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CSO Exam 2022 > Chemotherapies, etc > Flashcards

Chemotherapies, etc Flashcards

1
Q

Bendamustine (Treanda)

A

Alkylating agent

IV

B-cell NHL, CLL

M, N, V, fatigue, hypersensitivity rxn, tumor lysis syndrome

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2
Q

Busulfan (Myleran or Busulfex)

A

Alkylating agent

IV

CML, HCT prep, polycythemia vera

M, N, V, D, mucositis, pulmonary symptoms, insomnia, dizziness, anxiety, alopecia

hepatic and adrenal insufficiency

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3
Q

Carboplatin (Paraplatin)

A

Alkylating agent

IV

Breast, cervix, endometrium, ovaries, bladder, esophagus, H&N, lung, sarcomas, germ cell

M, N, V, hypersensitivity rxn, mild alopecia

hypomagnesia, peripheral neuropathy, renal toxicity

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4
Q

Carmustine (BCNU)

A

Alkylating agent OR considered nitrosourea

IV

Brain, HD, NHL, MM, cutaneous T-cell lymphoma

M, N, V

Hepatic, renal and pulmonary toxicity

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5
Q

Chlorambucil (Leukeran)

A

Alkylating agent

Oral

CLL, HD, NHL, cancers of breast, ovaries and testes

N, V, skin rash, seizures in children

hyperuricemia, pulmonary toxicity

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6
Q

Cisplatin (Platinol, CDDP)

A

Alkylating agent

IV

H&N, esophagus, lung, stomach, ovaries, testes, cervix, bladder; NHL

M, N, V (acute and delayed), metallic taste

Renal toxicity, SIADH, ototoxicity (hearing loss), hypersensitivity rxn, peripheral nueropathy

hypomagnesemia, low calcium, hypokalemia

HYDRATION, receives fluids before and after infusion, must produce 250 mL urine before administration (SMH)

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7
Q

Cyclophosphamide (Cytoxan, CTX)

A

Alkylating agent

IV, oral, intrapleural

CLL, HD, NHL, MM, mycosis fungoides, lung, breast, endometrium, ovaries and testes, neuroblastoma, Wilms’, sarcomas

M, N, V, SIADH, alopecia

Bladder and cardiac toxicity

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8
Q

Dacarbazine (DTIC)

A

Alkylating Agent

IV

medullary thyroid, sarcoma, neuroblastoma, malignant melanoma, HD

M, N, V, flu-like symptoms (fever, chills)

CNS toxicity (neuroblastoma), photosensitivity (Melanoma)

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9
Q

Ifosfamide (Ifex)

A

Alkylating Agent

IV

H&N, Lung, bladder, cervix, germ cell, HD, NHL, sarcoma

M, N, V, anorexia, SIADH, alopecia

Bladder toxicity (hemorrhagic cystitis, dysuria), Neurotoxicity (seizure, lethargy)

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10
Q

Mechlorethamine (nitrogen mustard)

A

Alkylating agent

IV

CLL, CML, HD, NHL, mycosis fungoides, breast and lung

M, N, V, hyperuricemia, alopecia

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11
Q

Melphalan (Alkeran)

A

Alkylating agent

IV, oral

Breast, ovarian, neuroblastoma, polycythemia vera, MM, HCT prep

M, N, V, D, mucositis, hypersensitivity rxn

ice chips 30 mins before infusion to reduce risk of mucositis

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12
Q

Oxaliplatin (Eloxatin)

A

Alkylating agent

IV

M, N, V, D

Neurotoxicity (cold sensitivity, peripheral neuropathy, esophageal dysethesia (pins and needles/ discomfort)
Hepatic toxicity

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13
Q

Temozolomide (Temodar)

A

Alkylating Agent

Oral

astrocytoma, glioblastoma

M, N, V, D, headache, rash, constipation, photosensitivity, hepatic toxicity

Take on an empty stomach

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14
Q

Thiotepa (Thioplex)

A

Alkylating Agent

IV, IM, IT, SC

HD, NHL. bladder, breast, ovarian

M, N, V, mucositis, skin changes (bronzing of the skin)

Renal toxicity

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15
Q

Azacitidine (Vidaza)

A

Antimetabolite (acts as false metabolite, S- phase)

SC, IV

CML, MDS

M, N, V, D, fatigue, constipation

hypokalemia, renal toxicity

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16
Q

Capecitabine (Xeloda)

A

Antimetabolite (acts as false metabolite, S- phase), Pyrimidine antagonist

oral- take with food

Esophagus, pancreas, rectum, colon, mBreast

M, N, V, D, fatigue, increased bilirubin

Hand Foot syndrome

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17
Q

Cytarabine (ARA-C)- think blood

A

Antimetabolite (acts as false metabolite, S- phase), Pyrimidine antagonist

IV, SC, IT, IM

ALL, AML, Acute promyeloctic leukemia (APL), CML, NHL

M, N, V, mucositis, anorexia, acute pancreatitis, conjunctivitis, keratitis (inflamed cornea)

Neuro, hepatic, and pulmonary toxicity

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18
Q

Fludarabine (fludara)

A

Antimetabolite (acts as false metabolite, S- phase)

IV

CLL, NHL, acute leukemias

M, N, V, D

neurotoxicity

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19
Q

Fluorouracil (5- FU)

A

Antimetabolite (acts as false metabolite, S- phase), Pyrimidine antagonist

IV, topical

H&N, thymic, neuroendocrine, breast, stomach, GI, pancreas, hepatobiliary, colon and rectum, cervix, unknown primary

M, N, V, D, mucositis, taste changes, photosensitivity, cardiac toxicity

ice chips 30 mins before infusion to reduce risk of mucositis

hand foot syndrome

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20
Q

Gemcitabine (Gemzar)

A

Antimetabolite (acts as false metabolite, S- phase), Pyrimidine antagonist

IV

lung, breast, sarcoma, pancreas, ovaries, bladder, NHL

M, N, V, rash, flu-like symptoms

pulmonary toxicity

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21
Q

Hydroxyurea (Hydrea)

A

Antimetabolite (acts as false metabolite, S- phase)

Oral

H&N, ovaries, blood disorders, CML

M, N, V, D, mucositis

darkening or thickening of the nails

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22
Q

Mercaptopurine (6-MP)

A

Antimetabolite (acts as false metabolite, S- phase)

oral- NO dairy

ALL, APL, lymphoma, ulcerative colitis/ Crohn’s

M, N, V, D, mucositis

hepatic toxicity, hyperuricemia

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23
Q

Methotrexate (MTX)

A

Antimetabolite (acts as false metabolite, S- phase)

IM, IV, IT, Oral

H&N, osteosarcoma, breast, bladder, NHL, ALL, rheumatoid arthritis

M, N, mucositis- oral and GI ulcerations, photosensitivity

Renal and hepatic toxicity

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24
Q

Pemetrexed (Alimta)

A

Antifolate antimetabolite (acts as false metabolite, S- phase)

IV

lung cancer, mesothelioma

M, N, V, D, fatigue, rash

***Folic acid and vitamin B12 are used to minimize some of the side effects of pemetrexed.

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25
Q

Thioguanine (6- TG)

A

Antimetabolite (acts as false metabolite, S- phase)

Oral

AML, CML

M, N, V, D, mucositis

hepatic and renal toxicity

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26
Q

Bleomycin (Blenoxane)

A

Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis)

IV, SC, IM

H&N, melanoma, squam skin cancer, cervix, vulva and testes, HD, NHL, malignant pleural effusions

hyperpigmentation, nail and skin changes, hypersensitivity infusion rxn

pulmonary and renal toxicity

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27
Q

Dactinomycin (Actinomycin D)

-think peds

A

Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis)

IV

Ewing Sarcoma, rhabdomyosarcoma, Wilms tumor, testicular cancer

M, N, V, D, mucositis, anorexia, alopecia

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28
Q

Mitomycin- C (Mutamycin)

A

Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis)

IV

H&N, esophagus, lung, stomach, pancreas, bladder, anus

M, N, V, D, mucositis, anorexia, alopecia

pulmonary and renal toxicity

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29
Q

Daunorubicin (Daunomycin)

A

Anthracycline Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis)

IV

ALL, AML, APL

M, N, V, D, mucositis, anorexia, hyperuremia, red urine, hyperpigmentation, alopecia

cardiotoxicity

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30
Q

Doxorubicin (Adriamycin)

A

Anthracycline Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis)

IV

squam H&N, lung, breast, stomach, liver, ovaries, prostate, sarcomas, NHL, HD, MM, ALL, AML

M, N, V, D, mucositis, anorexia, hyperpigmentation, red- orange urine, alopecia

cardiotoxicity, hand foot syndrome

avoid black cohosh

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31
Q

Doxorubicin Liposomal (Doxil)

A

Anthracycline Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis)

IV

Aids- related kaposi sarcoma, breast, ovaries and other solid tumors

M, N, V, D, mucositis, hyperpigmentation, alopecia, red- orange urine, infusion rxn

cardiotoxicity, hand foot syndrome

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32
Q

Epirubicin (Ellence)

A

Anthracycline Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis)

IV

Breast

M, N, V, D, mucositis, red urine, alopecia, skin rash

cardiotoxicity

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33
Q

Idarubicin (Idamycin)

A

Anthracycline Antitumor Antibiotic (blocks cell division by messing up DNA/ preventing RNA synthesis)

IV

AML, ALL, CML, MDS

M, N, V, D, mucositis, red urine, alopecia, elevation of liver enzymes

cardiotoxicity, hand foot syndrome

34
Q

Etoposide (Vespid, VP-16)

A

Epidophyllotoxin (Damages cells in late S/ early G2 phase, inhibits topoisomerase II)

IV, Oral

lung, stomach, uterus, bladder, prostate, germ cell, HD/ NHL

M, N, V, mucositis, anorexia, hypersensitivity rxn, alopecia, orthostatic HTN, yellowing of skin and eyes

metallic taste at infusion, Diarrhea ***

35
Q

Teniposide (Vumon, VM- 26)

A

Epidophyllotoxin (Damages cells in late S/ early G2 phase, inhibits topoisomerase II)

IV

childhood ALL

M, N, V, hypotension, pulmonary toxicity

36
Q

Paclitaxel (Taxol)

A

Taxane (M-phase, microtubule agent that prevents mitosis)

IV

H&N, esophagus, lung, breast, pancreas, ovaries, prostate, bladder

M, N, V, D, mucositis, alopecia, hypersensitivity rxn

arthralgia/ myalgia, peripheral neuropathy, swelling of feet and ankles

37
Q

Docetaxel (Taxotere)

A

Taxane (M-phase, microtubule agent that prevents mitosis)

IV

H&N, lung, breast, stomach, pancreas, bladder, ovaries, prostate, sarcomas

M, N, V, D, mucositis, hair and skin changes, alopecia, hypersensitivity rxn, peripheral neuropathy

fluid retention syndrome

avoid black cohosh

38
Q

Paclitaxel Protein Bound (Abraxane)

A

Taxane (M-phase, microtubule agent that prevents mitosis)

IV

NSCLC, breast, pancreas

M, N, V, D, mucositis, alopecia, eye problems, peripheral neuropathy

arthralgia/ myalgia, swelling of the feet and ankles

39
Q

Vincristine (Oncovin)

A

Vinca Alkaloid (bind to protein tubulin, disrupt mitotic spindle formation, prevent mitosis)

IV

brain and thyroid cancers, neuroblastoma, Wilms’, Ewing Sarcoma, rhabdomyosarcoma, ALL, AML, HD, NHL

M, N, mucositis, taste changes, SIADH, hypersensitivity rxn, alopecia

abd cramps, constipation, jaw pain

40
Q

Vinblastine (Velban)

A

Vinca Alkaloid (bind to protein tubulin, disrupt mitotic spindle formation, prevent mitosis)

IV

H&N, lung, breast, testes, bladder, sarcomas, ND, NHL, blood disorders

M, mucositis, stomatitis (sore mouth), HTN, alopecia

constipation, taste changes, jaw pain

41
Q

Vinorelbine (Navelbine)

A

Vinca Alkaloid (bind to protein tubulin, disrupt mitotic spindle formation, prevent mitosis)

IV

NSCLC, breast, ovaries, HD

M, N, V, stomatitis, anorexia, alopecia, transient elevated liver function tests

Constipation

42
Q

Targeted Therapy

A

Specific to tumor type or concentrate on a genetic change

falls into 2 categories- acts on specific genes or proteins in cancer cells OR acts on tissues/ environment r/t cancer growth

ex: Monoclonal antibodies and small- molecule drugs

43
Q

Targeted Therapy Side Effects

A

Different side effects than chemo/ RT

vascular, coagulatory, dermatologic, immunologic, ocular, pulmonary toxicities

44
Q

Monoclonal Antibodies

A

Target specific receptors on the outside of the cell to disrupt cell function and cause apoptosis

used alone of in conjunction with other therapies, can be used as vehicles for radioactive molecules (tositumomab)

includes immune checkpoint inhibitors like pembrolizumab (keytruda) and nivolumab (Opdivo)

45
Q

BRAF V600E

A

Cell growth signaling protein

46
Q

CD20

Ibrutumomab (Zevalin)

A

B-lymphocyte antigen CD20

IV

NHL, follicular lymphoma

M, Asthenia (weakness), infections, mild N/V, cough, dyspnea, infusion rxn

47
Q

CD20

Rituximab (Rituxan)

A

B-lymphocyte antigen CD20

IV

NHL, CLL

M, mild N/V, tumor lysis syndrome, possible infusion rxn, skin rxn

48
Q

EGFR

Cetuximab (Erbitux)

A

epidermal growth factor receptor

IV

mColorectal, NSCLC, squam H&N, squam skin

N, V, D, anorexia, pulmonary toxicity, skin rash, pruritis, possible infusion rxn

hypomagnesemia

49
Q

EGFR

Panitumumab (Vectibix)

A

epidermal growth factor receptor

IV

colorectal

Diarrhea, pulmonary toxicity, acneiform skin rash, pruritis, possible infusion rxn, malaise

hypomagnesemia

50
Q

ERBB2

Pertuzumab (Perjeta)

A

human epidermal growth factor receptor 2

IV

ERBB2+ breast cancer

M, N, V, D, rash, possible infusion reaction

51
Q

ERBB2

Trastuzumab (Herceptin)

A

human epidermal growth factor receptor 2

IV

ERBB2+ breast cancer, gastric cancer

M (rarely), N, V, D (all mild), cardiotoxicity, pulmonary toxicity, possible infusion rxn

52
Q

ERBB2

Ado- trastuzumab emantansine (Kadcyla)

A

human epidermal growth factor receptor 2

IV

ERBB2+ metastatic breast cancer

M, N, peripheral neuropathy, increased liver enzymes, decreased serum potassium, possible infusion rxn

53
Q

PD-1/ PD- L1

Ipilimumab (Yervoy)

A

programmed cell death ligand 1

IV

melanoma

N, V, D, anemia, rash, pruritis, pulmonary symptoms

54
Q

PD-1/ PD- L1

Nivolumumab (Opdivo)

A

programmed cell death ligand 1

IV

melanoma, NSCLS, renal cell cancer

M, N, V, C, colitis, pruritis, pulmonary symptoms, pneumonia

hyponatremia, hypokalemia, hypomagnesemia

55
Q

PD-1

Pembrolizumab (Keytruda)

A

programmed cell death ligand 1, for tumors that express PD-L1

IV

melanoma, NSCLC, squam H&N, endometrial

Anemia, N, pruritis, pulmonary symptoms, increased liver enzymes

hyponatremia, hypoalbuminemia, hyperglucemia

56
Q

RANKL

Denosumab (Xgeva OR Prolia)

A

receptor activated nuclear factor KappaB ligand

IV

Xgeva: bone mets, giant cell tumor of the bone
Prolia: osteoporosis with high risk of fracture

N, V, D, hypocalcemia, osteonecrosis of the jaw

57
Q

CD52

Alemtuzumab (Campath)

A

IV

CLL

M, N, V, poss infusion rxn

58
Q

VEGF

A

Vascular endothelial growth factor- small molecule drug, angiogenesis inhibitor
recognizes and binds to VEGF, thus stopping it from activating the VEGF receptor. This action helps to arrest endothelial cell proliferation and angiogenesis

59
Q

Side Effects of Monoclonal Antibodies

A

infusion related symptoms- flushing, chills, fever, fatigue, headache, dyspnea, HTN/ hypotension

Muscular-skeletal side effects like aches and pains

skin- related changes like rash, facial erythema, hand foot syndrome

GI effects- mouth sores, N, V, D, decreased appetite

60
Q

Small Molecule Drugs

A

Protein targeted agents or angiogenesis inhibitors

PTA- Uses small molecules that penetrate malignant cell membranes to interact with specific areas of the target proteins

AI- hinder formation of new blood vessels in primary and metastatic tumors

61
Q

Side Effects of Angiogenesis Inhibitors

A

HTN, arterial thromboembolic events (MI, stroke, angina), nosebleeds, hematuria, GI bleeding, vaginal bleeding, GI perforation

Some people can develop hypothyroidism

Proteinuria occurs in 1/3 of patients treated with bevacizumab

62
Q

Immunotherapy

A

AKA biotherapy or biological therapy

treatment to boost or restore the ability of the immune system to fight cancer infection

consists of substances made by the body or made in a lab

Ex. monoclonal antibodies, small molecule drugs or long lasting cancer vaccines (HPV and Hep-B)

63
Q

Tyrosine Kinase Inhibitors

A

Tyrosine kinases are involved in tumor growth, angiogenesis, and metastasis

Ex. Imatinib (Gleevac), Crizotinib (Xalkori), Erlotinib (tarceva- avoid green tea)

64
Q

mTOR Inhibitors

A

Mammalian target of rapamycin (mTOR) inhibitors: block angiogenesis by preventing the release of vascular endothelial growth factor (VEGF) and platelet- derived growth factor (PDGF), thus blocking tumor cell proliferarion and causing cell death

Ex. Temsirolimus (Torisel), Everolimus (affinitor)

65
Q

Proteasome Inhibitors (think MM)

A

Inhibit breakdown of intracellular proteins and disrupt the proteasome pathway

Ex. Bortezomib (Velcade- MM, mantle cell lymphoma)

66
Q

BRAF Inhibitors

A

target the mutant form of BRAF protein

Ex. Vemurafenib (Zelboraf)

67
Q

Bevacizumab (Avastin)

A

mColorectal cancer, NSCLC, mBreast, glioblastoma, mrenal cell cancer

generalized weakness, pain, abdominal pain, N, V, reduced appetite, upper respiratory infection, low white cell count

68
Q

Lenalidomide (Revlimide)

A

Ubiquitin E3 Ligase cereblon- interacts with and targets this enzyme to degrade Ikaros transcription factors IKZF1 and IKZF3.

Inhibits angiogenesis, tumor secreted cytokines, and tumor proliferation

MM, mantle cell lymphoma, MDS

N, V, C, D, rash, tiredness, fever, itching

69
Q

Thalidomide (Thalomid)

A

Mechanism not fully understood- inhibits tumor angiogenesis and pro-inflammatory tumor secreted cytokines (TNF- a, IL1B, IL-6)

MM, RCC, glioblastoma multiforme

headache, dizziness, drowsiness, weakness, anxiety, agitation, confusion, tremors, muscle weakness, wt gain or loss, rash, dry skin

70
Q

Nonspecific Immunotherapy

A

stimulates broad immune response

fatigue, N, V, D, flu- like symptoms, fever, chills, headache, arthralgias/ myalgias

Ex. Interferon- A, Interleukin-2

71
Q

Chimeric Antigen Receptor T-cell Therapy (CAR-T)

A

Collects patients own T-cell lymphocytes and uses them to treat cancer.

Obtained through apheresis, genetically modded in a lab to have a CAR site on surface so they can recognize antigens on targeted tumor cells

S/E: cytokine release syndrome (N, headache, chills fatigue) and neuro symptoms like confusion, aphasia, weakness and seizures

72
Q

Hormone Therapy

A

AKA endocrine therapy is used to treat horomone sensitive cancers

  • stopping or reducing the body’s ability to produce hormones
  • interfering with or blocking hormone receptors
  • substituting chemically similar agents for active hormones but that can’t be used by the tumor
73
Q

Selective Estrogen Receptor Modulators (SERMs)

A

nonsteroidal antiestrogen agents that compete with estrogen for binding to estrogen receptors

Ex: Tamoxifen citrate (Novaldex), Toremifene (Fareston), raloxifene (Evista)

74
Q

SERM indications and side effects

A

Tamoxifen/ Toremifene: breast cancer
Raloxifene: osteoporosis or post- meno atrisk for breast cancer

Menstrual symptoms (hot flashes, sweating, nausea, menstrual irregularities, mood changes, dec libido, fatigue), thromboembolic complications, skin changes, rash, joint aches and pains

fluid retention and peripheral edema

wt gain

75
Q

Aromatase Inhibitors

A

Block production of estrogen by inhibiting conversion of adrenal androgens to estrogen.

primarily used in post menopausal women because pre-menopausal produce too much aromatase to block.

used for breast cancer

ex anastrozole (arimidex), letrozole (femara), exemaestane (Aromasin)

76
Q

Aromatase inhibitor side effects

A

hot flashes, arthralgias, mild N/V, asthenia, thromboembolic events, HTN (letrozole), fever, malaise, myalgias

77
Q

Progesterones

A

possess antiestrogenic effects and inhibit the stability, availability and turn over of estrogen receptors

Ex. Megace (megesterol acetate)

Used in breast, endometrial, renal cell cancers

Prescribed as an app stimulant in cancer and HIV/ AIDS

78
Q

Progesterone side effects

A

Wt gain (fluid retention)
thromboembolic events
N/V
menstrual bleeding, hot flashes, sweating and mood change

hyperglycemia

79
Q

Antiandrogens

A

These bind to androgen receptors and block the effects of testosterone in androgen- sensitive cancer cells

Ex. Bicalutamide (casodex), Flutamide (Eulexin)

used to treat prostate cancer

80
Q

Antiandrogen side effects

A

Wt gain

hot flashes, fatigue

decreased libido, impotence

bone pain

81
Q

What are Luteinizing Hormone-releasing Hormone (LHRH) agonists

A

synthetic proteins which are similar to naturally occurring LHRH and signal the pituitary to stop producing luteinizing hormone. This results in the suppression of testosterone to manage the growth and spread of prostate cancer.

Can also be used to suppress ovarian function by interfering with ovarian signals to the pituitary to produce estrogen

Ex. Leuprolide acetate (Lupron) and goserelin (Zoladex)

82
Q

LHRH agonist side effects

A

hot flashes, fatigues, headaches

bone pain, muscle weakness

decreased libido, impotence

gynecomastia

CSO Exam 2022 (9 decks)

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