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PT 2 > Chemo > Flashcards

Chemo Flashcards

1
Q

What are the 6 important alkylating agents?

A
  1. Cyclophosphamide
  2. Ifosfamide
  3. Temozolamide
  4. Cisplatin
  5. Carboplatin
  6. Oxaliplatin
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2
Q

MOA and CCS of the alkylating agents

A

MOA - alkylate DNA (N7 of guanine specifically for Cyclo and Ifos)

CCNS

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3
Q

Which alkylating agent needs to be bioactivated?

A

Cyclophosphamide

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4
Q

Which two alkylating agents cause hematuria and how is this addressed?

A

Cyclophosphamide and Ifosfamide

Coadminister with mesna

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5
Q

Alkylating agent - pneumocystis pneumonia

A

Temozolamide

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6
Q

Alklyating agent - administer with hydration and mannitol diuresis

A

Cisplatin

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7
Q

Dosing based on creatinine clearance and AUC target

A

Carboplatin

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8
Q

Acute cold-induced neuropathy + chronic sensory neuropathy

A

Oxaliplatin

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9
Q

Uses for cyclophosphamide (2)

A

Breast

Lymphoma

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10
Q

Uses for Ifosfamide (2)

A

Sarcoma

Testicular

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11
Q

Use for Temozolamide (1)

A

Brain tumors

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12
Q

Uses for Cisplatin and Carboplatin (5)

A 
Bladder
Head and neck
Lung (both)
Ovarian
Testicular
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13
Q

Uses for Oxaliplatin

A

Colorectal
Gastric
Pancreatic

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14
Q

Which 2 alkylating agents have a non-myelosuppression dose limiting toxicity?

A
  1. Cisplatin (renal toxicity)

2. Oxaliplatin (neurotoxicity)

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15
Q

List the 4 plant alkaloids and their MOAs/CCS.

A
  1. Vincristine (prevent tubulin polymerization)
  2. Vinblastine (ditto)
  3. Paclitaxel (prevent tubulin disassembly)
  4. Etoposide (topoisomerase II inhibitor)

All CCS (1-3 = M)

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16
Q

Which plant alkaloid has a non-myelosuppressive dose limiting toxicity

A

Vincristine (neuropathy - sensory and autonomic)

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17
Q

Premedicate this plant alkaloid with steroids to avoid infusion reactions

A

Paclitaxel

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18
Q

Which plant alkaloid is leukemogenic?

A

Etoposide

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19
Q

What are the 2 uses of Vincristine?

A

ALL

NHL

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20
Q

What are the 2 uses of Vinblastine?

A

Breast

Lung

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21
Q

What are the 4 uses of Paclitaxel?

A

Breast
Gastroesophageal
Lung (non)
Ovarian

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22
Q

What are the 3 uses of Etoposide?

A

Lung (small)
Lymphoma
Testicular

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23
Q

What are the three antitumor antibiotics, their MOA, and CCS?

A
  1. Doxorubicin (topoisomerase II inhibitor, CCNS)
  2. Irinotecan (topoisomerase I inhibitor, CCNS)
  3. Bleomycin (binds to DNA, causes breaks, CCS)
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24
Q

Schedule dependent cumulative cardiac toxicity (not dose limiting)

A

Doxorubicin

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25
Q

Acute cholinergic diarrhea treated with atropine, late secretory diarrhea

A

Irinotecan

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26
Q

Cumulative pulmonary toxicity

A

Bleomycin

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27
Q

NO myelosuppression

A

Bleomycin

High dose MTX

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28
Q

4 uses of doxorubicin

A

Breast
Leukemia
Lymphoma (both H/NH)
Sarcoma

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29
Q

1 use of irinotecan

A

GI tract

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30
Q

1 use of bleomycin

A

Testicular

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31
Q

2 uses of prednisone (high dose)

A

Lymphoma

Multiple myeloma

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32
Q

2 uses of dexamethasone

A

Reduce cerebral edema and initial treatment for spinal cord compression

In combination with other drugs to treat chemo-related emesis

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33
Q

Used to block the flare reaction caused by leuprolide acetate?

A

Flutamide

34
Q

What are the 4 anti-metabolites, their MOA, and CCS?

A
  1. MTX (blocks dihydrofolate reductase)
  2. Cytarabine (inhibits DNA polymerase)
  3. 5-FU (conversion to F-dUMP, blocks thymidylate synthetase)
  4. 6-MP (incoporation into DNA)

All CCS (S)

35
Q

Intrathecal administration

A

MTX

Cytosine arabinoside

36
Q

Anti-metabolite with schedule dependent cytotoxicity

A

Cytarabine

37
Q

Cerebellar toxicity

A

High dose cytarabine
(Also hepatic toxicity)

5-FU (ataxia)

38
Q

What is the 3+7 regiment for AML?

A

3 days doxo/daunorubicin + 7 days of continuous infusions of cytarabine

39
Q

Leucovorin enhances cytotoxicity and toxicity

A

5-FU

40
Q

Dihydropyrimidine deficiency

A

5-FU toxicity

41
Q

Hand-foot syndrome

A

5-FU

42
Q

Oral prodrug of 5-FU?

A

Capecitabine

43
Q

Reduce this drug by 50-75% if given with allopurionl

A

6-MP

44
Q

4 uses of MTX?

A

Leukemia
Lymphoma
Psoriasis
RA

45
Q

1 use of Cytarabine?

A

AML

46
Q

3 uses of 5-FU?

A

Breast
GI
Head and Neck

47
Q

1 use of 6-MP?

A

ALL

48
Q

1 use of asparaginase?

A

ALL

49
Q

AE - asparaginase?

A

Allergic reactions, pancreatitis, clots (reduced anti-thrombin III), elevated ALT/AST

50
Q

1 use of hydroxyurea?

A

Emergently decrease high WBC counts in AML

51
Q

2 drugs to treat acute promyelocytic leukemia?

A

All-trans retinoic acid

Arsenic trioxide

52
Q

Symptoms of retinoic acid syndrome

A

Fevers
Pulmonary infiltrates
Dyspnea
Pleural/pericardial effusions

53
Q

AE - arsenic trioxide

A

Retinoic acid syndrome

Prolonged QT

54
Q

MOA - imatinib

A

TK inhibitor

55
Q

2 uses of imatinib

A

CML, GI stromal tumor

56
Q

MOA - cetuximab

A

Inhibits EGFR

57
Q

AE - hypomagnesemia (2)

A

Cetuximab

Cisplatin

58
Q

2 uses of Cetuximab

A

Lung cancer

Metastatic wildtype KRAS/NRAS colorectal cancer

59
Q

MOA of erlotinib

A

Small molecular inhibitor of the TK domain associated with EGFR

60
Q

Metabolized by CYP3A4

A

Imatinib

Erlotinib

61
Q

DoC - metastatic adenocarcinoma with an activating EGFR mutation

A

Erlotinib and NO chemo

62
Q

Rx - Her2Neu breast and gastric cancer

A

Trasuzumab

63
Q

MOA - Trastuzumab

A

Binds to Her2Neu receptor (EGFR)

64
Q

Non-cumulative cardiac toxicity

A

Trastuzumab

65
Q

VEGF inhibitor

A

Bevacizumab

66
Q

AE - reversible posterior encephalopathy syndrome

A

Bevacizumab

67
Q

2 uses of bevacizumab

A

Lung

Metastatic colorectal

68
Q

MOA - crizotinib

A

Binds anaplastic lymphoma kinase

69
Q

DoC - metastatic adenocarinoma with ALK rearrangement

A

Crizotinib

70
Q

BRAFv600e mutation in melanoma

A

Vemurafenib

71
Q

4 drugs with non-myelosuppressive DL toxicity

A

Cisplatin (renal)
Oxaliplatin (neuro)
Vincristine (neuro)
Bleomycin (pulmonary)

72
Q

4 vesicants

A

Vincristine
Vinblastine
Paclitaxel
Doxorubicin

73
Q

2 drugs - dose reduction in renal insufficiency

A

Cisplatin

MTX

74
Q

4 drugs - dose reduction in jaundice

A

Vincristine
Vinblastine
Doxorubicin
Irinotecan

75
Q

1 drug - dose reduction in hepatic disease

A

Paclitaxel

76
Q

1 drug - dose reducation for both hepatic and renal disease

A

Etoposide

77
Q

AE - trichomegaly

A

Cetuximab

78
Q

AE - conjunctivitis (2)

A

High dose MTX

High dose cytosine arabinoside

79
Q

Radiation sensitizer

A

5-FU

80
Q

UG1A1*28 (Gilbert’s syndrome) increases toxicity of what drug

A

Irinotecan

81
Q

This drug does not work without chemo

A

Bevacizumab

82
Q

AE - hyperpigmetnation

A

Bleomycin

5-FU

PT 2 (15 decks)

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