Chemotherapy Flashcards
Common Alkylating Agents
- Nitrogen mustards - Cyclophosphamide + Ifosfamide, bendamustine + chlorambucil
- Triazenes: Dacarbazine, temozolomide
- Nitrosureas: streptozotocin, carmustine
- Platins - carbo, cis, oxali
- Other: Busulfan
How to alkylating agents work + what are the routes
-impair cell function by breaking DNA helix + interfering with DNA replication
-IV and PO
What to watch for with cyclophosphamide
-hemorrhagic cystitis
-transient SIADH
What to look for with Busulfan
“Busulfan lung” - fibrosis
what to watch for with cisplatin
-renal toxicity and electrolyte imbalance
What alkylating agent is the least toxic
-Chlorambucil
Administrating advice with Dacarbazine
-painful IV - reduce pain by withdrawing blood into syringe before injecting
education for cyclophosphamide
-push fluids and empty bladder frequently
Common Antimetabolites
-bines/dines/sines: Azacitidine, cladribine, clofarabine, cytarabine, cytosine, decitabine, fludarabine, capecitabine, gemcitabine, nelarabine - 10!!
-other: 5FU, leucovorin, pentostatin
-exes: Pemetrexed, pralatrexate, raltitrexed, trimetrexate
How do antimetabolites work
-inhibit enzymes necessary for DNA synthesis
what are routes for antimetabolites
-IV
-Intrathecal (cytarabine, MTX)
-PO
-Intracavity, topically - 5FU
common side effect for cladribine
Fevers - 50%
Common side effect for clofarabine
-LFT abnormalities (80%)
Common side effect for capecitabine
hand-foot syndrome
common side effect for decitabine
low K/low Mg
Concern for intrathecal MTX
-acute aseptic meningitis
Concern with high-dose Ara-C
-cerebellar toxicity + keratitis
Concner with 5FU
photosensitivity
What is contraindicated while on gemcitabine
What is contraindicated while on Fludarabine
-no gemcitabine while on radiation
-no fludarabine with pentostatin - causes fatal pulmonary toxicity
how does leucovorin work with MTX
-rescue for antifol toxicity
what do you do for giving pentoastatin
-2L D5NS
education for patients getting 5FU bolus
-suck on ice