabolite

Cell Cycle:S

Indication: liver, biliary, pancreatic, orval cavity, and breast cancers

Route: interarterially into the hepatic artery. When given intravenously, transformed to 5-FU.

Toxicity:stomatitis and diarrhea

Precautions: Urine needs to be alkanized before and after treatment. Leucovorin is given after high dose treatment to reduce bone marrow toxicity.

SE: alopecia , dermititis, hand/foot syndrome

Answer 12

Floxuridine (FUDR)

Question 13

Reversal

Class:Antimetabolite

Indication: mycosis fungoides, low-grade lymphomas, chronic B-cell lymphocytic leukema

Toxicity: myelosuppression, tumor lysis syndrome

Precautions:

SE: anorexia, diarrhea, fever, chills, rash, myalgia, fatigue, weakness, GI bleeding, visual disturbances, and UTIs.

Answer 13

fludarabine (Fludara)

Question 14

Reversal

Class:Antimetabolite

Cell Cycle:S

Indication: acure nonlymphocytic leukemia, acure lymphocytic leukemia, acue myelogenous leukemia, chronic myelocytic leukemia, and meningeal leukemia.

Toxicity:myelosuppression

Precautions: Corticosteroid eyedrops are usually started before treatment to prevent conjunctivitis

SE: anorexia, diarrhea, anal ulceration, alopecia, hand/foot syndrome

Answer 14

cytarabine

Question 15

Reversal

Class:Antimetabolite

Cell Cycle: non specific

Indication: refractory hairy cell leukemia

Toxicity:myelosuppression

Precautions:

SE: anorexia, nausea, vomiting, stomatits, abdominal pain, diarreha, headache, fatigue, rashes, chills, fever, pain, depression, and nervousness

Answer 15

pentostatin (Nipent)

Question 16

Reversal

Class:Antimetabolite

Cell Cycle:

Indication: malignant pleural mesothelioma, non-small cell lung cancer

Toxicity: myelosuppression

Precautions: The antitumor effect is dependent upon the size of the celluar folate pools, so oral folic acid must be concurrently administered to increase the efficacy and minimize toxicity. Patients also receive B₁₂ injections every three treatment cycles.

SE: anorexia, stomatitis, diarrhea

Answer 16

pemetrexed (Alimta)