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Pharmacology PaxFlan > chemo drugs > Flashcards

chemo drugs Flashcards

1
Q

common ADRs of chemo drugs

A 
Nausea/Emesis
Anorexia
Alopecia 
Myelosuppression
Secondary malignancies
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2
Q

ways to give chemo

A

IV, oral, intravesical, intraperitoneal

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3
Q

alkylating drugs

A

cyclophosphamide

cisplatin

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4
Q

indications for cyclophosphamide

A
  • CA
  • nephrotic syndrome
  • GPA
  • SLE
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5
Q

cyclophosphamide ADRs

A
  • sterility

- hemorrhagic cystitis *evaluated very aggressively!

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6
Q

cisplatin ADRs

A
  • nephrotoxicity

- ototoxicity

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7
Q

monitoring for cisplatin

A

audiology

renal function

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8
Q

anti-metabolites

A
  • MTX
  • 5-FU
  • cytarabine
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9
Q

MTX ADRs

A
  • stomatitis
  • pulmonary toxicity
  • hepatotoxicity
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10
Q

reversal agents for MTX

A

leucovorin + glucarpidase

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11
Q

MTX interactions

A
  • drugs that affect renal function (diuretics, NSAIDs, cyclosporine)
  • other antimetabolites (TMP-SMX)
  • PIs increase MTX (toxicity)
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12
Q

5-FU ADRs

A
  • stomatitis
  • enterocolitis
  • hyperpigmentation
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13
Q

cytarabine ADRs

A

cytarabine syndrome

cerebellar toxicity

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14
Q

cytarabine syndrome characteristics & when it occurs

A

fever, bone pain, chest pain, MP rash, myalgia, malaise, conjunctivitis
occurs 6-12 hours following administration

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15
Q

how do you manage cytarabine syndrome

A

corticosteroids

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16
Q

chemo antibiotics

A
  • doxorubicin

- bleomycin

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17
Q

doxorubicin baseline monitoring

A

cardiac eval via ECG, MUGA +/- ECHO

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18
Q

doxorubicin ADR

A

cardiotoxicity

radiation recall

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19
Q

who is doxorubicin contraindicated in

A

if LVEF is <30-40%

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20
Q

when can doxorubicin cardiotoxicity present

A

may be delayed for 7-8 years after tx

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21
Q

what is radiation recall

A
  • occurs with doxorubicin in pts who have had prior XRT

- warmth, erythema, dermatitis at prior radiation port –> severe desquamation/ulceration

22
Q

when does radiation recall occur

A

5-7 days after administration of doxorubicin

23
Q

bleomycin ADRs

A
  • rash, striae, induration, hyperkeratosis, vesiculation, peeling = most common on palmar/plantar surfaces
  • acute/chronic interstitial pneumonitis > pulmonary fibrosis
24
Q

major thing to monitor with Bleomycin

A

PFTs, CXR

25
Q

plant alkaloids

A
  • vinblastine

- paclitaxel

26
Q

ADRs of vinblastine

A
  • SIADH
  • hyperuricemia
  • myelosuppression
27
Q

ADRs of paclitaxel

A
  • peripheral neuropathy
  • hypersensitivity rxn
  • myelosuppression
  • arthralgia/myalgia
  • rhythm abnormalities
28
Q

what should you monitor with paclitaxel

A

hypersensitivity rxn

29
Q

what drugs help improve delayed CINV

A

substance P/NK inhibitors (-pitant)

30
Q

what drugs help improve acute CINV

A

serotonin antagonists (-setron)

31
Q

what serotonin agonist is only approved for CINV

A

palonosetron (2nd gen)

32
Q

what is important to remember with serotonin antagonists for CINV

A

SCHEDULE THEM!

33
Q

ADRs of serotonin antagonists

A
  • QTc prolongation

- HA

34
Q

dexamethasone’s role in CINV

A

helps with acute and delayed CINV

for highly emetogenic agents

35
Q

marijuana CINV drugs

A

dronabinol

nabilone

36
Q

dronabinol schedule

A

III

37
Q

nabilone schedule

A

II

38
Q

indication for dronabinol & nabilone

A

tx of CINV that hasn’t responded to other agents

39
Q

EPO stimulating agents (ESAs)

A
  • epoetin alfa
  • darbepoetin alfa
  • peginesatide
40
Q

indications for ESAs

A

anemia in CKD, AZT-tx HIV pts, chemotherapy cancer pts

41
Q

ESA monitoring

A
  • hgb
  • BP
  • transferrin saturation
  • CBC, BUN, K
42
Q

3 big ADR/precautions for ESA

A
  1. ckd pts
  2. cancer pts
  3. major surgery
43
Q

what is the big deal with giving ESA to CKD pts

A

more deaths, more HTN, CHF, progression to HD

44
Q

how to prevent ADRs of ESA in CKD pts

A

keep hgb between 10-12, do not exceed 13

45
Q

what is the big deal with higher Hgb in cancer pts

A

shortened survival, time-to-tumor progression, more thromboembolic events if target hgb was >/= 12

46
Q

how to prevent ADRs of ESAs in cancer pts

A

prescribing and access restrictions to give ESAs to cancer pts (APPRISE oncology program)

47
Q

what is the big deal with ESAs in surgery pts

A

associated with increase DVT after orthopedic surgery

48
Q

how to prevent ADRs of ESAs in orthosurg pts

A

limit dosing to maintain the lowest HgB level needed to avoid transfusions

49
Q

granulocyte-colony stimulating factor

A

Filgastrim

Pegfilgastrim

50
Q

granulocyte-macrophage colony stimulating factor

A

sargramostim

51
Q

indications for CSFs

A

cancer pts receiving myelosuppressive chemo

cancer pts receiving bone marrow transplant

52
Q

ADRs of CSFs

A
  • fever
  • rash/petechiae
  • splenomegaly
  • bone pain
  • myeloid leukemia

Pharmacology PaxFlan (12 decks)

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