Chemo Drugs Flashcards
CYP3A4 inducers May decrease drug activity for example St John’s wort and
Also avoid CYP3A4 inhibitors which may increase drug activity, for example and grapefruit juice , Ketoconazole, and erythromycin be
Axinib (Inlyta) take two times a day, 12 hours apart.
Bortezomib ( velcade)
Exemestane (Aromasin) take after a meal
Dasatinib (Sprycel) don’t crush
Erlotinib (tarceva)
Lapatinib( Tykerb) take on an empty stomach. One hour before or two hours after meals. Take same time everyday with a full glass of water
Everolimus (Afinitor) take same time each day
Tamoxifen (nolvadex) take same time each day
Imatinib mesylate (Gleevec) take with a meal
Sunitinib (sutent)
Sorafenib (Nexavar)
Bexarotene (Targretin)
GRAPEFRUIT JUICE juice may increase concentration and
LIMIT VITAMIN A intake to greater than or equal to 1,500 IU per day to avoid possible ADDICTIVE toxicity with this drug
Take as a single dose with food.
CLUE: The XA =”A”ddictive in Bexarotene ; “Targret” for less than 1500 IU and to avoid grapefruit juice to be safe
Bortezomib ( velcade)
Green tea should be avoided while taking this drug, especially in liquid and capsule forms.
CYP3A4 Inhibitors or inducers may alter this drug activity so monitor closely
Drug can be taking intravenous or subcutaneously
Clue: zombies are green
Busulfan (Myleran)
Side effects are nausea, diarrhea, vomiting, MUCOSITIS
Avoid aspirin while taking this drug
This drug should be taken on an empty stomach.
For chronic leukemia
Clue: bufferin is an aspirin Myleran , M= mucositis
Capecitabine (Xeloda)
Side effects are nausea vomiting and diarrhea and myelosuppression and hand foot syndrome
Altered coagulation may happen when taken with Warfarin so monitor closely.
Vitamin B6 (a dose of 50 to 100 mg, 2 to 3 times a day) may help to prevent or reduce the incidence and severity of hand-foot syndrome.
Clue: tell Bill to take a Loda his feet or could get blood clots..
Take this drug within 30 minutes of a meal with a full glass of water.
Colon and metastatic breast cancers
Cetuximab (Erbitux)
Side effects are nausea vomiting diarrhea and constipation. LOW MAGNESIUM
Monitor magnesium (1.5-2.4) and calcium (8.5-10.2) levels closely.
At-risk population are elderly people who have hypomagnesemia at Baseline, and patients who have received prior treatment with oxaliplatin (Eloxatin)
Monoclonal antibodies/ EGFR
Clue: the peanut character wears a tux. Most nuts are a good source of calcium and magnesium. But peanuts are low in calcium and magnesium. So we would need to monitor these levels in the peanut character to keep his bones strong . And those with colorectal and head and neck cancers should not eat peanuts
Drug for cancers o fColorectal and head and neck
Chlorambucil (leukeran)
Side effects include nausea, vomiting, hyperuricemia (elevated Uric acid in the blood)
There is a risk of toxicity if barbituate have been taken
Take this drug on an empty stomach, either one hour before meals or two hours after meals
Used for pancreatic cancer
Cisplatin (platinol)
Side effects are: nausea, vomiting , METALLIC TASTE and kidney toxicity, LOW MAGNESIUM, Peripheral neuropathy, loss of appetite, taste changes( taste like Platinum)
HYDRATION IS IMPORTANT to prevent nephrotoxicity, MAY NEED IV FLUIDS
Carefully monitor renal function or, <7 BUN ; .
<0.6w or <0.8m creatinine, <1.5 magnesium ,<8.5 calcium, <135 sodium and <3.5 potassium levels.
At-risk elderly, renal pts, and those with hypomagnesemia
OMEGA 3 & TURMERIC & milk thistle ENHANCES BENEFITS
Bladder, cervical, esophageal, head and neck, lung, ovarian,prostate, testicular
Dasatinib (Sprycel)
Type of cancer?
Avoid St John’s wort and phenobarbital which may decrease drug activity
Avoid grapefruit juice ketoconazole and erythromycin which may increase drug activity
Do not crush or cut drug
Deferasiox ( Exjade)
Type of cancer?
If this drug is not fully dissolved it can cause diarrhea
This drug contains lactose. So it may cause diarrhea in lactose intolerant patients
Recommend lactase enzyme supplement with dosing
Dissolve tablets completely in water before taking
Clue: you must try to get the patient to DEFER to using SOIX milk instead of cow milk because this product contains LACTOSE which causes DIARRHEA. If the patient uses this product they must also use a LACTASE ENZYME supplement and completely DISSOLVE this and water before taking it to avoid diarrhea.
Erlotinib ( tarceva)
SIDE EFFECTS nausea, vomiting, diarrhea, low appetite, hand-foot syndrome and rash
NO St John’s Wort or phenobarbital, grapefruit juice or erythromycin
Take on an empty stomach either one hour before meals or two hours after meals. Take same time everyday with a full glass of water.
for pancreatic & lung ca
Tyrosine kinase inhibitor ; targets inside of cell
Clue; Tarzan lives in the jungle where he often has empty stomach for lack of food. Which often causes him nausea vomiting diarrhea rash and Lou appetite. He also uses his hands and feet swing around the jungle. With limited food he eats same time every day and drinks plenty of water.
Everolimus ( afinitor)
Type of cancer?
Drug activity May decrease if taken with st. John’s Wort or phenobarbital
Drug activity may increase of taking with grapefruit juice or erythromycin
Do not chew or Crush
Take once a day at the same time
Fluorouracil ( 5-fu)
Side effects: nausea, vomiting, diarrhea, mucositis
Have patient melt ice chips in their mouth 10 to 15 min pre and post IV infusion to reduce chances of mucositis
Hand -foot syndrome is common, use B6 supplements (50 to 100 mg, 2 to 3 times a day) to avoid this
Clue: it has 5 side effects, nausea, vomiting ,diarrhea mucositis, hand-foot syndrome
(5FU) F=foot, U= u love ice for mUcositis
Breast, colorectal, GI, head and neck, pancreatic, and ovarian
Anti-metabolite, cell cycle specific
Imatinib mesylate (Gleevec)
G i s t
This is a protein targeted therapy
Side effects include, rash, hand-foot syndrome, nausea and vomiting, diarrhea, poor appetite, hair turns White
Avoid St John’s wort and grapefruit juice
Lapatinib ( Tykerb)
Drug activity may increase if grapefruit juice or erythromycin… And St John’s Wort…
Do not chew or crush
Take on an empty stomach either one hour before meals or two hours after meals and take with a full glass of water
Clue: Lapatinib ( TykErb) E= empty stomach
Melphalan (Alkeran)
Side effects include nausea, vomiting, diarrhea, and mucositis
Premedicate with an anti-nausea medication 1 hour before the dose of this medication
Encourage small frequent meals and snacks
Take on an empty stomach either one hour before meals or two hours after meals
Alkylating agent for Breast, & ovarian cancers
Women’s cancers… for Mel(anie) & Keran
Clue: MelphalaN (Alkeran) M= mucositis, N=nausea(premedicate, small frequent meals, and empty stomach)
Mercaptopurine (6- MP)
Side effects include nausea, vomiting, diarrhea and mucositis and hyperuricemia
Avoid consuming Dairy containing foods when taking
Take on an empty stomach 1 hour before meals or two hours after meals
Leukemia’s
Clue: Mercaptopurine, M=mucositis
MP or military police can’t do dairy unless it’s on an empty stomach or they’ll get diarrhea, nausea vomiting mucositis and hyperuricemia
Methotrexate, Folex or Rheumatrex (MTX)
Side effects include nausea, mucositis oral and Gi ulcerations, sensitive to light
Avoid folic acid & alcohol
Take on an empty stomach either one hour before or two hours after meals
Clue: even though you must avoid the sunlight, DON’T TREXs the strip at Carbondale for ALCOHOL & if you sleep around and get pregnant DON’T do FOLIC ACID or you will get nausea oral and GI sores and mucositis
Bladder, breast, and neck
You
Nilotinib ( Tasigna)
Grapefruit juice may increase drug
This drug contains lactose so lactose intolerant patients May experience diarrhea
Recommend lactase enzyme supplement with dosing
Take on an empty stomach with water
Oxaliplatin (Eloxatin)
Side effects include nausea , vomiting, diarrhea, sensitivity to cold, hand- foot syndrome
Minimize exposure to cold for up to 5 days after the infusion by avoiding handling, eating and drinking cold or frozen foods. Sensitivity to cold May persist for longer periods of time with subsequent dosing
CLUE: he loxs the refrigerator to avoid eating cold food, and getting nausea vomiting diarrhea and cold hands and feet
Vitamin B6, a dose of 50 to 100 mg, 2 to 3 times a day, may help to prevent or reduce the severity of hand-foot syndrome
Colorectal, pancreatic, gastroesophageal cancers
This is an alkylating agent, cell cycle non specific
Panitumumab (Vectibix)
Side effects are diarrhea (in the bed pan) and fatigue
Can cause low magnesium, Monitor magnesium levels
Clue: PanituMUMab = MagnesiUM
At-risk are the elderly and patients with low magnesium
For colorectal cancer
Is a monoclonal antibody / EGFR
Pemetrexed (Alimta)
Side effects include nausea, vomiting, diarrhea and fatigue, SEVERE ANEMIA
Clue: Pemetrexed (AlimtA)= AnemiA
To prevent possible SEVERE ANEMIA:
- Folic acid, 350-1000mg, orally should be started at week one before the first treatment daily throughout treatment and post-treatment
- vitamin B12 (1000 mg) injections should be given every three Cycles beginning week one before the first treatment and continually through treatment
For lung cancer and mesothelioma
Procarbazine Hydrochloride ( Matulane)
Side effects are CONSTIPATION, diarrhea, DRY MOUTH
Follow a low tyramine diet when on this and for two weeks after. Tyramine Foods include ALL CAFFEINE AND ALCOHOL, beer, red wine, Sherry, distilled Spirits, brewer’s yeast, Fava beans, raspberries, figs, dried fruits,( raisins and prunes,) avocados, bananas, miso soup, soy sauce, sauerkraut, aged or strong cheese ( cheddar, gruyere, manchego, Gouda, blue, parmesan), anchovies and caviar, beef and chicken livers, meat extract, meat such as sausage, bologna, pepperoni, and salami.
USED FOR BRAIN TUMORS
Regorafenib (Stivarga)
Side effects include anorexia, nausea and vomiting, diarrhea, and mucositis of COLON CA TX
High-fat meals can alter the absorption of drug
Take meals in the morning with a low fat meal that contains less than or equal to 8 grams of fat
Clue: RegoraFenib (Stivarga)= F=low fat (8 letters=8g)
Spiuleucel- T (Provenge)
Avoid caffeine on the day of leukapheresis
Drink more water than usual on the day of treatment
Consume a calcium rich breakfast prior to receiving this treatment
Clue; SpiuleuCel- T =C = avoid Caffeine/eat Calcium
A vaccine for prostate cancer
Streptozocin (Zanosar)
Not sure what type of cancer used
This drug Alters glucose metabolism, or causes HYPOglycemia, and some patients.
This drug is given intravenously
Clue: Streptozocin (ZanosAR)= SugAR
Torisel causes HYPERglycemia
Sorafenib (Nexavar)
Used for liver or kidney ca
Side effects include anorexia, nausea and vomiting, diarrhea , hand-foot syndrome, rash, White hair
Avoid St John’s Wort, phenobarbital, and dexamethasone as they may decrease drug activity
Also avoid CYP3A4 inhibitors which may increase drug activity, for example and grapefruit juice , Ketoconazole, and erythromycin
Take on an empty stomach, either one hour before meals or two hours after meals
Take with a full glass of water
This is a protein targeted therapy, Tyrosine Kinase inhibitor; it targets inside cell
Sunitinib (Sutent)
GIST, renal cell cancer, pancreatic neuroendocrine tumor
This is a protein targeted therapy, Tyrosine Kinase inhibitor; it targets inside cell
Side effects are nausea, vomiting, diarrhea, poor appetite, hand-foot syndrome, rash, hair turns white.
Avoid st. John’s Wort and phenobarbital as it may decrease drug activity
Avoid grapefruit juice, Ketoconazole, and erythromycin is it may increase drug activity
Tamoxifen (Nolvadex)
Anti estrogen agent for breast cancer
Side effects include hot flashes, nausea, vomiting, weight gain, fluid retention, peripheral edema
Avoid st. John’s wort and phenobarbital
Avoid grapefruit juice, Ketoconazole and erythromycin
Avoid antacids within 2 hours of taking the drug
Take at the same time each day
Flaxseed May enhance the efficacy of tamoxifen
Temsirolimus (Torisel)
Not sure for what cancer
Can cause hyperglycemia
Can cause hyper cholesterol
Streptoz (Zanosar) causes hypoglycemia
Temozolomide (Temodar )
For glioblastoma
Side effects include nausea, vomiting, fatigue, headache, photosensitivity, rash
Take at bedtime or on an empty stomach the full glass of water
Do not chew or Crush
Alkylating agent; cell cycle, nonspecific drug
Thalidomide (Thalomid )
Causes constipation, nausea and xerostomia or dry mouth
Drug interactions with barbiturates, chloropromazide and reserpine.
Avoid alcohol
Take at bedtime or after the evening meal
Used for graft-versus-host disease in Hematopoietic Cell Transplantation patients
Angiogenesis inhibitor
Vinblastine (Velban)
Breast, testicular, head and neck cancers
Side effects include mucositis, stomatitis,
SEVERE constipation, hypertension, JAW PAIN
Use stool softeners or laxatives to help prevent severe constipation
Avoid St John’s Wort , dexamethasone and grapefruit juice
Clue: may need stool softeners to BLAST away the SEVERE constipation
Vincristine (Oncovin)
Leukemia, lung cancer, neuroblastoma , Ewing’s sarcoma, Wilms sarcoma, brain and thyroid cancer
Side effects are Severe Constipation, and jaw pain, decreased appetite
To avoid severe constipation take stool softeners and or laxatives
Omega-3 fats - May enhance clinical benefit
Avoid St John’s Wort, phenobarbital, dexamethasone
Avoid grapefruit juice, Ketoconazole, and erythromycin
This is a vinca alkaloid
Zoledronic Acid (Zometa )
Given for bone metastases or bone pain
Patient should take an oral supplement of 500 mg of calcium and 400 IU of vitamin D daily when taking this medication
This is given intravenously
Side effects of Monoclonal Antibodies, or chemotherapy that targets outside the cells
Infusion related symptoms: fever, chills, fatigue
Gastrointestinal: nausea, vomiting, diarrhea. Mild.
Cardiotoxicity: Despina and peripheral edema
Myelosuppression
Pulmonary toxicity
Skin rash and hand-foot syndrome
Side effects of Protein Targeted Therapies, or chemotherapy that targets INSIDE the cell
Nausea, vomiting, diarrhea and poor appetite Rash Hand-foot syndrome Cardiotoxicity Hair turns White Hypertension Bleeding
Names of Protein Targeted Therapies, or chemotherapy that targets INSIDE the cell
Erlotinib or tarceva Gefitinib or Iressa Imatinib or Gleevec Sorafenib or Nexavar Sunitinib or Sutent Temsirolimus or Torisel Everolimus Affinitor Bortezomib or Velcade
Examples of Monoclonal Antibodies, or chemotherapy that targets outside of the cell
Cd20, Ibritimomab (Zevalin) Cd20, Rituximab ( Rituxan) Her 2 Neu, Pertuzumab ( Perjeta) Her 2 Neu, Trastuzumab ( Herceptin) Her 2 Neu, Ado- Trastuzumab (Kadcyla) EGFR, Cetuximab (Erbitux) EGFR, Panitumumab (Vectibix) RANKL, Denosumab (Xgeva) RANKL, Denosumab (Prolia)
What do angiogenesis Inhibitors type of chemotherapy do
They hinder the formation of new blood vessels
What are the possible side effects of Angiogenesis Inhibitor type chemotherapy?
Hypertension Heart attack, angina, stroke Protein urea, especially with bevacizumab Bleeding GI perforation Hypothyroidism… VEGF, Bevacizumab (Aviston) Lenalidomide (revlimid) CLUE: Matt's brother lives in Aviston. He has a pig farm. Eating pigs gives these side effects eggs are a protein. you poke a pig
What are examples of Angiogenesis Inhibitor type chemotherapy
VEGF, Bevacizumab (Aviston) - proteinuria is common
Lenalidomide (revlimid)
Thalidomide
What are cytokines
A type of biotherapy chemotherapy that stimulates a broad-based immune response
What are the possible side effects of cytokines
Flu like symptoms like fever, chills, headache arthralgias and myalgias
Fatigue and anorexia
Anemia
Nausea, vomiting and diarrhea
Renal insufficiency and CAPILLARY LEAK SYNDROME
What are examples of Cytokine Therapies?
Interleukin-2 or IL-2 (Aldesleuken)
Interferon-a (Roferon or Intron A)
What are examples of selective estrogen receptor modulators or anti estrogens?
These are hormonal agents
Tamoxifen citrate or nolvadex
Toremifene citrate or Fareston
Raloxifene or Evista
The first two are used for breast cancer
Third is used for osteoporosis or postmenopausal women at risk for breast cancer
Side effects include hot flashes, sweating, nausea, vomiting, weight gain, fluid retention
What are examples of the hormonal agents called aromatase inhibitors?
Anastrozenole or Arimidex
Letrozole or femara
Exemestane or Aromasin
These drugs are used for breast cancer
What are the side effects of aromatase Inhibitors used for postmenopausal breast cancer
Hot flashes Mild nausea and vomiting Blood clots Fever and fatigue Joint and muscle aches and pains
High cholesterol with Letrozole
These cause bone loss so take calcium and vitamin D if deficient
