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Pharm > Chemotherapy V > Flashcards

Chemotherapy V Flashcards

1
Q

Tyrosine Kinase Inhibitors

Small molecule (2)
Monoclonal Antibodies (3)
A

Small molecule: Imatinib, Erlotinib

Monoclonal Ab: Trastuzumab, cetuximab, bevacizumab

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2
Q

Imatinib MOA

A

Binds and blocks BCR-ABL

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3
Q

Where is Imatinib metabolized

A

LIVER- avoid coadministration with inducers/inhibitors of CYP3A4

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4
Q

Imatinib SE

A 
SUPERFICIAL EDEMA
nausea
MUSCLE CRAMPS
Abdominal pain
Rash
Diarrhea
Anemia
Neutropenia, thrombocytopenia
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5
Q

What should you monitor in patients taking Imatinib?

A

TSH level

Increases clearance of thyroid hormone

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6
Q

Imatinib Indications

A

CML

GI stromal tumors

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7
Q

Other drugs like Imatinib?

A

Dasatanib

Nilotinib

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8
Q

Cetuximab MOA

A

Monoclonal antibody to EGFR (transmembrane TK)

Sensitizes cell to chemo and radiation

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9
Q

Cetuximab Indication

A

Metastatic lung, colon cancer

Head, neck cancers (+radiation)

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10
Q

Cetuximab SE

A 
Rash
Diarrhea
HYPOMAGNESEMIA
Infusion reaction
Skin toxicity
Trichomegaly
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11
Q

What must you treat patients taking Cetuximab with?

A

IV therapy for hypomagnesemia

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12
Q

What type of mutational analysis should you perform on a patient with COLORECTAL cancer to determine if they will respond to Cetuximab?

A

KRAS
NRAS

Wildtype: respond to Cetuximab
Mutated: no response

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13
Q

Erlotinib MOA

A

Small molecule inhibitor of the TK associated with EGFR

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14
Q

How is erlotinib metabolized?

A

CYP3A4

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15
Q

Erlotinib SE

A

Rash, nausea, anorexia, fatigue, paronchia (nailbed pain)

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16
Q

Perform mutational analysis on non-small cell lung cancers for ____ activating mutations

A

EGFR

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17
Q

Bevacizumab

A

Monoclonal Ab, binds to VEGF, prevents signaling for new blood vessel formation

18
Q

Bevacizumab Indication

A

Metastatic colorectal cancer
Metastatic lung cancer

*significant prolongation or survival!

19
Q

Bevacizumab SE

A

HTN, proteinuria, arterial clots, colon perf, bleeding, reversible posterior leukoencephalopathy syndrome, infusion reactions

20
Q

Small molecule VEGF receptor TK inhibitors

A

Sorafenib, Pazopanib, Sunitinib

21
Q

Small molecule VEGF receptor TK inhibitors metabolism

A

CYP3A4

22
Q

Small molecule VEGF receptor TK inhibitors SE

A

Similar to bevacizumab +
Hand foot syndrome
Congestive heart failure

23
Q

Small molecule VEGF receptor TK inhibitors Indication

A

All 3 - renal cell cancer (clear cell)

Sunitnib- pancreatic neuroendocrine cancer, GI stromal tumor

Sorafenib- unresectable hepatocellular cancer

24
Q

Trastuzumab MOA

A

Monoclonal Ab to extracellular domain of EGFR receptor, HER-2 Neu

25
Q

Trastuzumab SE

A

CARDIAC TOXICITY

fever, n/v/d, cough, HA, SOB, back pain, rash, myalgia

26
Q

The greatest risk of cardiac toxicity is in patients taking Trastuzumab and this other drug

A

Anthrcycline

27
Q

What should you monitor in a patient taking Trastuzumab?

A

Cardiac ejection fraction

28
Q

Trastuzumab Indication

A 
Breast cancer (Her2/neu+)
Stomach and gastroesophageal junction cancer (Her2/neu+)
29
Q

When should you use trastuzumab?

A

when Her2/neu is overexpressed

30
Q

Crizotinib Indication

A

Pts with ALK-anaplastic lympoma kinase rearrangements in adenocarcinoma of lung

31
Q

Vemurafenib Indication

A

Melanoma with V600E mutation in BRAF (activating mutation)

32
Q

L-asparaginase MOA

A

Depletes asparagine pools rapidly

Leukemia cells lack asparagine synthetase and cannot synthesize asparagine

decrease in protein synthesis

33
Q

L-asparaginase SE

A

CLOTTING (decreased antithrombin 3)

34
Q

L-asparaginase Indication

A

Acute lymphoblastic leukemia

35
Q

Hydroxyurea MOA

A

Inhibits DNA synthesis by inhibiting ribonucleotide reductase

36
Q

Hydroxyurea Indication

A

Acute myelogenous leukemia

37
Q

All-trans retinoic acid MOA

A

Induces terminal differentiation of leukemic cells

38
Q

All-trans retinoic acid Indication

A

Acute promyelocytic leukemia (APL)

39
Q

Arsenic Trioxide Indication

A

Treatment of relapsed APL

40
Q

Arsenic Trioxide SE

A

QT prolongation

Pharm (20 decks)

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