Cytotoxic Drugs

Question 1

Alkylating Drugs?

Answer 1

Those ending in - f/phamide

So: Cyclophosphamide, Ifosfamide

Also Melphalan

Question 2

Anthracycline drugs?

Answer 2

-rubicins

Question 3

Anti metabolites?

Answer 3

Methotrexate
Mercaptopurine
Fluorouracil
CYTARABINE

Question 4

Cytotoxic antibiotics?

Answer 4

Bleomycin, Mitomycin

Question 5

Platinum compounds?

Answer 5

-platins

Question 6

Taxanes?

Answer 6

-taxels

Question 7

Vinca Alkaloids?

Answer 7

-stines/sines

Vin-

Vincrisitine, Vinblastine, Vindesine

Question 8

What is Oral mucositis? Associate with what drugs?

Answer 8

MEANS SORE MOUTH!

Associated with: Fluorouracil, Methotrexate, Anthracyclines

Question 9

Preventative method of Oral mucositis?

Answer 9

Good Hygiene measures +
Sucking ice chips with Fluorouracil

Question 10

Oral Mucositis treatment?

Answer 10

Saline Mouthwash

Question 11

Methotrexate induced Oral mucositis treatment?

Answer 11

Folinic acid (Levofolinic acid)

Question 12

Tumour lysis syndrome occurs why?

Answer 12

Due to rapid destruction of Malignant cells

Question 13

Tumour Lysis higher in which conditions?

Answer 13

Non Hodgkins Lymphoma

Burkitts lymphoma

Acute Lymphoblastic leukemia

Myeloid Leukemia

Question 14

What Pt groups are at high risk of Tumour lysis?
(HINT: 3 groups?)

Answer 14

Those with Renal impairment

Those with pre existing Hyperuricaemia

Those Dehydrated

Question 15

Tumour lysis causes what electrolyte imbalances? And what they can lead to?

Answer 15

• Hyperkalaemia
• Hypocalcaemia
• Uricaemia
• Ph

Leading to Renal damage + Arrhythmias

Question 16

Hyperuricaemia present in what conditions? Also what treatment would you give?

Answer 16

High grade Leukaemia + Lymphoma

Treatment: aLLopurinol 24hr before tumour treatment + hydrate pt

2 L’s condition 2 L’s Treatment

Question 17

Alternative Hyperuricaemia treatment? When would u give it?

Answer 17

Febuxostat - 2 days prior to treatment

Question 18

Which are the 2 only cytotoxic drugs do not cause Bone suppression?

Answer 18

• Vincristine
• Bleomycin

Question 19

What test must be done before treatment to help avoid bone marrow suppression?

Answer 19

FBC - Reduce dose if bone marrow hasn’t recovered

Question 20

If neutrophenic fever?

Answer 20

Broad spectrum ABX

Question 21

Bleeding in Urethral area - Haemorrhage

Which Cyto drugs is this common in?

Answer 21

Cyclophosphamide

Ifosfamide

Aka the -f/phamides - Alkylating drugs

Question 22

Treatment of Urethral bleeding - Haemorrhage?

Given with either Cyclophosphamide or Ifafamide?

Answer 22

Mesna

Question 23

Myelosuppression which drugs side effect?

Answer 23

Methotrexate - treat for toxicity (Folinic)

Question 24

Cytotoxic drugs Pregancy?

Answer 24

Avoid - use PPP - Contraception

Teratogenic

Question 25

Alkylating Drugs (-famides) or Procarbazine major side effect to consider?

Answer 25

Risk of Permanent Male loss of sperm Think of sperm storage Also women: premature menopause

Question 26

Highest N&V Cytotoxic drugs?

Answer 26

Cisplatin Dacarbazine High Cyclophosphamide doses

Question 27

Lowest (MILD) N&V cytotoxic drugs?

Answer 27

Fluorouracil Methotrexate Vinca Alkaloids Etoposide

Question 28

Moderate N&V risk Cytotoxic drugs?

Answer 28

-Rubicins , - Taxanes high dose methotrexate low dose cyclophosphamide

Question 29

Acute N&V treatment from cytotoxic? Low risk?

Answer 29

Dexamethasone or Lorazepam

Question 30

Acute N&V treatment from cytotoxic? High risk?

Answer 30

Ondansetron + Dexamethasone + Ariprepitant

Question 31

Preventing Delayed N&V symptoms? With Moderate N&V drugs?

Answer 31

Dexamethasone + Ondansetron

Question 32

Preventing Delayed N&V symptoms? With High N&V drugs?

Answer 32

Dexamethasone + Ariprpitant

Question 33

Anticipatory symptoms N&V?

Answer 33

Lorazepam **Think Anxious - Benzodiazepines **

Question 34

Anthracyclines - Rubicins Urine colour?

Answer 34

RED Rubi red urine

Question 35

Which cytotoxic drugs are Cardiotoxic?

Answer 35

Rubicins - Anthracyclines

Question 36

Which formulation would you consider to reduce Cardiotoxic side effects?

Answer 36

Liposomal However can cause painful Macular skin eruptions!! (Avoid by cooling hands/feet) no socks no gloves

Question 37

Antimetabolites common side effects?

Answer 37

Mucositis and Myelosuppression

Question 38

Cytotoxic Antibiotics common side effects?

Answer 38

Pulmonary fibrosis Pulmonary toxicity - SOB , wheezing

Question 39

Taxanes monitor what?

Answer 39

- Cardiac output - Pneumonitis and Sepsis signs

Question 40

If first time having Taxanes what would you give premeditated?

Answer 40

Corticosteroids and Antihistamines Avoid Hypersensitivity reactions

Question 41

ROUTE FOR VINCA ALKALOIDS?

Answer 41

IV only - if not could be fatal

Question 42

Common side effects of Vinca Alkaloids?

Answer 42

Bronchospasms Neurotoxicity - Neuropathy , Motor Weakness, Myalgia