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PM&R Pharm Cards > Cancer > Flashcards

Cancer Flashcards

1
Q

____ may cause distal axonal degeneration, severe neuropathic pain, and rarely motor involvement which can lead to quadriparesis

A

Vincristine

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2
Q

What three chemotherapy medicines can cause autonomic neuropathies, resulting in fluctuating BP and HR.

A
  1. Cisplatin
  2. Bortezomib
  3. Vincristine
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3
Q

____ and ____ are two of the most common chemo agents that could cause hemorrhagic cystitis.

A

Ifosfamide
cyclophosphamide

risk increases with IV use

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4
Q

Which chemo agent?
Neurotoxicity:
Acute cerebellar toxicity, encephalopathy, seizures, peripheral neuropathy

A

Cystosine Arabinoside

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5
Q

Which chemo agent?

Neurotoxicity: Neuropsychiatric syndrome, CVA

A

L asparaginase

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6
Q

Which chemo agent?

Neurotoxicity: Acute encephalopathy, leukoencephalopathy (with XRT)

A

MTX

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7
Q

What is the neurotoxicity effect of ifosphamide?

A

encephalopathy, This drug also causes hemorrhagic cystitis.

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8
Q

Which chemo agent?

Neurotoxicity: acute cerebellar dysfunction

A

fluorouracil

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9
Q

Which chemo agent?

Neurotoxicity: Leukoencephalopathy

A

Fludarabine

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10
Q

Which chemo agent?

Neurotoxicity: Distal sensory polyneuropathy, cold intolerance

A

Oxaliplatinum – very common (74% mild, 2% severe)

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11
Q

Which chemo agent?

Neurotoxicity: Peripheral sensory polyneuropathy, ototoxicity (20%), optic neuropathy (Rare)

A

Cisplatinum - common, dose-dependent, large sensory nerves

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12
Q

Which chemo agent?

Neurotoxicity: Peripheral sensory polyneuropathy, Ototoxicity (5-10%)

A

carboplatinum - less common/severe than cis or oxaliplatinum

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13
Q

Cisplatinum affects which nerves in a peripheral poly

A

large sensory nerves

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14
Q

Which chemo agent?

Neurotoxicity: sensory/motor peripheral neuropathy (60% mild, 4% severe)

A

Paclitaxel (Taxol) - common, dose-dependent, dose-limiting.

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15
Q

Which chemo agent?

Neurotoxicity: sensory/motor peripheral neuropathy (49% mild, 3% severe)

A

Decetaxel (Taxotere) - less common and less severe than taxol (paclitaxel)

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16
Q

Which chemo agent?

Neurotoxicity: Peripheral sensory/motor polyneuropathy, autonomic neuropathy, cranial nerve palsy, encephalopathy

A

Vincristine - almost 100%, dose-dependent

17
Q

Which chemo agent?

Neurotoxicity: sensory peripheral polyneuropathy

A

Vinorelbine - common (25% mild, 1% severe)

18
Q

Which chemo agent?

Neurotoxicity: Sensory motor axonal polyneuropathy

A

Thalidomide - common, dose-dependent

19
Q

Which chemo agent?

Neurotoxicity: sensory peripheral polyneuropathy (36%) and autonomic neuropathy (11%)

A

Bortezomib (Velcade) - very common, painful, dose dependent/limiting.

20
Q

Which non-opioid is centrally acting with low affinity for mu-opioid receptors which also inhibits reuptake of NE and sertonin.

Max dose?

A

Tramadol

Max dose: 400mg/day

21
Q

Name the step 2 opioids of the WHO analgesic ladder

A

“weak” - codeine, hydrocodone, oxycodone

+ tramadol

22
Q

Name the step 3 opioids of the WHO analgesic ladder

A

morphine, oxycodone, methadone, levorphanol, fentanyl

Morphine is agent of choice

23
Q

Of the NSAIDs used to treat cancer pain, which has the lease incidence of thrombocytopenia?

A

Ketoralac

24
Q

Conversion of morphine from IV:PO

A

10 —> 30mg or 3

25
Q

MEthadone conversion from IV to PO

A

10 –> 20mg or 2

26
Q

Hydromorphone conversion from IV to PO

A

1.5 –> 7.5 or 5

27
Q

Meperidine (demerol) conversion from IV to PO

A

75 –> 300 or 4

28
Q

Levorphanol (Levo-Dromoran) conversion from IV to PO

A

2 –> 4 or 2

29
Q

Codeine conversion from IV to PO

A

130 –> 200 or 1.5

30
Q

Name the three mixed agonist-antagonists for treatmetn of cancer pain

A

Pentazocine (Talwin)
Nalbuphine (Nubain)
Butorphanol (Stadol)

31
Q

Conversion of Pentazocine (Talwin) from IV to PO

A

60 –> 180mg or 3.

32
Q

Which of the step 2 opioids can be given per IV?

A

Codeine 50mg q4-6h

33
Q

Which step 3 opioids are not recommended for routine use?

A

IV meperidine, methadone, levorphanol.

34
Q

Name the four more accepted medications for cancer n/v.

A

serotonin receptor antagonists:

zofran (ondansetron), Kytril (granisetron), Anzemet (dolasetron), and Aloxi (palonesetron)

Advantages over conventional antiemetics such as metoclopramide include lack of extrapyramidal efects, akathisia, and other CNS effects.

PM&R Pharm Cards (6 decks)

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