Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

12. Chemotherapy > Breast Cancer Drugs > Flashcards

Breast Cancer Drugs Flashcards

1
Q

Treatment of cancer

A

Hormone therapy

  • Estrogen-sensitive breast cancer
  • Anti-estrogen: Tamoxifen, Raloxifen
  • Aromatase inhibitors

Targeted therapy
- Trastuzumab (Herceptin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hormone Therapy

  • Antiestrogen
  • Aromatase Inhibitor - 1st line
A

Antiestrogen

  • Tamoxifen - Nolvadex
  • Toremifene - Fareston
  • Raloxifen - Evista

Aromatase Inhibitors

  • Anastrozole - Arimidex
  • Letrozole - Femara
  • Exemestane - Aromasin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Nolvadex

  • MOA
  • Dose
    • PRE-menopausal
    • POST-menopausal
  • SEs
A

Tamoxifen

  • MOA: STIMULATES uterine estrogen receptors

Dose

  • 20 mg BID in PRE-menopausal
  • 10 mg BID or 20 mg QD in POST-Menopausal

SEs

  • Hot flashes, breast pain, wt gain, HA, edema, nausea
  • ** Thrombo-embolism
  • Endometrial cancer
  • Menstrual irregularities, hyperCa, bone loss, cataracts, tumor flare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nolvadex

DDI

  • Strong 2D6 inhibitors
  • Mod 2D6 inhibitors
  • Alternative
A

Tamoxifen

  • Is a prodrug convert by 2D6
  • Strong 2D6 inhibitors: paroxetin, fluoxetin
  • Mod 2D6 inhibitors: setraline, duloxetine, amiodarone

Alternative:

  • Switch tamoxifen to aromatase inhibitor (anastrozole), but it’s not for PRE-manopausal
  • SSRIs or venlafaxine, desvenlafaxine, wellbutrin, bupropion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Evista

  • Indication
A

Raloxifene

  • I: reduce risk of breast cancer. Only for postmenopausal women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Evista

  • MOA
  • Indication
  • FDA approved:
  • BBW
A

Raloxifense

  • MOA: BLOCKS estrogen receptor
  • Indication: to reduce risk of breast cancer
  • FDA approved: POSTmenopausal women with osteoporosis with high risk of breast cancer. NOT for PRE-menopausal women
  • BBW: blood clot and stroke => d/c 72H b/4 prolonged immobility
  • An alternative to tamoxifen to REDUCE breast cancer in post-menopausal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Raloxifense and Tamoxifen Comparison

A
  • Raloxifene is less likely to lead to uterine cancer, hysterectomy, or cataracts
  • Raloxifense box warning: blood clot and stroke => d/c 72H b/4 prolonged immobility
  • Tamoxifen STIMULATES uterine estrogen receptors while Raloxifense BLOCKs them
  • Both increase risk of blood clot but Raloxifense is less likely
  • If pt switches from tamoxifen to Evista, the clock does NOT start over. Pt should be on these drugs for 5-10 yrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Arimedex

  • Class:
  • Dose
A

Anastrozole

  • Aromatase Inhibitors
  • 1mg PO QD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Femara

  • Class:
  • Dose
A

Letrozole

  • Aromatase Inhibitors
  • Dose: 2.5mg QD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Aromasin

  • Class:
  • Dose
A

Exemestane

  • Aromatase Inhibitors
  • Dose: 25mg QD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Aromatase Inhibitors

  • SEs
  • DDI
  • Advantage over tamoxifen
A
  • SEs: hot flashes, tumor flare, HA, wt gain, vaginal bleeding, GI upset
  • DDI: Tamoxifen decreases aromatase inhibitors

Adv:

  • No hyperCa++
  • No thromboembolism
  • No endometrial cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fareston

  • Class
  • Dose
A

Toremifene

  • Class: Anti-estrogen
  • Dose: 60mg QD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

EGFR

A
  • Epidermal Growth Factor Receptor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Herceptin

A

Trastuzumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Herceptin

  • Class:
  • Indication
  • Dosage form:
  • Duration of treatment
A

Trastuzumab

  • Class: Monoclonal antibody
  • I: Herceptin + Paclitaxel = 1st line tx of HER-2 overexpressing metastatic breast cancer & HER-2 + metastatic stomach cancer
  • DF: injection

Dose

  • Initial: 4mg/kg IV infusion over 90 min
  • Then: 2mg/kg IV over 30 min weekly x 51 weeks
  • Total is 52 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HerCePtIn = Herceptin

  • SE
  • BBW
A

Trastuzumab

SE:

  • Flu like symptoms: 40%
  • Fever, chills
  • N/V
  • Diarrhea, infection, rash, increase cough, HA, fatigue, SOB, low white and RBC

BBW

  • Cardiotoxicity = C
  • Pulmonary toxicity = P
  • Infusion rxn: SOB => stop drug => when pt feels better => continue
17
Q

Perjeta

  • Indication:
  • Dosage Form:
A

Pertuzumab

  • Indication: Combo Perjeta + Herceptin + docetaxel for tx of HER-2 + metastatic breast cancer who HAVE NOT received prior anti-HER-2 therapy or chemo
  • Dosage Form: IV only
18
Q

Kadcyla

  • Indication
  • Dose Form
  • Boxed Warning
A

Ado-Trastuzumab emtansine

  • I: tx of HER-2 + metastatic breast cancer who PREVIOUSLY received HERCEPTIN + TAXANE
  • DF: IV only

BW:

  • Hepatotoxicity
  • Cardiac (L.V dysfxn)
  • Embryo-fetal toxicity
19
Q

Ixempra

A

Ixabepilone

20
Q

Ixempra

  • Class:
  • Indication:
  • Dosage form:
  • Vial contain:
  • Pretreatment with:
  • DDI:
A

Ixabepilone

  • Class: Epothilone microtubule inhibitor
  • I: Tx of metastatic or locally adv breast cancer in pts whose tumors are resistant or refractory or anthracyclines, taxanes, and capecitabine
  • DF: Vial and powder for IV
  • Contain EtOH and castor oil
  • Pretx with H1 and H2 1H prior to infusion and w/ steroid if hypersensitivity rxn occurs
  • DDI: avoid CYP 3A4 inhibitors/inducers
21
Q

Ixempra - IxabepiLoNE

  • CI
A

CI

  • Liver fxn
  • Neutrophils: CI if neutrophil less than 1500 and platelets less than 100000
22
Q

Tykerb

  • Indication:
  • SEs
A

Lapatinib

  • I: breast cancer

SEs

  • Diarrhea, hand/food syndrome
  • Decrease LVEF
  • QT prolongation
23
Q

Halaven

  • MOA
  • Indication:
A

Eribulin

  • MOA: Microtubule inhibitor
  • I: Pts w/ metastatic breast cancer who have received at least 2 prior chemo regimens for late-stage disease
24
Q

Faslodex (Fulvestrant)

  • Dosage form
  • MOA
  • Indication:
  • Hepatic adjustment
A

Fulvestrant

  • Give IM Once a month
  • MOA: estrogen receptor antagonist
  • I: hormone receptor + metastatic breast cancer in postmenopausal women with disease progression following antiestrogen therapy
  • Hepatic: cut dose by 1/2
25
Q

Faslodex

  • Warning
  • ADES
A

Fulvestrant

Warning/Precaution

  • Bleeding
  • Thrombocytopenia

SEs
- Inj site rxn, GI upset, bone pain, HA, back pain, fatigue, pain in extremity, hot flash, anorexia, musculoskeletal pain, cough, dyspnea, constipation, increased hepatic enzymes

26
Q

Megace

  • Indication
  • SEs
A

Megestrol

  • Progestin => Increase appetite = wt gain

Indications:

  • Palliative tx of advanced breast
  • Endometrial cancer
  • Stimulate appetite

Dose

  • Breast: 40 mg BID
  • Endometrial: 40-320 mg in divided doses

SEs

  • Thromboembolism
  • HF
  • Breakthrough bleeding
  • HyperG
  • HyperTN
  • Wt gain
  • Hot flashes

12. Chemotherapy (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions