cancer drugs Flashcards

1
Q

dose limiting toxicity

A

toxicity that may result in a dosage decrease or treatment delay or discontinuation

ex myelosuppression

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2
Q

hallmark toxicity

A

a toxicity that is significant or unique for a particular drug

not always dose-limiting

ex. teratogenicity, hair loss

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3
Q

cyclophosphamide, ifosfamide MOA

A

alkylating agents

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4
Q

HMT of alkylating agents

A

hemorrhagic cystitis (s/s of UTI)

hydrate before & after therapy! urinate frequently!

mesna may help

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5
Q

cisplatin, carboplatin, oxiplatin MOA

A

platinum agents

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6
Q

cisplatin HMT & special info

A

N/V

significant!!! pretreat & hydrate

delayed hypersensitivity

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7
Q

carboplatin HMT & special info

A

myelosuppression

dosed based on area under the curve

delayed hypersensitivity

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8
Q

oxaliplatin HMT & special info

A

peripheral neuropathy exacerbated by cold

prolonging admin way help

delayed hypersensitivity

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9
Q

methotrexate MOA

A

folate analog - inhibits DHFR which depletes cofactors for thymidylate and purine synthesis

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10
Q

methotrexate HMT & special info

A

myelosuppression, mucositis & diarrhea, nephrotixicity

interactions w bactrim & NSAIDs
Leucovorin helps with HMTs
keep urine pH >7 to help w nephrotox

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11
Q

5-FU & capecitabine MOA

A

pyrimidine analogs

nucleoside analaogs

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12
Q

5-FU HMT & special info

A

stomatitis, diarrhea

drug interactions w warfarin
leucovorin helps enhance efficacy and toxicity

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13
Q

capecitabine HMT & special info

A

hand-foot syndrome

PO
counsel about hand-foot syndrome! can get worse

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14
Q

6-mercaptopurine MOA ?????

A

purine analog

converted to inactive metabolite by xanthine oxidase

allopurinol inhibits xanthine oxidase, so we must decrease the dose of 6-mercaptopurine if using allopurinol

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15
Q

vincristine MOA

A

vinca alkaloid - bind to tubulin and block polymerization into microtubules

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16
Q

vincristine HMT & special info

A

peripheral toxicity

fatal if given intrathecally –> dispense in mini-bags

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17
Q

paclitaxel MOA

A

microtubule-damaging agent

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18
Q

paclitaxel HMT & special info

A

complete alopecia

hypersensitivity - pre-med w dexamethasone, benadryl, H2antagonist

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19
Q

ironotecan MOA

A

camptothecin analog

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20
Q

ironetecan HMT & special info

A

delayed diarrhea

loperamide 4mg at onset then 2mg q2

UGT1A1 mutation

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21
Q

doxorubacin MOA

A

anthracycline

22
Q

doxorubicin HMT & special info

A

delayed cardiotoxicity

baseline EF before tx
maximum lifetime dosage 550mg/m2

23
Q

lenalidomide MOA

A

anti-angiogenesis agent

24
Q

lenalidomide HMT & special info

A

fatigue

REMS program b/c high risk of teratoginicity

increased risk of DVT/PE w dexamethasone

25
Q

protein kinase inhibitors special info

A

many drug-drug interactions!!!

CYP3A4

26
Q

osimertinib & cetuximab MOA

A

EGFR inhibitor

27
Q

osirmertinib & cetuximab HMT & special info

A

rash - wear sunscreen & protective clothing
cardiomyopathy

teratogenic

28
Q

Imatinib MOA

A

BCR-ABL inhibitor

29
Q

imatinib HMT & special info

A

edema

dizziness & blurred vision - caution driving

30
Q

alectinib MOA

A

ALK inhibitor

31
Q

alectinib HMT & special info

A

elevated CPK - monitor q 2 weeks!

32
Q

Dabrafenib & trametinib MOA

A

BRAF V600 E mutation

33
Q

Dabrafenib & trametinib HMT & special info

A

decreased LVEF
MUGA scan before tx, 1 mo post, q 2-3 mos

must be used together!

34
Q

niraparib MOA

A

PARP inhibitor

35
Q

niraparib special considerations

A

dose adjust for weight <77kg or plts <150

36
Q

pazopanib& bevacizumab MOA

A

VEGEF inhibitor

37
Q

pazopanib & bevacizumab HMT & special considerations

A

hypertension, bleeding

use in caution w pt w HTN or MI/stroke

38
Q

bortezomib MOA

A

protease inhibitor

39
Q

bortezomib HMT & special info

A

peripheral neuropathy

SQ route decreases incidence

40
Q

palbociclib MOA

A

cycllin-dependent kinas inhibitor

41
Q

palbociclib HMT & special info

A

infection

give in combo w aromatase inhibitor

42
Q

rituximab MOA

A

CD 20 - targeted antibody

43
Q

rituximab HMT & special info

A

infusion rxn

start at slow rate then advance

44
Q

trastuzumab MOA

A

HER2/neu positive treatment

45
Q

trastuzumab HMT

A

ventricular dysfunction

do not administer concurrently w anthracyclines
baseline echo

46
Q

pembrolizumab & nivolumab MOA

A

anti-PD-1 monoclonal antibodies

47
Q

pembrolizumab & nivolumab HMT

A

immune-mediated toxicities

tx w steroids

48
Q

CAR-T therapies special info

A

premedicate w diphenhydramine & avoid steroids

49
Q

male most common & most lethal cancers

A

prostate, lung, colorectal

lung, prostate, colorectal

50
Q

female most common and most lethal cancers

A

breast, lung, colorectal

lung, breast, colorectal