Chemotherapy Medications Flashcards by Sarah Anderson

Alkylating Agents
(mechanism of action)

Interferes with DNA bases causing breaks in DNA helix strands, thus preventing DNA replication and transcription of RNA

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Cell Cycle non-specific drugs

damages cells in all phases of the cell cycle. Alkylating agents, antitumor antibiotics, hormone therapies, and nitrosoureas

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Cell Cycle specific drugs

exert their effects within a specific phase of the cell cycle (when cells are dividing). Antimetabolites and camptothecins, plant alkaloids and taxanes

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Carboplatin

Classification, brand name, route, indication, nutrition side effects

Alkylating agent
Paraplatin
IV
Indication: bladder, endometrial, germ cell, HNC, lung, and ovarian
SE- myelosuppression, N, V, renal toxicity, alopecia, peripheral neuropathy

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Cisplatin

Classification, brand name, route, indication, nutrition side effects

Alkylating Agent
Platinol (CDDP)
IV
Indication: bladder, cervical, esophageal, HNC, lung, NHL, ovarian, prostate, testicular
SE: Myelosuppression, N, V, metallic taste, SIADH, renal toxicity, hypomagnesemia, ototoxicity, peripheral neuropathy

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Cyclophosphamide

Classification, brand name, route, indication, nutrition side effects

Alkylating Agent
Cytoxan, CTX
IV, PO, IP
Indication: breast, ovarian, CLL, NHL, HD, MM, mycosis fungoids, neuroblastoma, sarcomas, Wilm’s tumors
SE: Myelosuppression, N, V, bladder toxicity, cardiac toxicity, SIADH, alopecia

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Ifosfamide

Classification, brand name, route, indication, nutrition side effects

Alkylating Agent
Ifex
IV
Indication: Bladder, cervical, germ cell, HNC, lung, HD, NHL, sarcomas
SE: Myelosuppression, N, V, anorexia, bladder toxicity, SIADH, lethargy, alopecia

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Oxaliplatin

Classification, brand name, route, indication, nutrition side effects

Alkylating Agent
Eloxatin
IV
Indication: colorectal, pancreatic, gastroesophageal
SE: Myelosuppression, N, V, D, neurotoxicity, hepatic toxicity

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Antimetabolites mechanism, of action

Interferes with DNA synthesis by acting as false metabolites. They are incorporated into the DNA strand or they block essential enzymes

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Fluorouracil

Classification, brand name, route, indication, nutrition side effects

Antimetabolites
5-FU
IV, topical
Indication: breast, colorectal, GI, HNC, pancreatic, ovarian, hepatoma
SE: Myelosuppression, N, V, D, mucositis, hand and foot syndrome, cardiac toxicity

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Gemcitabine

Classification, brand name, route, indication, nutrition side effects

Antimetabolites
Gemzar
IV
Indication: bladder, breast, ovarian, pancreatic, lung, NHL, sarcoma
SE: Myelosuppression, N, V, pulmonary toxicity, flu-like symptoms

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Methotrexate

Classification, brand name, route, indication, nutrition side effects

Antimetabolites
MTX
IM, IV, IT, PO
Indication: bladder, breast, HNC, NHL, CNS lymphoma, ALL, sarcoma
SE_: Myelosuppression, N, mucositis, oral and GI ulcerations, renal toxicity

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Pemetrexed

Classification, brand name, route, indication, nutrition side effects

Antimetabolites
Alimta
IV
Indication: mesothelioma, lung
SE: Myelosuppression, N, V, D, fatigue

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Antitumor antibiotics and anthracyclines mechanism of action

Inhibits cell division by binding to DNA and interfering with RNA synthesis

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Mitomycin-C

Classification, brand name, route, indication, nutrition side effects

Antitumor antibiotic
Mutamycin
IV
Indication: anal, bladder, breast, esophagus, HN, lung pancreas, and stomach
SE: Myelosuppression, N, V, mucositis, D, anorexia, pulmonary toxicity, renal toxicity, fatigue, alopecia

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Doxorubicin

Classification, brand name, route, indication, nutrition side effects

Antitumor antibiotics anthracyclines
IV
Indication: breast, liver, lung, ovarian, prostate, NHL, HD, MM, AML, squamous cell of HNC
SE: myelosuppression, N, V, D, mucositis, anorexia, hand and foot syndrome, cardio toxicity

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Epipodophyllotoxins mechanisms of action

Damages the cell prior to mitosis, late S and G2 phases. Inhibits topoisomerase II

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Etoposide

Classification, brand name, route, indication, nutrition side effects

Epipodophyllotoxins
Vepesid, VP-16
IV
Indications: small cell and non-small cell lung, HD, NHL, gastric, germ cell
SE: Myelosuppression, N, V, D, mucositis, anorexia, metallic taste, alopecia

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Taxanes mechanism of action

Activate in the mitosis phase of the cell cycle, Anti-microtubule agent, which leads to inhibition of mitosis and cell division

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Paclitaxel

Classification, brand name, route, indication, nutrition side effects

Taxanes
Taxol
IV
Indication: bladder, breast, esophageal, HNC, ovarian, pancreatic, lung
SE: Myelosuppression, D, mucositis, sensory neuropathy, alopecia

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Docetaxel

Classification, brand name, route, indication, nutrition side effects

Taxanes
Taxotere
IV
Indication: Breast, gastric, HNC, ovarian, prostate, lung
SE: Myelosuppression, mucositis, D, neurotoxicity, fluid retention, skin and nail changes,

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Vinca Alkaloids mechanism of action

Binds to protein tubulin and disrupts mitotic spindle formation and prevents cell division in the mitosis phase

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Vincristine

Classification, brand name, route, indication, nutrition side effects

Vinca alkaloid
Oncovin
IV
Indication: ALL, AML, CML, HD, NHL, MM, small cell lung, neuroblastoma, Ewing's sarcoma, Wilms' tumor, brain and thyroid
SE: Myelsoupression, constipation, SIADH

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Chemos that interact with St. John’s Wart (15)

Axitinib/Inlyta
Bortezomib/Velcade
Dasatinib/Sprycel
Erlotinib/Traceva
Everillmus/Afinitor
Exemestane/Aromsmasin
Imatinib mesylate/Gleevec
Lapatinib/Tykerb
Nilotnib/Tasigna
Sorafenib/Nexavar
Sunitinib/Sutent
Tamoxifen/Nolvadex
Vinblastine/Velban
Vincristine/Oncovin

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Chemos that require V B6 supp to reduce hand-foot syndrome (3)

Supplementation: 50-100 mg BID or TID Capecitabine/Xeloda Fluorouracil/Adrucil Oxaliplatin/Eloxatin

Drugs that contain Lactose (2)

Deferasiox/Exjade | Nilotinib/Tasigna

Drugs that alter lab values (5)

Cetuximab/Erbitux (Ca, Mg) Cisplatin/Plantinol (Ca, Na, K, Mg) Panitumumab/Vectibix (Mg) Streptozocin/zanosar (glucose/hypoglycemia) Temsirolimus/Torisel (glucose/hyperglycemia, hypercholesterolemia)

What chemo must avoid folic acid and alcohol

Methotrexate/Folex/Rheumatrex

What supplements are needed prior to and during treatment with Pemetrexed/Alimta

``` Folic acid (350-1000 mcg) PO beginning 1 week before 1st tx, daily throughout and post tx V B12 (1000 mcg) IM injections q 3 cycles ```

Procarbazine hydrochloride/Matulane food interaction

Avoid tyramine-containing foods and caffeine while taking and two weeks after

Supplementation when taking Zoledronic acid/Zometa

PO 500 mg Ca and 400 IU VD Daily

Bendamustine | Classification, brand name, route, indication, nutrition side effects

Alkylating agent Treanda IV IN: B-cell, NHL, CLL, Mantel Cell Leukemia SE: Myelosuppression, N, V, fatigue, hypersensitivity to infusion

Busulfan | Classification, brand name, route, indication, nutrition side effects

Alkylating agent Myleran (PO); Busulfex (IV) IN: CML. HCT preparation SE: Myelosuppression, N, V, D, mucositis, cough, dyspnea

Carmustine | Classification, brand name, route, indication, nutrition side effects

Alkylating Agent BCNU IV IN: Brain cancer, HD, NHL, MM, glioblastoma SE: Myelosuppression, N,V, hepatic toxicity, renal toxicity, pulmonary toxicity

Chlorambucil | Classification, brand name, route, indication, nutrition side effects

``` AA Leukeran PO IN: CLL, HD, NHL SE: Myelosuppression, hyperuricemia, pulmonary toxicity ```

Darcarbazine | Classification, brand name, route, indication, nutrition side effects

``` AA DTIC IV IN: HD, malignant melanoma, neuroblastoma, sarcomas SE: Myelosuppression, N, V, CNS toxicity ```

Mechorethamine | Classification, brand name, route, indication, nutrition side effects

``` AA nitrogen mustard IV IN: CLL, CML, HD, NHL, mycosis fungoides SE: Myelosuppression, N,V, hyperuricemia ```

Melphalan | Classification, brand name, route, indication, nutrition side effects

AA Alkeran IV, PO IN: breast, ovarian, MM, HCT, polycythemia vera SE: Myelosuppression, N,V, mucositis, D, infusion reaction

Thiotepa | Classification, brand name, route, indication, nutrition side effects

``` AA Thioplex IV, IM, IT, SC IN: bladder, breast, ovarian SE: Myelosuppression, N, V, mucositis, renal toxicity ```

Azacitidine | Classification, brand name, route, indication, nutrition side effects

``` Antimetabolites Vidaza SC, IV IN: Myelodysplastic syndrome SE: Myelosuppression, N, V, D, fatigue, hypokalemia, renal toxicity ```

Cytarabine | Classification, brand name, route, indication, nutrition side effects

Antimetabolites ARA-C IV, SC, IT, IM IN: Acute lymphocytic leukemia, AML, CML, NHL SE: Myelosuppression, N, V, mucositis, anorexia, acute pancreatitis, neurotoxicity, hepatic toxicity, pulmonary toxicity

Fludarabine | Classification, brand name, route, indication, nutrition side effects

``` Antimetabolites Fludara IV IN: CLL, NHL, T-cell, HCL SE: Myelosuppression, N, V, D, neurotoxicity ```

Capecitabine | Classification, brand name, route, indication, nutrition side effects

``` Antimetabolite Xeloda PO IN: colon and metastatic breast cancer SE: Myelosuppression, N, V, D, fatigue, increased bilirubin, hand-foot syndrome ```

Mercaptopurine | Classification, brand name, route, indication, nutrition side effects

``` Antimetabolite 6-MP PO IN: ALL, AML, CML, NHL SE: Myelosuppression, N,V, D, mucositis, hepatic toxicity, hyperuricemia ```

Thioguaine | Classification, brand name, route, indication, nutrition side effects

``` Antimetabolite 6-TG PO IN: ALL, AML, CML SE: Myelosuppression, N,V,D, mucositis, hepatic and renal toxicity ```

Bleomycin | Classification, brand name, route, indication, nutrition side effects

``` Antitumor antibiotics Blenoxane IC,SC,IM IN: HD, NHL, HNC, SE: Myelosuppression, pulmonary and renal toxicity ```

Dacitinomycin | Classification, brand name, route, indication, nutrition side effects

Antitumor antibiotic Actinomycin D IV IN: Ewing sarcoma, rhabdomysarcoma, Wilm's tumor, testicular cancer SE: Myelosuppression, N, V, D, M, A, hyperuremia, cardiotoxicity

DUNORUBICIN | Classification, brand name, route, indication, nutrition side effects

``` Anthracyclines Daunomycin IV IN: ALL, AML SE: Myelosuppression, N,V,M,D,A, hyperuremia, cardiotoxcitiy ```

Doxorubicin liposomal | Classification, brand name, route, indication, nutrition side effects

Anthracyclines Doxil IV In: AIDS-related Kaposi's sarcoma, ovarian, MM, sarcoma, hepatocellular carcinoma SE: Myelosuppression, N,V,D,M, hand and foot syndrome

Epirubicin | Classification, brand name, route, indication, nutrition side effects

``` Anthracyclines Ellence IV IN: breast and gastric SE: Myelosuppression, N,V,D,M, cardio ```

Idarubicin | Classification, brand name, route, indication, nutrition side effects

``` Anthracyclines Idamycin IV IN: AML, ALL, CML, MDS SE: Myelosuppression, N,V,D,M, cardio, elevated liver enzyes ```

Paclitaxel protein-bound | Classification, brand name, route, indication, nutrition side effects

``` Taxane Abraxane IV IN: breas, NSCLC SE: Myelosuppression, N,V,D,M ```

Teniposide | Classification, brand name, route, indication, nutrition side effects

``` Epipodophyllotoxin Vumon IV IN: Childhood ALL SE: Myelosuppression, N,V, hypotension, pulmonary toxicity ```

Vinblastin | Classification, brand name, route, indication, nutrition side effects

Vinca Alkaloids Velban IV IN: breast and testicular, HD, HCN, sarcoma SE: Myelosuppression, M, stomatitis, C, HTN, jaw pain

Vinorelbine | Classification, brand name, route, indication, nutrition side effects

``` Vinca Alkaloids IV Navelbine IN: breast, ovarian, NSCLC SE: Myelosuppression, N,V,C,A, stomatitis, elevated liver function tests ```

Ibitumomab tiuxetan | Classification, brand name, route, target, nutrition side effects

``` Monoclonal Antibodies Zevalin IV CD20 SE: Myelosuppression, N,V,infections, cough, dyspena ```

Rituximab | Classification, brand name, route, target, nutrition side effects

``` Monoclonal Antibodies Rituxan CD20 IV SE: Myelosuppression, N,V ```

Pertuzumab | Classification, brand name, route, target, nutrition side effects

``` Monoclonal Antibodies Perjeta IV HER2/neu SE: cardio, fatigue ```

Trastuzumab | Classification, brand name, route, target, nutrition side effects

``` Monoclonal Antibodies Herceptin IV HER2/neu SE: Myelosuppression. N,V,D, fatigue, cardio, pulmonary ```

Ado-trastuzumab emtansine | Classification, brand name, route, target, nutrition side effects

``` Monoclonal Antibodies Kadcyla IV HER2/neu SE: cardio, hepatic, pulmonary, C ```

Cetuximab | Classification, brand name, route, target, nutrition side effects

``` Monoclonal Antibodies Erbitux IV EGFR SE: N,V,D,A, hypomagnesemia, pulmonary ```

Panitumumab | Classification, brand name, route, target, nutrition side effects

``` Monoclonal Antibodies Vectibix IV EGFR SE: Hypmagnesemia, D, malaise, pulmonary ```

Denosumab | Classification, brand name, route, target, nutrition side effects

Monoclonal Antibodies Xgeva RANKL SE: risk of osteonecrosis of jaw, hypocalcemia, N,V,D

Denosumab | Classification, brand name, route, target, nutrition side effects

Monoclonal Antibodies Prolia RANKL SE: risk of osteonecrosis of jaw, hypocalcemia, N,V,D

Vinca alkaloids mech of action

Binds to protein tubulin and disrupts mitotic spindle formation and prevents cell division in mitosis stage

Taxane mech of action

Active in the mitosis phase of the cell cycle. Anti-microtubule agent which leads to inhabitation of mitosis and cell division