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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
Q

CAPOX: capecitabine (xeloda), Oxaliplatin

A

Colorectal

most notable: diarrhea, cold sensitivity, mucositis

less notable: abdominal cramping, anorexia, n/v, taste changes

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26
Q

Carboplatin (Paraplatin)

A

breast, bladder, cervix, esophagus, Head/neck, lung ovarian, sarcoma

most notable: nausea, vomiting, taste changes

less notable: diarrhea, constipation, mucositis

other: hypomagnesemia, renal toxicity

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27
Q

Cisplatin (Platinol, CDDP)

A

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

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28
Q

Carfilzomib (Kyprolis)

A

MM

most notable- diarrhea

less notable: n/v, constipation, anorexia

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29
Q

Carmustine (BCNU)

A

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

nutrition side effects: nausea, vomiting

toxicities: renal, hepatic, pulmonary

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30
Q

Cetuximab (Erbitux)

A

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

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31
Q

CyBorD
Cyclophosphamide- IV or PO
Bortezomid- IV
Dexamethazone - PO

A

MM

most notable: Nausea, vomiting

less notable: diarrhea, mucositis, xerostomia, constipation, anorexia

other: hyperglycemia

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32
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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33
Q

Velcade (bortezomid)

A

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)

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34
Q

Dexamethasone (Decadron)

A

used to prevent allergic reactions, treatment of nausea, used in leukemia, lymphoma, MM

hyperglycemia, increased appetite, insomnia, heartburn, muscle weakness

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35
Q

RCHOP
Rituxan, Cytoxan, Adriamycin (doxorubincin), Oncovin, and Prednisone

A

NHL

most notable: nausea, constipation
Less notable: mouth sores, xerostomia, diarrhea, taste changes, anorexia

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36
Q

Rituximab (Rituxan)
part of RCHOP

A

NHL, CLL

mild nausea, vomiting

37
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

38
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

39
Q

Vincristine (Oncovin)

A

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
Q

Prednisone (Deltazone)

part of RCHOP

A

Hyperglycemia, increased appetite, heartburn, insomnia, muscle weakness, impaired wound healing

41
Q

Cytarabine (Cytostar-U, ARA-C)

A

ALL, AML, CML, NHL

side effects: n/v, mucositis, anorexia, acute pancreatitis

Toxicities: neuro (lethargy, confusion), hepatic, pulmonary

42
Q

Daratumumab (Darzalex)

A

MM

Nausea, anorexia, diarrhea, minimal risk for vomiting

43
Q

Denosumab (Prolia and Xgeva)

A

Prolia- osteoporosis with high fracture risk
xgeva- bone mets

nausea, vomiting, diarrhea, hypocalcemia, osteonecrosis of jaw

44
Q

Doxorubicin liposomal (Doxil)

A

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
Q

Etoposide (Vepesid, VP-16)

A

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
Q

Everolimus (Affinitor)

A

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
Q

Exemestane (Aromasin)

A

breast

side effects: increased appetite, mild nausea, osteoporosis

48
Q

Filgrastim (Neupogen and Zarxio)

A

Neutropenia prevention–> stimulates WBC production

side effect: nausea

49
Q

Fulvestrant (Faslodex)

A

breast

nutrition related side effects not common but may include: N/V, constipation, diarrhea

50
Q

Hydroxyurea (Hydrea)

A

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
Q

Ipilimumab (Yervoy)

A

Melanoma

most notable: diarrhea
less notable: N/V

52
Q

Lanreotide (somatuline depot injection)

A

Gastrointestinal, pancreatic, and neuroendocrine tumors

side effects: nausea, diarrhea

53
Q

Lenalidomide (Revlimid)

A

PO: Swallow whole with water

MM, mentle cell lymphoma, MDS

most notable: diarrhea
less notable: N/V, constipation

54
Q

Lenvatinib (Lenvima)

A

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
Q

Letrozole (Femeara)

A

PO- with or without food
Breast

increased appetite, wt gain

other: osteoporosis

56
Q

Leuprolide (Lupron Depot)

A

Prostate, breast, ovarian, endometrial

no nutrition related side effects

57
Q

Mitomycin-C (mutamycin)

A

Anus, bladder, breast, esophagus, head/neck, lung, pancreas, stomach

nausea, vomiting, mucositis, diarrhea, anorexia

Toxicities: pulmonary, renal

58
Q

Nivolumab (Opdivo)

A

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
Q

Novaldex (Tamoxifen)

A

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
Q

TCHP
Taxotere (doxetaxel)
Carboplatin
Herceptin
Perjeta

A

Breast

more notable: nausea, diarrhea, taste changes
less notable: anorexia, mucositis

61
Q

Docetaxol (Taxotere)

part of TCHP

A

Bladder, breast, lung, prostate, stomach, Head and neck

most notable: diarrhea

less notable: nausea, vomiting, mucositis

other: peripheral neuropathy

62
Q

Carboplatin (Paraplatin)

A

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
Q

Pertuzumab (Perjeta)

part of TCHP

A

breast

nausea, vomiting, taste changes, anorexia

64
Q

Trastuzumab (Herceptin or Kanjinti)
Part of TCHP

A

HER2+ breast, gastric

most notable: diarrhea
Less notable: nausea, vomiting

toxicities: cardio, pulmonary

65
Q

Paclitaxel (Taxol)

A

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
Q

Paclitaxel protein bound (Abraxane)

A

Pancreas, breast, NSCLC, ovarian, fallopian, peritoneal

more notable:N/V, diarrhea, mucositis, anorexia
Less notable: constipation, taste alterations

67
Q

Panitumumab (Vectibix)

A

Colorectal

diarrhea, nausea, vomiting

68
Q

Pegfilgrastim (Neulasta)

biosimilar (Ziextenzo)

A

neutropenia prevention; stimulate WBC production

side effects: bone pain,

69
Q

Pembrolizumab (Keytruda)

A

Melanoma, NSCLC, SCC, head and neck, endometrial

more notable: diarrhea
Less notable: nausea, vomiting, constipation, anorexia

70
Q

Pemetrexed (Alimta)

A

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
Q

Procarbazine (Mutulane)

A

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
Q

Foods that should be avoided if a patient is taking Procarbazine (Mutulane)

A

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
Q

Regorafenib (Stivarga)

A

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
Q

Some examples of an appropriate breakfast for a patient taking Regorafenib (Stivarga)

A

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
Q

Gemcitabine (Gemzar)

A

pancreas, lung, ovary, breast, bladder, NHL, sarcoma

most notable: nausea, vomiting, and diarrhea

less notable: mucositis, anorexia

Toxicity: Pulmonary

76
Q

FOLFOX
Folinic acid (Leucovorin)
Flourouracil (5-FU)
Oxaliplatin

A

Colorectal

Nausea, vomiting, diarrhea, mucositis, anorexia, taste changes, cold sensitivity

77
Q

Folinic acid (Leucovorin)

“FOL” in FOLFOX, FOLFIRINOX, and FOLFIRI

A

Colorectal, Head and neck, esophageal, GI cancers

N/V- rare

used to rescue from Methotrexate toxicity

78
Q

Fluorouracil (5-FU)

Part of: FOLFOX, FOLFIRINOX, and FOLFIRI

A

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
Q

Oxaliplatin (Eloxatin)

part of FOLFIRINOX, FOLFOX

A

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
Q

FOLFIRI
Folinic acid (Leucovorin)
Flourouracil (5-FU)
Irinotecan (Campostar)

A

Colorectal

Nausea, vomiting, diarrhea, mucositis, anorexia, taste changes

81
Q

Irinotecan (Campostar)

part of : FOLFIRI, and FOLFIRINOX

A

metastatic colon/rectum

most notable: diarrhea
less notable: N/V, anorexia, taste changes, mucositis, constipation

toxicity- hepatic

82
Q

FOLFIRINOX
Folinic acid (Leucovorin)
Flourouracil (5-FU)
Irinotecan (Campostar)
Oxaliplatin

A

Pancreatic

nausea, vomiting, diarrhea, mucositis, anorexia, taste changes, cold sensitivity

83
Q

St. Johns wort should be avoided with these chemotherapy agents.

A

Imatinib (Gleevec) and irinotecan

84
Q

Milk thistle should be avoided with these chemotherapy agents

A

Rifampicin, Erlotinib, Paclitaxel

85
Q

These two oral chemotherapies need to be taken on an empty stomach 1 hour before meal or 2 hours after.

A

Tarceva and Temodar and Nexavar

86
Q

Mannitol

A

given with Cisplatin to reduce renal toxicity

87
Q

These chemotherapy agents should be taken after food or meal (within 30) minutes of eating.

A

Capecitabine (Xeloda), Imatinib (Gleevec), and Palbociclib (Ibrance), Bexartoten (Targentin)

88
Q

These need to be taken on an EMPTY stomach

A

Erlotinib (Tarceva)
Temozolomid (Temodar)
Sorafenib (Nexavar)
Chlorabucil (Leukeran)
Busulfan (Myleran
Oral Methotrexate
Dabrafenib (Tafinlar)

89
Q

These need to be taken on am empty stomach, 1 hour before or 2 hours after eating

A

Tarceva, Temodar, Nexavar

2023 CSO Exam Studying (32 decks)

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