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OCN > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

Common Alkylating Agents

A
  1. Nitrogen mustards - Cyclophosphamide + Ifosfamide, bendamustine + chlorambucil
  2. Triazenes: Dacarbazine, temozolomide
  3. Nitrosureas: streptozotocin, carmustine
  4. Platins - carbo, cis, oxali
  5. Other: Busulfan
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2
Q

How to alkylating agents work + what are the routes

A

-impair cell function by breaking DNA helix + interfering with DNA replication
-IV and PO

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3
Q

What to watch for with cyclophosphamide

A

-hemorrhagic cystitis
-transient SIADH

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4
Q

What to look for with Busulfan

A

“Busulfan lung” - fibrosis

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5
Q

what to watch for with cisplatin

A

-renal toxicity and electrolyte imbalance

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6
Q

What alkylating agent is the least toxic

A

-Chlorambucil

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7
Q

Administrating advice with Dacarbazine

A

-painful IV - reduce pain by withdrawing blood into syringe before injecting

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8
Q

education for cyclophosphamide

A

-push fluids and empty bladder frequently

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9
Q

Common Antimetabolites

A

-bines/dines/sines: Azacitidine, cladribine, clofarabine, cytarabine, cytosine, decitabine, fludarabine, capecitabine, gemcitabine, nelarabine - 10!!
-other: 5FU, leucovorin, pentostatin
-exes: Pemetrexed, pralatrexate, raltitrexed, trimetrexate

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10
Q

How do antimetabolites work

A

-inhibit enzymes necessary for DNA synthesis

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11
Q

what are routes for antimetabolites

A

-IV
-Intrathecal (cytarabine, MTX)
-PO
-Intracavity, topically - 5FU

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12
Q

common side effect for cladribine

A

Fevers - 50%

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13
Q

Common side effect for clofarabine

A

-LFT abnormalities (80%)

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14
Q

Common side effect for capecitabine

A

hand-foot syndrome

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15
Q

common side effect for decitabine

A

low K/low Mg

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16
Q

Concern for intrathecal MTX

A

-acute aseptic meningitis

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17
Q

Concern with high-dose Ara-C

A

-cerebellar toxicity + keratitis

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18
Q

Concner with 5FU

A

photosensitivity

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19
Q

What is contraindicated while on gemcitabine
What is contraindicated while on Fludarabine

A

-no gemcitabine while on radiation
-no fludarabine with pentostatin - causes fatal pulmonary toxicity

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20
Q

how does leucovorin work with MTX

A

-rescue for antifol toxicity

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21
Q

what do you do for giving pentoastatin

A

-2L D5NS

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22
Q

education for patients getting 5FU bolus

A

-suck on ice

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23
Q

Antitumor antibiotics

A

-mycin/icin
-Actinomycin, Bleomycin, Mitomycin, mitoxantrone
-Daunorbicin, Doxorubicin, Epirubicin, Idarubicin

24
Q

how do antitumor antibiotics work

A

-prevent DNA replication and RNA production + other things

25
Q

how can you give Antitumor Antibiotics

A

-Infusion
-IVP
-IM/SC/intrapleural (bleomycin)
-intravesicular (mitomycin)

26
Q

Bleo concerns + curiosities

A

-hypersensitivity
-pneumonitis/pulmonary toxicity - need PFT
-may produce a rancid smell about 10sec after injection

27
Q

Daunorubicin concerns

A

-precipitous fatal cardiomyopathy months after administration

28
Q

Doxorubicin concern

A

-“radiation-recall reaction” - former radiation sites will desquamate

29
Q

Mitomycin concern

A

-Hemolytic Uremic Syndrome (HUS) - rare but potentially fatal - hemolysis leading to renal failure
-with 6+ months of mitomycin therapy

30
Q

Common plant alkaloids

A

-cabacitaxel, docetaxel, paclitaxel
-Vs: Vincristine, vinblastine, vinorelbine, vindesine
-Eribulin, estramustine, ixabepilone

31
Q

how do plant alkaloids work?

A

-inhibit microtubule assembly which dissolves mitotic spindle structure

32
Q

% alopecia with taxol

33
Q

big concern with cabazitaxel

A

-pancytopenia

34
Q

concern with eribulin

A

-prolonged QT

35
Q

Concern with estramustine + use

A

Gynecomastia and thromboembolism
-only used with prostate cancer

36
Q

Concern with Vinblastine and Vincristine

A

-Vinblastine - muscle cramps/pain
-Vincristine - constipation

37
Q

Contraindications with ixabepilone

A

-grape juice and St. John’s wort

38
Q

Common Topoisomerase inhibitors

A

-etop + teniposide
-topotecan + irinotecan

39
Q

how. totopoisomerase inhibitors work?

A

-inhibit topoisomerase which interferes with transcription/replication of DNA

40
Q

Etop routes

A

can be oral or IV

41
Q

Contraindication for etoposide

A

-administering <30 min infusion - causes hypotension
-St. John’s wort
-watch for crystallization in tubing

42
Q

Tyrosine Kinase Inhibitors (TKIs)

A

-NIBS
-Crizotinib, Dasatinib, Erlotinib, IMatinib, .. and more

43
Q

how do TKIs work

A

-prevent transfer of phosphate from ATP to a cell protein which prevents intracellular communication and activity like cell division
-prevents mutated cells from proliferating

44
Q

Routes for TKIs

A

-oral only

45
Q

Dosing for TKIs

A

-set dosage and tolerance based, not weight

46
Q

Crizotinib concern

A

-visual disturbances

47
Q

Dasatinib concern

A

-Low ca/phos

48
Q

Erlotinib concern

A

LOng QT, and rash

49
Q

Imatinib concern

A

transient fluid retention

50
Q

Pzopanib concern

52
Q

Contraindications for dasatinib

A

-antacids/PPIs

53
Q

Sutinib + Sorafenib

A

-Sutinib - bleeidng (nose, etc) + yellow skin + diarrhea
-Sorafenib - hand/foot reaction + Diarrhea

54
Q

Contraindications erlotinib

A

-grapefruit juice, st. John’s wort + smoking

55
Q

administration for TKIs
-Empty stomach
-Meal + water

A

-empty: erlotinib, lapatinib, nilotinib, pazopanib, sorafenib
-food - imotinib
-DONT CRUSH

OCN (7 decks)

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