Cancer Flashcards
how can breast CA be prevented
exercise, healthy diet, tamoxifen
name the SERMs for breast CA
Tamoxifen (Nolvadex), Raloxifene (Evista)
MOA of SERMs
decrease cancer cell growth
Max use of tamoxifen
5 years
why should you be careful with SERMs if you don’t have CA
Carcinogenic if you don’t have CA
ADR of SERMs
stroke*, flushing, bone pain
unlabeled use for SERMs
endometrial carcinoma
which SERM is a prodrug?
Tamoxifen changes to endoxifen via 2D6
What are some drugs that can cause drug interactions with SERMs
Fluoxetine: strong, Sertraline: moderate
Dose of tamoxifen
20mg once daily
Name the aromatase inhibitors used to treat breast CA
anastrazole (Arimidex), Letrozole (femara)
MOA of aromatase inhibitors
inhibits T –> E
Benefits of aromatase i over SERMs
decreased stroke risk
ADR of aromatasei
Fx, osteoporosis, MSK pain, flushing
treatment of premenopausal breast CA
chemo + tamoxifen if ER+, + trastuzumab if HER/neu+
treatment of postmenopausal breast CA
ER+ gets tamoxifen or aromatasei + trastuzumab in HER/neu+
name the anti-HER2 agents
trastuzumab (Herceptin), Lapatinib (Tykerb)
Dose for Tykerb
250mg 5 tablets once daily
MOA of anti HER2 agents
change genetic messages from CA cells
what can people taking tykerb not eat d/t 3A4 metabolism
grapefruit juice, take on empty stomach
ADR tykerb
GI, acne
which HER2 agent need premedication?
trastuzumab
What workup should you do on pts taking trastuzumab before prescribing?
EKG, LVEF d/t cardiac toxicity
