Antineoplastics Flashcards

1
Q
Alemtuzumab
MOA
Indication
SE's
DI
Comments
A

MOA - Anti CD52 MAB
Indication - CLL
SE’s - Immunosuppression, neutropenia, infusion related reactions
DI - Vaccines and immunosuppressants
Comments - interactions are not enzyme mediated

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2
Q
Arsenic Trioxide
MOA
Indication
SE's
DI
Comments
A
MOA - Differentiating agent
Indication - APL
SE's - Differentiation syndrome, neuropathies
DI - QT prolonging medications
Comments - NA
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3
Q
Azacitidine
MOA
Indication
SE's
DI
Comments
A
MOA - Hypomethylating agent
Indication - AML, MDS
SE's - Myelosuppression, nausea
DI - Immune suppressants, echinacea
Comments - Delayed onset of effect (2-4 cycles)
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4
Q
Belinostat
MOA
Indication
SE's
DI
Comments
A
MOA - Histone deacetylase inhibitor
Indication - Peripheral T-cell lymphoma
SE's - Myelosuppression, nausea, fatigue
DI -UGT1A1 and PGP inhibitors or inducers
Comments - NA
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5
Q
Bendamustine
MOA
Indication
SE's
DI
Comments
A
MOA - Alkylating agent
Indication - CLL, NHL
SE's - Myelosuppression, nausea, emesis
DI - CYP 1A2 inhibitors
Comments - N/A
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6
Q
Bleomycin
MOA
Indication
SE's
DI
Comments
A
MOA - inhibits DNA and RNA synthesis
Indication - HD, NHL
SE's - Pulmonary toxicity, hyper pigmentation, Raynauds
DI - Brentuximab vaccines
Comments - Lifetime max dose 400 units
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7
Q
Blinatumomab
MOA
Indication
SE's
DI
Comments
A

MOA - anti CD 19 MAB that links to cytotoxic T-cells
Indication - ALL
SE’s - Cytokine release syndrome, tumor lysis, leukoencephalopathy
DI - vaccines
Comments - murine antibody

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8
Q
Bortezomib
MOA
Indication
SE's
DI
Comments
A

MOA - Proteasome inhibitor
Indication - Myeloma, NHL
SE’s - Neuropathy, diarrhea, thrombocytopenia
DI - CYP 3A4 inducers, green tea, CYP 2C19 substrates
Comments - SQ administration decreases neuropathy

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9
Q
Brentuximab vedotin
MOA
Indication
SE's
DI
Comments
A

MOA - Anti-CD 30 MAB linked to microtubule inhibitor
Indication - HD
SE’s - Rach, neuropathy, myelosuppression
DI - Bleomycin, CYP 3A4 inhibitors or inducers
Comments - Dosing maxed at 100kg (dosed per kg)

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10
Q
Busulfan
MOA
Indication
SE's
DI
Comments
A

MOA - Alkylating agent
Indication - CML, used for BMT
SE’s - Myelosuppression, hyperpigementation, n/v, lowers seizure threshold, veto-occlusive disease
DI - APAP, avoid CYP inhibitors and inducers
Comments - Prophylactic anticonvulsants used with BMT

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11
Q
Carboplatin
MOA
Indication
SE's
DI
Comments
A
MOA - Platinum alkylating agent
Indication - HD, NHL
SE's - N/V, myelosuppression, neuropathy
DI - Mesna, immune suppressants
Comments - Dosed per GFR based on Calvert formula
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12
Q
Carfilzomib
MOA
Indication
SE's
DI
Comments
A
MOA - Proteasome inhibitor
Indication - myeloma
SE's - heart failure, fatigue, nausea
DI - PGP/BCRP inhibitors
Comments - Dosed at maximum BSA 2.2m squared
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13
Q
Carmustine
MOA
Indication
SE's
DI
Comments
A

MOA - Alkylating agent
Indication - HD, NHL
SE’s - Myelosuppression, pulmonary fibrosis, n/v
DI - immunosuppressants, vaccines
Comments - dissolved in dehydrated alcohol

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14
Q
Chlorambucil
MOA
Indication
SE's
DI
Comments
A
MOA - Alkylating agent
Indication - CLL
SE's - myelosuppression, mucositis
DI - Other myelosuppressive agents
Comments - Take on empty stomach
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15
Q
Cisplatin
MOA
Indication
SE's
DI
Comments
A
MOA - Platinum alkylating agent
Indication - NHL, HD
SE's - N/v, nephrotoxic, neuropathies
DI - Concomitant nephrotoxins
Comments - delayed nausea common
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16
Q
Cladribine
MOA 
Indication
SE's
DI
Comments
A
MOA - purine analog
Indication - CLL, NHL, hairy cell leukemia
SE's - infections, myelosuppression
DI - live vaccines
Comments - Needs PJP prophylaxis
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17
Q
Clofarabine
MOA
Indication
SE's
DI
Comments
A
MOA - Purine analog
Indication - ALL< AML
SE's - Infections, myelosuppression, capillary leak syndrome
DI - Live vaccines
Comments - needs PJP prophylaxis
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18
Q
Cyclophosphamide
MOA
Indication
SE's
DI
Comments
A

MOA - Alkylating agents
Indication - ALL, NHL, myeloma
SE’s - hemorrhagic cystitis, myelosuppression, SIADH
DI - CYP 2B6 inhibitors, CYP inducers
Comments - Mesna may be used as a bladder protectant

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19
Q
Cytarabine
MOA
Indication
SE's
DI
Comments
A

MOA - Pyrimidine analogue
Indication - AML, NHL, HD
SE’s - Myelosuppression (high dose - conjunctivitis, cerebellar toxicity), acral erythema
DI - Concomitant immune suppressants
Comments - Steroid eye drops used with high dose

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20
Q
Dacarbazine
MOA
Indication
SE's
DI
Comments
A

MOA - Alkylating agent
Indication - HD
SE’s - myeosuppression, n/v, photosensitivity
DI - CYP 1A2 oe 2E1 inhibitors or inducers
Comments - N/A

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21
Q
Daratumumab
MOA
Indication
SE's
DI
Comments
A

MOA - AntiCD 38 MAB
Indication - myeloma
SE’s - infusion reactions, myelosuppression
DI - none
Comments - interferes with RBC cross-matching

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22
Q
Dasatinib
MOA
Indication
SE's
DI
Comments
A
MOA - Inhibits BCR-ABL kinase
Indication - CML, Ph+ALL
SE's - Fluid retention, rash, myelosuppression, pleural effusion
DI - CYP 3A4 inhibitors, acid reducers
Comments - Taken w/o regards to food
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23
Q
Daunorubicin
MOA
Indication
SE's
DI
Comments
A

MOA - DNA intercalator, free radical generation, topoisomerase II inhibitor
Indication- AML, ALL
SE’s - Vesicant, HF, arrhythmias, skin flare, urine discoloration, myelosuppression
DI - Avoid PGP and ABCB1 inducers or inhibitors
Comments - Lifetimes maximum of 500 mg/m squared suggested

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24
Q
Decitabine
MOA
Indication
SE's
DI
Comments
A
MOA - Hypomethylating agent
Indication - AML, MDS
SE's - Myelosuppression, edema, nausea
DI - N/A
Comments - May take several cycles for full effect
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25
Q
Doxorubicin
MOA
Indication
SE's
DI
Comments
A

MOA- DNA intercalator, free radical generation, topoisomerase II inhibitor
Indication - NHL, HD, myeloma
SE’s - Vesicant, HF, arrhythmias, skin flare, urine discoloration, myelosuppression
DI - Avoid CYO 3A4 and PGP inhibitors or inducers
Comments - Lifetime maximum of 550 mg/m squared suggested

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26
Q
Dexamethasone
MOA
Indication
SE's
DI
Comments
A

MOA - Lympholytic corticosteroid
Indication - CLL, ALL, NHL, HD, myeloma
SE’s - Hyperglycemia, osteoporosis, mood changes, cataracts
DI - Inhibits multiple CYP enzymes so be aware of other substrates with narrow therapeutic margins
Comments - Take with food, infuse large doses slowly

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27
Q
Doxorubicin, Liposomal
MOA
Indication
SE's
DI
Comments
A

MOA - DNA intercalator, free radical generation, topoisomerase II inhibitor
Indication - myeloma
SE’s - hand foot syndrome, arrhythmia, HF, myelosuppression, infusion reactions
DI - avoid CYP 3A4 inhibitors or inducers
Comments - lifetime max of 550 mg/m2 suggested

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28
Q
Elotuzumab
MOA
Indication
SE's
DI
Comments
A
MOA - Anti SLAMF-7 MAB
Indication - Myeloma
SE's - N/A
DI - M/A
Comments - Premedicate with H1 and H2  blocker and APAP
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29
Q
Etoposide
MOA
Indication
SE's
DI
Comments
A

MOA - Topoisomerase II inhibitor
Indication - NHL, AML, HD
SE’s - Myelosuppression, hypotension, nausea, stomatitis
DI - Avoid CYP 3A4 inhibitors and inducers
Comments - Infuse over 1 hour minimum

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30
Q
Fludarabine
MOA
Indication
SE's
DI
Comments
A
MOA - Purine analog
Indication - AML, CLL, NHL
SE's - myelosuppression, encephalopathy, infections
DI - Live vaccines
Comments - Needs PJP prophylaxis
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31
Q
Gemtuzumab
MOA
Indication
SE's
DI
Comments
A

MOA - Anti CD 33 MAB linked to an alkylating agent
Indication - AML
SE’s - Myelosuppression, veni-occlusive disease
DI - N/A
Comments - Light sensitive compound

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32
Q
Hydroxyurea
MOA
Indication
SE's
DI
Comments
A
MOA - Ribonucleotide reductase inhibitor
Indication - AML, ALL, CML
SE's - Myelosuppression, cutaneous ulcers, hyperuricemia
DI - N/A
Comments - Take without regards to food
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33
Q
Ibritumoman Y-90
MOA
Indication
SE's
DI
Comments
A

MOA- Anti CD 20MAB linked to I-131
Indication - NHI
SE’s - myelosuppression, infusion reactions
DI - N/A
Comments - Pre-dose targeting done to estimate location and extent of radiation and exposure, murine antibody

34
Q
Ibrutinib
MOA
Indication
SE's
DI
Comments
A

MOA - Bruton’s tyrosine kinase inhibitor
Indication
- CLL, NHL
SE’s - hemorrhage, myelosuppression, infections, rash
DI - Avoid CYP 3A4 inducers and strong 3A4 inhibitors
Comments - Take on empty stomach

35
Q
Idelalisib
MOA
Indication
SE's
DI
Comments
A

MOA - PI-3 kinase inhibitor
Indication - CLL
SE’s - Cutaneous reaction, increased glucose and triglycerides
DI - Avoid CYP inducers, strong 3A4 inhibitors
Comments - Take with food

36
Q
Idarubicin
MOA
Indication
SE's
DI
Comments
A

MOA - DNA intercalator, free radical generation, topoisomerase II inhibitor
Indication- AML
SE’s - Myelosuppression, vesicant, colors urine red, radical arrhythmias and HF
DI - Avoid PGP/ABCB1 inhibitors and inducers
Comments - Maximum lifetimes dose of 150mg/m2

37
Q
Ifosfamide
MOA
Indication
SE's
DI
Comments
A

MOA - Alkylating agent
Indication - NHL, HD
SE’s - Myelosuppression, encephalopathy, hemorrhagic cystitis, n/v
DI - Avoid Cap 2A6, 2C19, and 3A4 inhibitors and inducers
Comments - use with Mesna

38
Q
Imatinib Mesylate (Gleevec)
MOA
Indication
SE's
DI
Comments
A
MOA - BCR-ABL kinase inhibitor
Indication - CML, Ph+ALL
SE's - Edema , nausea, rash, myelosuppression
DI - Inhibits CYP 3A4
Comments - Take with food
39
Q
Interferon (Intron A)
MOA
Indication
SE's
DI
Comments
A

MOA - Immune Modulator
Indication - CML, NHL
SE’s - Flulike symptoms, depression, anorexia, myelosuppression
DI - N/A
Comments - May aggravate autoimmune disorders

40
Q
Ixazomib (Ninlaro)
MOA
Indication
SE's
DI
Comments
A
MOA - Proteasome inhibitor
Indication - myeloma
SE's - peripheral neuropathy, diarrhea, thrombocytopenia, edema
DI - Avoid strong CYP 3A4 inducers
Comments - Take on an empty stomach
41
Q
L-asparaginase (Erwinaze)
MOA
Indication
SE's
DI
Comments
A

MOA - Enzyme vs asparagine
Indication - ALL
SE’s - Hypersensitivity reactions, pancreatitis, thrombosis, bleeding
DI - Methotrexate, prednisone, vincristine
Comments - Give after vincristine

42
Q
Lenalidomide (Revlimid)
MOA
Indication
SE's
DI
Comments
A

MOA - Immune modulating agent
Indication - MDS, myeloma, NHL
SE’s - Thrombosis, myelosuppression, secondary leukemia
DI - PGP inhibitors
Comments - Teratogenic, take without regard to food

43
Q
Lomustine (CeeNU)
MOA
Indication
SE's
DI
Comments
A
MOA - Alkylating agent
Indication- HD
SE's - Melosuppression, CNS side effects, N/V
DI - N/A
Comments - Take on an empty stomach
44
Q
Meclorethamine (mustargen)
MOA
Indication
SE's
DI
Comments
A
MOA - Alkylating agent
Indication - HD
SE's - Myelosuppression, n/v
DI - N/A
Comments - N/A
45
Q
Melphalan (Alkeran)
MOA
Indication
SE's
DI
Comments
A
MOA - Alkylating agent
Indication - Myeloma
SE's - myelosuppression, rash, mucositis
DI - N/A
Comments - Use cryotherapy in mouth during high dose infusions, oral taken on empty stomach
46
Q
Mercaptopurine (Purinethol)
MOA
Indication
SE's
DI
Comments
A
MOA - Purine analog
Indication - ALL
SE's - Myelosuppression, diarrhea, mucositis
DI - Allopurinol
Comments - Take on an empty stomach
47
Q
Methotrexate (Trexal)
MOA
Indication
SE's
DI
Comments
A

MOA - Dihydrofolate reductase inhibitor
Indication - NHL, ALL
SE’s - Myelosuppression, mucositis, nephrotoxic
DI - PCN, NSAIDs, PPI, quinolones
Comments - Need to alkalinize urine when administering high dose

48
Q
Methylprednisone (Medrol)
MOA
Indication
SE's
DI
Comments
A

MOA - Lympholytic corticosteroid
Indication - CLL, ALL, NHL, HD, myeloma
SE’s - Hyperglycemia, osteoporosis, mood changes, cataracts
DI - inhibits multiple CYP enzymes so be aware of other substrates with narrow therapeutic margins
Comments - Take with food, infuse large doses slowly

49
Q
Mitoxantrone (Novantrone)
MOA
Indication
SE's
DI
Comments
A

MOA - DNA intercalator, free radical generation, topoisomerase II inhibitor
Indication - AML, NHL
SE’s - Myelosuppression, vesicant, cardiotoxic (HF, arrythmias), colors urine blue-green
DI - N/A
Comments - Lifetime max dose 160 mg/m2

50
Q
Nelabarine (Arranon)
MOA
Indication
SE's
DI
Comments
A
MOA - Purine analog
Indication - T-ALL and NHL
SE's - Myelosuppression, neurotoxicity
DI - Live vaccines
Comments - Requires PJP prophylaxis
51
Q
Nilotinib (Tasigna)
MOA
Indication
SE's
DI
Comments
A

MOA - BCR-ABL kinase inhibitor
Indication - CML, Ph+ALL
SE’s - Myelosuppression, QTc prolongation, pancreatitis
DI - Avoid CYP 3A4 inhibitors and inducers. It is a moderate inhibitor of 2D6, 2C8/9 so avoid substrates with narrow margins
Comments - Take on empty stomach

52
Q
Nivolumab (Opdivo)
MOA
Indication
SE's
DI
Comments
A
MOA - Anti PD-1 MAB
Indication - HD
SE's - Autoimmune conditions
DI - N/A
Comments - N/A
53
Q
Obinatuzumab (Gazyva)
MOA
Indication
SE's
DI
Comments
A

MOA - Anti CD 20 MAB
Indication - CLL, NHL
SE’s - Infusion reactions, Hep B reactivation, PML, tumor lysis syndrome
DI- N/A
Comments - Concider holding anti-hypertensives the day of infusion

54
Q
Ofatumumab (Arzerra)
MOA
Indication
SE's
DI
Comments
A

MOA - Anti CD 20 MAB
Indication - CLL
SE’s - Infusion reactions, Hep B reactivation, PML, tumor lysis syndrome
DI - N/A
Comments - Consider holding antihypertensives the day of infusion

55
Q
Omacetaxine (Synribo)
MOA
Indication
SE's
DI
Comments
A

MOA - protein synthesis inhibitor
Indication - CML
SE’s - Myelosuppression, diarrhea, fatigue
DI - N/A
Comments - Delayed time to response but affects many mutated BCR-ABL forms

56
Q
Oxaliplatin (Eloxatin)
MOA
Indication
SE's
DI
Comments
A
MOA - Platinum alkylating agent
Indication - NHL
SE's - myelosuppression, n/v, neuropathy
DI - N/A
Comments - Do not touch or consume cold items for 72 hours postdose
57
Q
Pabobinostat (Farydak)
MOA
Indication
SE's
DI
Comments
A
MOA - Histone deacetylase inhibitor
Indication - Myeloma
SE's - diarrhea, fatigue, nausea
DI - N/A
Comments - N/A
58
Q
Pegasparaginase (Oncaspar)
MOA
Indication
SE's
DI
Comments
A

MOA - Enzyme vs asparagine
Indication - ALL
SE’s - Hypersensitivity reactions, pancreatitis, thrombosis, bleeding
DI - Methotrexate, prednisone
Comments - Less antigenic than other asparaginase forms

59
Q
Pentostatin (Nipent)
MOA
Indication
SE's
DI
Comments
A
MOA - Purine analogue
Indication - CLL, NHL
SE's - myelosuppression, neurologic changes, infections
DI - live vaccines
Comments - need PJP prophylaxis
60
Q
Pomalidomide (Pomalyst)
MOA
Indication
SE's
DI
Comments
A

MOA - Immune modulating agent
Indication - Myeloma
SE’s - Myelosuppression, thrombogenic, neuropathy, secondary AML
DI - Avoid 1A2 and 3A4 inhibitors and inducers
Comments - teratogenic

61
Q
Ponatinib (Iclusig)
MOA
Indication
SE's
DI
Comments
A

MOA - BCR-ABL kinase inhibitor
Indication - CML
SE’s - hypertension, thrombosis, hepatic abnormalities, pancreatitis, HF
DI - Avoid use with strong 3A4 inhibitors or inducers
Comments - Take without regard to food

62
Q
Pralatrexate (Folotyn)
MOA
Indication
SE's
DI
Comments
A

MOA - Dihydrofolate reductase inhibitor
Indication - NHL
SE’s - Myelosuppression, mucostis, nausea
DI - Uricosurics, nephrotoxins, sulfa drugs
Comments - Take B-12 and folate supplementation

63
Q
Prednisone (Deltasone)
MOA
Indication
SE's
DI
Comments
A

MOA - Lymptholytic corticosteroid
Indication - CLL, ALL, NHL, HD, myeloma
SE’s -hyperglycemia, osteoporosis, mood changes, cataracts
DI - Inhibits multiple CYP enzymes so be aware of other substrates with narrow therapeutic margins
Comments - Take with food, infuse large doses slowly

64
Q
Procarbazine (Matulane)
MOA
Indication
SE's
DI
Comments
A

MOA - Alkylating agent
Indication - NHL, HD
SE’s - myelosuppression, n/v, neurotoxicity
DI - Amphetamines, meperidine, SSRI, tricyclics, ethanol
Comments -Avoid fermented beverages and foods (MAOI)

65
Q
Rituximab (Rituxan)
MOA
Indication
SE's
DI
Comments
A

MOA - Anti CD 20 MAB
Indication - NHL, CLL, ALL
SE’s - Infusion reactions, Hep B reactivation, PML, tumor lysis syndrome
DI - N/A
Comments - Consider holding antihypertensives the day of infusion

66
Q
Romidepsin (Istodax)
MOA
Indication
SE's
DI
Comments
A
MOA - Histone deacetylase inhibitor
Indication - NHL
SE's - fatigue, fever, n/v, myelosuppression
DI - avoid CYP inhibitors and inducers
Comments - N/A
67
Q
Ruxolitinib (Jakafi)
MOA
Indication
SE's
DI
Comments
A

MOA - Jak 1 and 2 kinase inhibitor
Indication - myelofibrosis, polycythemia vera
SE’s - myelosuppression, peripheral edema, diarrhea, hepatic abnormalities
DI - Avoid CYP inhibitors and inducers
Comments - Rebound effect after stopping. Take without regard to food.

68
Q
Temozolomide (Teomdar)
MOA
Indication
SE's
DI
Comments
A
MOA - Alkylating agent
Indication - NHL
SE's - Myelosuppression, n/v, rash
DI - N/A
Comments - Administer consistently with regard to food, empty stomach preferred
69
Q
Teniposide (Vumon)
MOA
Indication
SE's
DI
Comments
A
MOA - Topoisomerase II inhibitor
Indication - Pediatric leukemias
SE's - myelosuppression, n/v, mucositis
DI - phenytoin, carbamazepine, phenobarbital
Comments - N/A
70
Q
Thalidomide (Thalomid)
MOA
Indication
SE's
DI
Comments
A

MOA - Immune modulating agent
Indication - MDS, myeloma
SE’s - Sedation, neuropathy, constipation, thrombogenic
DI - N/A
Comments - Teratogenic, take on an empty stomach

71
Q
Thioguanin (Tabloid)
MOA
Indication
SE's
DI
Comments
A
MOA - purine analogue
Indication - ALL
SE's - myelosuppression, diarrhea, mucositis
DI - N/A
Comments - Take without regard to food
72
Q
Thiotepa (Tepadina)
MOA
Indication
SE's
DI
Comments
A

MOA - Alkylating agent
Indication - NHL, HD
SE’s - myelosuppression, skin toxicity, mucositis
DI - N/A
Comments - Cower several times a day during high dose as secreted in sweat

73
Q
Topotecan (Hycamtin)
MOA
Indication
SE's
DI
Comments
A
MOA - Topoisomerase I inhibitor
Indication - NHL, HD
SE's - Myelosuppression, mucositis, n/v
DI - phenytoin, cisplatin
Comments - Give before cisplatin
74
Q
Tositumomab I-131 (Bexxar)
MOA
Indication
SE's
DI
Comments
A

MOA - Anti CD 20 MAB linked to Y-90
Indication - NHL
SE’s -myelosuppression, infusion reactions
DI - N/A
Comments - Pre-dose targeting done to estimate location and extent of radiation exposure, murine antibody thyroid protective agent given prior to dose

75
Q
Tretinoin (Vesanoid)
MOA
Indication
SE's
DI
Comments
A

MOA - Differentiating agent
Indication - APL
SE’s - Hepatotoxic, headaches, skin changes
DI - Avoid CYP 2C8 inhibitors and inducers
Comments - Take with food

76
Q
Venetoclax (Venclextra)
MOA
Indication
SE's
DI
Comments
A
MOA - N/A
Indication - CLL
SE's - N/A
DI - N/A
Comments - N/A
77
Q
Vinblastine (Velban)
MOA
Indication
SE's
DI
Comments
A
MOA - Inhibits microtubule formation
Indication - HD
SE's - myelosuppression, neuropathy
DI - Avoid CYP 3A4 inhibitors or inducers
Comments - Fatal if given intrathecally
78
Q
Vincristine (Oncovin)
MOA
Indication
SE's
DI
Comments
A
MOA - Inhibits microtubule formation 
Indication - ALL, NHL, HD, myeloma
SE's - Neuropathy, SIADH
DI - Avoid CYP 3A4 inhibitors or inducers
Comments - Fatal if given intrathecally
79
Q
Vincristine, Liposomal (Marquibo)
MOA
Indication
SE's
DI
Comments
A

MOA - Inhibits microtubule formation
Indication - ALL
SE’s - Fever, constipation, myelsuppression, neuropathy
DI - Avoid CYP 3A4, PGP, ABCB1 inhibitors and inducers
Comments - Fatal if given intrathecally

80
Q
Vorinostat (Zolinza)
MOA
Indication
SE's
DI
Comments
A
MOA - Histone deacetylase inhibitor
Indication - NHL
SE's - diarrhea, edema, fatigue, hyperglycemia
DI - Valproic acid
Comments - Take with food