Chemo Flashcards

Question

CytoSTAR

Answer 1

CyTARABINE Forms: IV IntraThecal - GIVE RIGHT AWAY Indications: AML Meningeal LEUKEMIA

Answer 2

FludaraBINE Forms: IV ONLY *SIGNIFICANT IMMUNOSUPP* “AIDS IN A BOTTLE” Neurotoxicity (IRREVERSIBLE BLINDNESS)

Answer 3

Forms: IV,IM, SUBQ SE: pulmonary fibrosis - (CXR) Skin TOXICITY No more than 400 units of lifetime doses

Answer 4

DoxoRUBicin/ DaunoRUBicin IRREVERSIBLE CHF - due to IRON ``` Give DEXrazoxane (Zinecard: Fe chelator) PROTECTS AGAINST CARDIOTOXICITY ``` Lifetime DOSAGE: 550mg/m^2 *URINE: RED LIKE RUBY* Extravasation$$

Answer 5

ValRUBicin BLADDER CANCER: intraVESICAL Urine: RED FOR RUBY

Answer 6

- IV ONLY - EXTREME EXTRAVASATION * toxic inhalation of VAPORS * contraindicated w/ active chk pox or HERPES zoster

Answer 7

MitoxANTRONE Indication: Acute leukemias; Prostate cancer; multiple sclerosis. Forms: IV ONLY Urine-EYES: BLUE DISCOLORATION *CARDIOTOXICITY: CHF CARDIOTOXICITY: doxorubicin, daunorubicin, idarubicin, epirubicin, mitoxantrone.

Answer 8

Docetaxel Form: IV ONLY * SEVERE HYPERSENSITIVITY* - premedicate with CORTICOSTEROIDS * FLUID RETENTION/ Pulmonary EDEMA: Lasix * PERIPHERAL NEUROPATHY * HEPATIC * OCULAR ADVERSE EFFECTS

Answer 9

PacliTAXEL IV ONLY Hypersen: premedicAte *Non-PVC piping ONLY* Ethanol in diluent “drunk-like” Disulfram rxn w/ meds: Flagyl *CASTOR OIL ALLERGY AVOID*

Answer 10

Etoposide Forms: PO - capsules IV Caution: *HYPOTENSION* Infuse slowly over 30-60 mins EtopoSIDE (VP-16) - capsules: REFRIGERATE

Answer 11

Forma: IV CAUTION: HYPOTENSION***

Answer 12

Irinotecan: onivyde, camptosar Topotecan: hycamtin Forms: irinotecan IV ONLY TOPOTECAN IV AND PO *I RAN TO THE CAN* ** SEVERE DIARRHEA AND DEHYDRATION** -If early —> atropine If late —> loperamide

Answer 13

VinCRISTINE MOST CNS TOX NEVER GIVE INTRATHECALLY

Answer 14

Most BONE MARROW SUPP

Answer 15

VinOrelBINE Most alopecia Iv ONLY All vinca alkaloids cause PERIPHERAL NEUROPATHY **CONSTIPATION VERY COMMON SO RECOMMENDED TO START WITH A STOOP SOFTENOR

Answer 16

Imatinib mesylate : TK Inhibitor With FOOD

Answer 17

Erlotinib Moa: targets EGFR Treats: lung and pancreatic cancer W/ empty STOMACHE

Answer 18

Lapatinib Treats: *breast cancer* Moa: mixed EGFR and HER-2 (ERBB2) inhibitors Take on EMPTY STOMACH SITTING ON THE CURB, While someone sitting on your lap DI: MAJOR CYP4A4 substrate SE: *DIARRHEA*, $$HAND-FOOT$$ syndrome

Answer 19

Nilotinib Treats: leukemiA - take on EMPTY STOMACHE - watch for QT

Answer 20

Panitumumab Form: IV ONLY MOA: EGFR Inhibitor Treats: colorecal cancer

Answer 21

Cetuximab Form: IV ONLY * USED FOR SOLID TUMORS* SE: Acneiform RASH

Answer 22

Bevacizumab Form: IV ONLY - mix with NS USED FOR SOLID TUMORS MOA: binds to Vascular EndotheliAl Growth Factor (VEGF) SE: GI perforation, hemorrhage, hemoptysis, GI bleeding, CNS hemorrhage, epistaxis

Answer 23

Vorinostat Indication: lymphoma Form: PO ONLY Caution: QT PROLONGATION Moa: Histone Deacetylase Inhibitors

Answer 24

Belinostat Form: IV ONLY MOA: Histone Deacetylase Inhibitors

Answer 25

Romidepsin Treats: Lymphom Form: IV ONLY MOA: Histone Deactylase Inhibitors

Answer 26

HydroxyUREA Treats: chronic myeloid leukemia Sickle cell Anemia Gloves should be worn

Answer 27

Thalidomide BIRTH DEFECTS STEPS PROGRAM

Answer 28

Pomalidomide Used for Multiple myeloma

Answer 29

Tamoxifen Form: tabs; oral sln MOA: Non-steroidal antiestrogen (**SERM**) Dose: 20mg daily AR: Hot flashes, CLOTS, Endometrial cancer, hypercalcemia, cataracts, CONTRAINDICATED WITH WARFARIN THERAPY. SE are like taking estrogen.

Answer 30

Tamoxifen is a prodrug and not activated until converted by CYP2D6 Strong 2D6 Inhibitors: paroxetine, fluoxetine, sertraline, duloxetine, bupropion, amiodarone SUGGEST —> other SSRI’s or Venlafaxine if needed. Switching to aromatase inhibitor would be okay unless woman is premenopausal, which only Tamoxifen treats

Answer 31

Forms: ORAL Treats: 1) decrease risk of breast cancer 2) Osteoporosis Notes: for POST-MEN ONLY ALT to Tamoxifen AR: CLOTS

Answer 32

Raloxefene is less likely to cause UTERINE CANCER, HYSTERECTOMY, or CATARACTS Tamoxifen STIMULATES uterine estrogen receptors while Raloxifene BLOCKS them BBW: **CLOTS**/ STROKES - D/C 72 hrs before

Answer 33

Anastrazole MOA: aromatase INHIBITOR: blocks production of testosterone SE: Hot Flashes, tumor flare, vaginal bleed, Wt gain, Gi upset DI: tamoxifen may decrease levels of AI’s Advantages —> NO INCREASE CALCIUM, CLOTS, OR UTERINE CANCER

Answer 34

Letrozole 2.5mg QD Aromatase INHIBITOR: blocks production of estrogen

Answer 35

Exemestane 25mg QD AROMATASE INHIBITORS: Block production of estrogen

Answer 36

Palbociclib CDK 4/6 Inhibitor —> g1 and s ADDED TO AI’s SE: NEUTROPENIA, PULMONARY EMBOLISM DI: CYP3A substrate

Answer 37

Ribociclib MOA: CDK 4/6 Inhibitor Treats: Hormone receptor + HER-2 - Used in COMBO with Aromatase Inhibitors DI: substrate of CYP3A4

Answer 38

Everolimus MOA: blocks mTOR Treats: Hormone (+) HER-2 (-) They are used along with aromatase Inhibitors

Answer 39

Fulvestrant Forms: IM ONLY MOA: *ESTROGEN RECEPTOR ANTAGONIST Dose: 500mg IM once a month Precaut/ warning: BLEEDING THROMBOCYTOPENIA ANTICOAGULANT USE HEPATIC IMPAIRMENT

Answer 40

Trastuzumab Form: IV ONLY Treats: HER-2 (+) breast cancer Her-2 (+) stomache cancer SE: *FLU-LIKE SYMPTOMS* BBW: CARDIOTOXICITY (CHF) PULMONARY TOXICITY ANAPHYLAXIS OR ANGIOEDEMA

Answer 41

Pertuzumab form: ONLY ONLY MOA: HER-2 receptor antagonist Indication: ALWAYS given in combination with TRAZTUZUMAB and chemo in HER-2 (+) treatment naive patients BBW: CARDIAC FAILURE

Answer 42

Ado-trastuzumab emtansine Form: IV ONLY - NS for dilution BBW: Hepatoxicity, CARDIAC TOX, embryo-fetal toxicity **LAST LINE**

Answer 43

Ixabepilone (PACITAXEL SIMILARITIES) Treats: BC refractory to other meds MOA: pothilone microtuble inhibitor Dosage: IV ONLY, contains CASTOR OIL AND ALCOHOL SPECIAL NOTE: PRETREAT WITH H1 and H2 BLOCKER 1 hour before DI: cyp3A4 substrate; AVOID CYP3A4 inducers and inhibitors

Answer 44

Eribulin mesylate Forms: IV MOA: microtuble inhibitor Indication: patients who have received anthracycline and taxane-based chemotherapy. Also for patients with TRIPLE-NEGATIVE breast cancer

Answer 45

Megestrol Progestin Indication: appetite stimulant in cancer patients Advance breast + endometrial cancer Form: PO MOA: works like female hormone progesterone to make woman hungry during chemo therapy SE: * THROMBOEMBOLISM*, wt gain, HOT-FLASHES

Answer 46

Gosrelin Forms: SUBQ Q 1M or Q3M MOA: LH-RH/GnRH Agonist Indications: PROSTATE, ENDOMETRIOSIS, and Pre-menapausal hormone (+) breast cancer AR: Tumor flare; give antiestrogen: Flutamide, Biclutamide, Nilutamide until starts working. - Pulmonary Embolism and MI

Answer 47

Leuprolide MOA: LH-RH/GnRH AGONIST forms: ELigard DEPOT IM Viadur IMPLANT Lupaneta Pack (co-package with leuprolide depot IM + norethindrone for endometriosis SE: tumor growth AT FIRST. GIVE ANTI-estrogens (Biclutamide, Flutamide,)

Answer 48

Triptorelin MOA: LH-RH AGONIST FORMS: IM Q1M or Q3M

Answer 49

DegaRELIX Form: SUBQ every 28 days MOA: LHRH Antagonist AR: Hot flashes, wt gain, and LFT’s Treats: prostate cancer

Answer 50

BiclutAMIDE ANTI-androgen DI: interacts with WARFARIN SE: diarrhea

Answer 51

Flutamide - WORST DIARRHEA - LIVER DF * yellow-green* discoloration

Answer 52

Nilutamide Anti-androgen used in combo with LHRH AGONIST - Disulfiram like rxn with alcohol - Diminished rxn to darkness: Watch Driving

Answer 53

EnzalutAMiDE -Refractory to other anti-androgens SE: SEIZURES Avoid inducers/inhibitors Warfarin monitoring

Answer 54

Ketoconazole - Reduces levels of test and cortisol - SE: hepatic, gynecomastia, N/V, Rash DI: needs ACIDIC environment CYP3A4 inhibitor

Answer 55

FinasTERIDE Form: oral Indication: prevent PROSTATE CANCER BPH MOA: Inhibits 5-alpha-reductase, the enzyme that converts test —> DHT Studies show that these drugs seem to lower the risk of less aggressive prostate cancers while increasing the risk of more aggressive cancers

Answer 56

DutasTERIDE Indication: Prevention MOA: Inhibits 5-alpha-reductase which converts test to DHT

Answer 57

Sipuleucel-T Vaccine to treat advance prostate cancer that is no longer responsive to hormone therapy. Uses patients immune system to fight against cancer

Answer 58

Pembrolizumab PD-1 inhibitor By blocking PD-1 keytruda allows the immune system to attack its own cancer cells Indications: MELANOMA NON-small cell lung cancer HEAD & neck cancer

Answer 59

Filgrastim (G-CSF) TREATS: chemo induced neutropenic fever/infection

Answer 60

Peg-filgrastim

Answer 61

Oprelvikin Chemo induced thrombocytopenia

Answer 62

Platinum : cis. Carbo, oxali PLATIN Taxanes: taxels Epothilones: ixabepilone (Ixempra) Plant alk: vinblastine, vincristine, vinorelbine, etoposide (VP-16)

Answer 63

1) calcium CARBONATE 2) calcium ACETATE( Phos-Lo, Eliphos, Phoslyra, 3) sevelamer (Renagel, Renvela) 4 Lanthanum(Fosrenol)

Answer 64

Osmotic diuresis which inhibits tubular reabsorption of water and electrolytes and increases urinary output ONCE the IV is made, inspect for crystals. If crystals are present, re-dissolve by warming solution and shaking to dissolve

Answer 65

1) calcium gluconate or calcium chloride to protect the HEART 2) insulin with dextrose to DRIVE Potassium into the cells 3) kay-exalate ( sodium polysterene sulfonate) which will remove excess potassium from the body

Answer 66

Sevelamer Hydrochloride (HCL)

Answer 67

Sevelamer CARBONATE

Answer 68

VinCRISTINE

Answer 69

** 1) IrinoTECAN 2) 5-FU, capecitabine 3)

Answer 70

1) Vincristine | 2) Thalidomide

Answer 71

Letrozole (Femera) Anastrozole (Arimidex) Exemastane (Aromasin) MOA: prevent conversion of androgens to estrogen in women. They are NOT USED in premenopausal women as they have NO activity against breast cancer in presence of functional ovaries

Answer 72

Amiodarone Bleomycin Busulfan MTX

Answer 73

Tamoxifen, Raloxifene, Gosrelin, megestrol