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2023 CSO Exam Studying > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

Verzenio (abemaciclib) taken by mouth for breast cancer. What should you inform your patient of.

A

Most common side effect is diarrhea
Other: nausea, vomiting, consitpation, mucositis, anorexia

take by mouth at the same time each day, with or without food

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2
Q

AC : Adriamycin (doxorubicin) + Cytoxan (cyclophosphamide)

A

Breast
most common: nausea/vomiting

less common: diarrhea, mucositis, anorexia

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3
Q

Doxorubicin (Adriamycin)

Part of AC for breast cancer and RCHOP

A

liver, lung, ovaries, prostate, gastric, NHL< HL, MM, ALL, AML, SCC, head/neck, sarcoma

most notable: nausea and vomiting

less notable: diarrhea, mucositis, anorexia

Other: red urine, cardiac toxicity, hand-foot

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4
Q

Cyclophosphamide (Cytoxan)

A

Lung, ovaries, testes, CLL, NHL, MM, part of AC for breast and RCHOP

most notable: nausea, vomiting

less notable: anorexia, diarrhea, mucositis

Toxicities: Cardiac, SIADH, Bladder/hemorrhagic cystitis –> hydration (3 L oral/day), empty bladder Q3 hr when awake—> Mensa given with high doses to prevent hemorragic cycstitis

increases effect of anticoagulants–> may need to be decreased

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5
Q

ABVD: Adriamycin (doxorubicin), bleomycin, vinblastine, dacarbazine

A

Hodgkin lymphoma
most common: nausea, vomiting, constipation

less common: diarrhea, mucositis, anorexia, taste changes

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6
Q

Doxorubicin (Adriamycin)

Part of AC for breast cancer and RCHOP

A

liver, lung, ovaries, prostate, gastric, NHL< HL, MM, ALL, AML, SCC, head/neck, sarcoma

most notable: nausea and vomiting

less notable: diarrhea, mucositis, anorexia

Other: red urine, cardiac toxicity, hand-foot

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7
Q

Bleomycin (Blenoxan)

A

HD, NHL, head/neck, squamous cell cancers of skin, cervix, vulva, testes, melanoma, malignant pleural effusions

most notable: mucositis
less notable: n/v, anorexia

toxicities: pulmonary, renal

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8
Q

Vinblastine (Velban)

A

Bladder, breast, testes

mucositis, stomatitis, constipation taste changes

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9
Q

Methotrexate (MTX)

A

NHL, ALL, bladder, breast, head/neck, osteosarcoma, gastric, lung

most notable: mucositis, GI ulcerations
less notable: nausea, anorexia, diarrhea, vomiting

Avoid folic acid during treatment (per old book) Avoid alcohol

Toxicities: renal, hepatic

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10
Q

DTIC (dacarbazine)

A

HD, melanoma, neuro, sarcomas, medullary thyroid cancer

side effects: nausea, vomiting, anorexia

Toxicity: central nervous system

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11
Q

Armidex (anastrozole)

A

Breast Cancer

most common: increased appetite, weight gain

less common: nausea, vomiting

long-term: decreased bone mineral density and hyperlipidemia

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12
Q

Tecentriq (atezolizumab)

A

metastatic urothelia, NSCLC, breast, melanoma

most notable: diarrhea

less notable: anorexia, nausea, constipation, vomiting

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13
Q

Bexoratene (Targretin)

A

Oral med, take with foods

Interactions: grapefruit juice increases concentrations and toxicities

Limit Vit A to < or equal to 1,500 IU/day to avoid possible drug toxicity

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14
Q

Inlyta (axitinib)

A

PO for advanced renal cell

most notable- diarrhea

less notable: anorexia, n/v, constipation, heartburn, HTN

CYP3A4 inducers (decrease drug activity)–> St.Johns Wort, Phenobarbital

CYP3A4 inhibitors (increase drug activity)–> grapefruit juice, Ketocanozole, erythromycin

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15
Q

Vidaza (azacitidine)

A

CML, MDS

most notable: nausea, diarrhea, constipation

less notable: vomiting, anorexia

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16
Q

Bendeka or Treanda (bendamustine)

A

B-cell lymphoma, NHD, CLL

Nausea, vomiting, diarrhea

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17
Q

Temozolomide (Temodar)

A

PO-Take on an empty stomach (1 hour before or 2 hours after meals or at bedtime) to reduce stomach upset.

astrocytoma, glioblastoma, brain tumors

More notable- nausea, diarrhea, taste changes
less notable- anorexia, mucositis

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18
Q

Sorafenib (Nexavar)

A

PO- without food 1-2 hours before eating

Renal cell, Thyroid, hepatocellular

more notable- diarrhea
less notable- anorexia, nausea, vomiting, constipation

CYP3A4 inducers (decrease drug activity)–> St.Johns Wort, Phenobarbital , dexamethasone

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19
Q

Tarceva (Erlotinib)

A

PO- on empty stomach–> 1 hour before or 2 hours after eating

metastatic NSCLC, unresectable pancreatic

side effects: diarrhea, n/v, poor appetite, fatigue

CYP3A4 inducers (decrease drug activity)–> St.Johns Wort, Phenobarbital

CYP3A4 inhibitors (increase drug activity)–> grapefruit juice, Ketocanozole, erythromycin

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20
Q

Tamoxifen (Novaldex)

A

PO- same time each day with full glass of water

Breast and ovarian

nausea

Milk Thistle should be used with caution

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21
Q

Avastin (bevacizumab)

biosimilar= Mvasi

A

metastatic colorectal, breast, renal cell, glioblastoma, NSCLC

Nutrition side effects: abdominal pain, nausea, vomiting, anorexia, mucositis, diarrhea, constipation

other: HTN

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22
Q

Imatinib (Gleevec)

A

PO- with large glass of water after a meal
If pills are hard to swallow, pt may dissolve in apple juice, then followup by large glass of water

CML, gastrointestinal stromal tumor (GIST), MDS, ALL

most notable: nausea and vomiting
Less notable: diarrhea, anorexia, constipation

CYP3A4 inducers (decrease drug activity)–> St.Johns Wort, Phenobarbital

CYP3A4 inhibitors (increase drug activity)–> grapefruit juice, Ketocanozole, erythromycin

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23
Q

Palbociclib (Ibrance)

A

PO- whole with water within 30 min of meal

postmenopausal breast, ER+, HER2- advanced

more notable: nausea, diarrhea
less notable: mucositis, anorexia, vomiting

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24
Q

Capecitabine (Xeloda)

A

PO- after food within 30 min of meal

Colorectal, breast, esophageal, gastric, hepatobiliary, NET, pancreatic, ovarian, falopian, peritoneal

most notable: diarrhea, mucositis

less notable: n/v, anorexia, constipation

Notes: altered coagulation when taken with warfarin–> monitor closely
Vit B6 (50-100 mg) 2-3x/day may reduce incidence and severity of hand-foot syndrome

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25
CAPOX: capecitabine (xeloda), Oxaliplatin
Colorectal most notable: diarrhea, cold sensitivity, mucositis less notable: abdominal cramping, anorexia, n/v, taste changes
26
Carboplatin (Paraplatin)
breast, bladder, cervix, esophagus, Head/neck, lung ovarian, sarcoma most notable: nausea, vomiting, taste changes less notable: diarrhea, constipation, mucositis other: hypomagnesemia, renal toxicity
27
Cisplatin (Platinol, CDDP)
Bladder, cervix, esophagus, head and neck, lung, prostate, ovaries, gastric, testes, HNL Major side effect: nausea and vomiting less notable: taste changes, anorexia other: rigorous oral hydration is necessary to prevent nephrotoxicity. causes low magnesium, low calcium, low potassium, SIADH, ototoxicity, peripheral neuropathy Elderly, those with impaired renal function and hypomagnesmia at baseline are at risk. Mannitol may be given with Cisplatin to reduce renal toxcitity
28
Carfilzomib (Kyprolis)
MM most notable- diarrhea less notable: n/v, constipation, anorexia
29
Carmustine (BCNU)
Brain, HL, NHL, MM, cutaneous T-cell lymphoma nutrition side effects: nausea, vomiting toxicities: renal, hepatic, pulmonary
30
Cetuximab (Erbitux)
metastatic colorectal, NSCLC, squamous cell of head/neck and skin most notable: Nausea, vomiting, diarrhea, anorexia less notable: mucositis ***Monitor serum magnesium and calcium levels closely for drops*** --> at risk populations are elderly and those who have previously been on oxaliplatin Toxicity: pulmonary
31
CyBorD Cyclophosphamide- IV or PO Bortezomid- IV Dexamethazone - PO
MM most notable: Nausea, vomiting less notable: diarrhea, mucositis, xerostomia, constipation, anorexia other: hyperglycemia
32
Cyclophosphamide (Cytoxan)
Lung, ovaries, testes, CLL, NHL, MM, part of AC for breast and RCHOP most notable: nausea, vomiting less notable: anorexia, diarrhea, mucositis Toxicities: Cardiac, SIADH, Bladder/hemorrhagic cystitis --> hydration (3 L oral/day), empty bladder Q3 hr when awake---> Mensa given with high doses to prevent hemorragic cycstitis increases effect of anticoagulants--> may need to be decreased
33
Velcade (bortezomid)
MM, mentle cell lymphoma most notable: diarrhea Less notable: fatigue, n/v, constipation, anorexia other: neuropathy food drug interactions: Avoid green tea especially in capsule form, CYP3A4 inhibitors/inducers may alter drug activity (St.Johns Wort, Grapefruit juice)
34
Dexamethasone (Decadron)
used to prevent allergic reactions, treatment of nausea, used in leukemia, lymphoma, MM hyperglycemia, increased appetite, insomnia, heartburn, muscle weakness
35
RCHOP Rituxan, Cytoxan, Adriamycin (doxorubincin), Oncovin, and Prednisone
NHL most notable: nausea, constipation Less notable: mouth sores, xerostomia, diarrhea, taste changes, anorexia
36
Rituximab (Rituxan) part of RCHOP
NHL, CLL mild nausea, vomiting
37
Cyclophosphamide (Cytoxan)
Lung, ovaries, testes, CLL, NHL, MM, part of AC for breast and RCHOP most notable: nausea, vomiting less notable: anorexia, diarrhea, mucositis Toxicities: Cardiac, SIADH, Bladder/hemorrhagic cystitis --> hydration (3 L oral/day), empty bladder Q3 hr when awake---> Mensa given with high doses to prevent hemorragic cycstitis increases effect of anticoagulants--> may need to be decreased
38
Doxorubicin (Adriamycin) Part of AC for breast cancer and RCHOP
liver, lung, ovaries, prostate, gastric, NHL< HL, MM, ALL, AML, SCC, head/neck, sarcoma most notable: nausea and vomiting less notable: diarrhea, mucositis, anorexia Other: red urine, cardiac toxicity, hand-foot
39
Vincristine (Oncovin)
leukemia, HL, NHL constipation (may need stool softeners), abdominal cramps, nausea, taste changes, mucositis CYP3A4 inducers (decrease drug activity)--> St.Johns Wort, Phenobarbital CYP3A4 inhibitors (increase drug activity)--> grapefruit juice, Ketocanozole, erythromycin
40
Prednisone (Deltazone) part of RCHOP
Hyperglycemia, increased appetite, heartburn, insomnia, muscle weakness, impaired wound healing
41
Cytarabine (Cytostar-U, ARA-C)
ALL, AML, CML, NHL side effects: n/v, mucositis, anorexia, acute pancreatitis Toxicities: neuro (lethargy, confusion), hepatic, pulmonary
42
Daratumumab (Darzalex)
MM Nausea, anorexia, diarrhea, minimal risk for vomiting
43
Denosumab (Prolia and Xgeva)
Prolia- osteoporosis with high fracture risk xgeva- bone mets nausea, vomiting, diarrhea, hypocalcemia, osteonecrosis of jaw
44
Doxorubicin liposomal (Doxil)
AIDS related Kaposi's sarcoma, breast, ovarian, other solid tumors most notable: mucositis less notable: nausea, vomiting, diarrhea Other: red/orange urine, cardiotoxicity, hand-foot
45
Etoposide (Vepesid, VP-16)
lung, testicular, bladder, prostate, gastric, uterine, HL, NHL, brain tumors, Ewing's Sarcoma side effects: nausea, vomiting, mucositis, diarrhea, metallic taste during infusion interactions: grapefruit and exotic oranges (Seville oranges, blood oranges)
46
Everolimus (Affinitor)
Renal, pancreatic, neuroendocrine, ER+ advanced breast most notable: mucositis, esophagitis less notable: diarrhea, N/V, anorexia PO, with or without food CYP3A4 inducers (decrease drug activity)--> St.Johns Wort, Phenobarbital CYP3A4 inhibitors (increase drug activity)--> grapefruit juice, Ketocanozole, erythromycin
47
Exemestane (Aromasin)
breast side effects: increased appetite, mild nausea, osteoporosis
48
Filgrastim (Neupogen and Zarxio)
Neutropenia prevention--> stimulates WBC production side effect: nausea
49
Fulvestrant (Faslodex)
breast nutrition related side effects not common but may include: N/V, constipation, diarrhea
50
Hydroxyurea (Hydrea)
PO- with water, may be dissolved in water CML, essential thrombocytosis, melanoma, head and neck with radiation, refractory ovarian side effects: N/V, diarrhea, mucositis, anorexia
51
Ipilimumab (Yervoy)
Melanoma most notable: diarrhea less notable: N/V
52
Lanreotide (somatuline depot injection)
Gastrointestinal, pancreatic, and neuroendocrine tumors side effects: nausea, diarrhea
53
Lenalidomide (Revlimid)
PO: Swallow whole with water MM, mentle cell lymphoma, MDS most notable: diarrhea less notable: N/V, constipation
54
Lenvatinib (Lenvima)
PO- with water, may be dissolved in water with or without food Renal, thyroid, hepatocellular, advanced endometrial most notable: diarrhea, nausea, vomiting less notable: anorexia, mucositis, constipation, taste changes, dry mouth other: HTN
55
Letrozole (Femeara)
PO- with or without food Breast increased appetite, wt gain other: osteoporosis
56
Leuprolide (Lupron Depot)
Prostate, breast, ovarian, endometrial no nutrition related side effects
57
Mitomycin-C (mutamycin)
Anus, bladder, breast, esophagus, head/neck, lung, pancreas, stomach nausea, vomiting, mucositis, diarrhea, anorexia Toxicities: pulmonary, renal
58
Nivolumab (Opdivo)
Melanoma, NSCLC, renal, classic HL, recurrent SCC of head and neck, SCLC, heptocellular, esophageal, gastric most notable: diarrhea, colitis less notable: N/V, constipation
59
Novaldex (Tamoxifen)
PO- with water, same time each day breast, ovarian nausea Avoid antacids within 2 hours of taking CYP3A4 inducers (decrease drug activity)--> St.Johns Wort, Phenobarbital CYP3A4 inhibitors (increase drug activity)--> grapefruit juice, Ketocanozole, erythromycin
60
TCHP Taxotere (doxetaxel) Carboplatin Herceptin Perjeta
Breast more notable: nausea, diarrhea, taste changes less notable: anorexia, mucositis
61
Docetaxol (Taxotere) part of TCHP
Bladder, breast, lung, prostate, stomach, Head and neck most notable: diarrhea less notable: nausea, vomiting, mucositis other: peripheral neuropathy
62
Carboplatin (Paraplatin)
breast, bladder, cervix, esophagus, Head/neck, lung ovarian, sarcoma most notable: nausea, vomiting, taste changes less notable: diarrhea, constipation, mucositis other: hypomagnesemia, renal toxicity
63
Pertuzumab (Perjeta) part of TCHP
breast nausea, vomiting, taste changes, anorexia
64
Trastuzumab (Herceptin or Kanjinti) Part of TCHP
HER2+ breast, gastric most notable: diarrhea Less notable: nausea, vomiting toxicities: cardio, pulmonary
65
Paclitaxel (Taxol)
Breast, ovarian, lung, bladder, prostate, melanoma, esophageal most notable: diarrhea less notable: N/V, mucositis other: swelling of feet and ankles, peripheral neuropathy NO MILK THISTLE
66
Paclitaxel protein bound (Abraxane)
Pancreas, breast, NSCLC, ovarian, fallopian, peritoneal more notable:N/V, diarrhea, mucositis, anorexia Less notable: constipation, taste alterations
67
Panitumumab (Vectibix)
Colorectal diarrhea, nausea, vomiting
68
Pegfilgrastim (Neulasta) biosimilar (Ziextenzo)
neutropenia prevention; stimulate WBC production side effects: bone pain,
69
Pembrolizumab (Keytruda)
Melanoma, NSCLC, SCC, head and neck, endometrial more notable: diarrhea Less notable: nausea, vomiting, constipation, anorexia
70
Pemetrexed (Alimta)
Lung, mesothelioma Nausea, vomiting, diarrhea, mucositis Note: Folic acid (350-1000 ug PO 1 week prior to 1st treatment, continue daily throughout and post treatment. Vit B12 1000 ug IM given every 3 cycles begin 1 week prior to treatment.
71
Procarbazine (Mutulane)
PO HL, NHL, MM, melanoma, lung more notable: nausea, vomiting less notable: anorexia, mucositis, constipation, diarrhea Note: Low-tyamine diet needed to prevent Hypertensive crisis
72
Foods that should be avoided if a patient is taking Procarbazine (Mutulane)
aged fermented foods:cheeses, yeast or meat extracts, fava or broad bean pods, smoked or picked meat, poultry, or fish, fermented sausage ( bologna, sausage, pepperoni), unfresh meat, or over-ripe fruit. No alcohol, do not drink large amounts of caffeine- coffee, tea, chocolate
73
Regorafenib (Stivarga)
PO with low fat meal <30% of calories coming from fat colorectal and heptocellular carcinoma decreased appetite, nausea, mucositis, other: increased liver enzymes, hand-foot syndrome, decreased sodium, decreased calcium and phos
74
Some examples of an appropriate breakfast for a patient taking Regorafenib (Stivarga)
2 slices of white toast with 1 tablespoon of low-fat margarine and 1 tablespoon of jelly, and 8 ounces of skim milk (319 calories and 8.2 grams of fat) or 1 cup of cereal, 8 ounces of skim milk, 1 slice of toast with jelly, apple juice, and 1 cup of coffee or tea (520 calories and 2 grams of fat)
75
Gemcitabine (Gemzar)
pancreas, lung, ovary, breast, bladder, NHL, sarcoma most notable: nausea, vomiting, and diarrhea less notable: mucositis, anorexia Toxicity: Pulmonary
76
FOLFOX Folinic acid (Leucovorin) Flourouracil (5-FU) Oxaliplatin
Colorectal Nausea, vomiting, diarrhea, mucositis, anorexia, taste changes, cold sensitivity
77
Folinic acid (Leucovorin) "FOL" in FOLFOX, FOLFIRINOX, and FOLFIRI
Colorectal, Head and neck, esophageal, GI cancers N/V- rare used to rescue from Methotrexate toxicity
78
Fluorouracil (5-FU) Part of: FOLFOX, FOLFIRINOX, and FOLFIRI
Colorectal, gastrointestinal, head and neck, pancreas, stomach, ovaries, and unknown primary most notable side effects: diarrhea, mucositis less notable: N/V, taste changes, anorexia Other: cardiotoxicity, hand-foot sydnrome Notes: cyrotherapy for bolus to reduce mucositis Vit B6 (50-100mg) 2-3 x/day may reduce hand/foot syndrome
79
Oxaliplatin (Eloxatin) part of FOLFIRINOX, FOLFOX
Colorectal, pancreatic most notable: N/V, cold intolerance, laryngopharyngeal dysethesia less notable: diarrhea, anorexia, mucositis, constipation other: neurotoxicity (neuropathy), hepatic toxicity other: Vit B6 (50-100mg) 2-3 x/day may reduce hand/foot syndrome
80
FOLFIRI Folinic acid (Leucovorin) Flourouracil (5-FU) Irinotecan (Campostar)
Colorectal Nausea, vomiting, diarrhea, mucositis, anorexia, taste changes
81
Irinotecan (Campostar) part of : FOLFIRI, and FOLFIRINOX
metastatic colon/rectum most notable: diarrhea less notable: N/V, anorexia, taste changes, mucositis, constipation toxicity- hepatic
82
FOLFIRINOX Folinic acid (Leucovorin) Flourouracil (5-FU) Irinotecan (Campostar) Oxaliplatin
Pancreatic nausea, vomiting, diarrhea, mucositis, anorexia, taste changes, cold sensitivity
83
St. Johns wort should be avoided with these chemotherapy agents.
Imatinib (Gleevec) and irinotecan
84
Milk thistle should be avoided with these chemotherapy agents
Rifampicin, Erlotinib, Paclitaxel
85
These two oral chemotherapies need to be taken on an empty stomach 1 hour before meal or 2 hours after.
Tarceva and Temodar and Nexavar
86
Mannitol
given with Cisplatin to reduce renal toxicity
87
These chemotherapy agents should be taken after food or meal (within 30) minutes of eating.
Capecitabine (Xeloda), Imatinib (Gleevec), and Palbociclib (Ibrance), Bexartoten (Targentin)
88
These need to be taken on an EMPTY stomach
Erlotinib (Tarceva) Temozolomid (Temodar) Sorafenib (Nexavar) Chlorabucil (Leukeran) Busulfan (Myleran Oral Methotrexate Dabrafenib (Tafinlar)
89
These need to be taken on am empty stomach, 1 hour before or 2 hours after eating
Tarceva, Temodar, Nexavar

2023 CSO Exam Studying (32 decks)

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