Drugs 2 Flashcards
raloxifene contraindications
past medical history of deep venous thrombosis, renal vein thrombosis, pulmonary embolism, malignancy, ***active smoking, or any thrombophilia
cetuximab, panitumumab MOAs
EGFR inhibitors
PARP inhibitors
olaparib
checkpoint inhibitor targets
CTLA-4 inhibitors, PD-1 inhibitors, PD-L1 inhibitors, LAG-3,
how PARP inhibitors work
Formation of double-stranded DNA breaks that in BRCA-competent tumors are repaired by homologous recombination. Tumors with germline BRCA mutations are unable to repair these defects, leading to cell death (referred to as synthetic lethality).
Platinum based chemotherapy agents
Cisplatin, carboplatin, oxaliplatin
How do platinum antineoplastics work
DNA cross linking, which inhibits DNA repair and synthesis in tumor cells
Cisplatin toxicity
Neurotoxic, neuropathy, ototoxocity, hemolytic anemia, nausea and vomiting (very emetogenic)
paclitaxel trade name
taxol
paclitaxel SE’s
peripheral neuropathy, alopecia, N/V, neutropenia, diarrhea, mouth sores
aloxi generic name
palonosetron hydrochloride
FOLFOX
leucovorin calcium (folinic acid), fluorouracil, and oxaliplatin.
bevacizumab trade name
avastin
bevacizumab SE profile
- epistaxis, headache, HTN, rhinitis, proteinuria, taste alteration, dry skin, rectal
hemorrhage, lacrimation disorder, back pain and exfoliative dermatitis. - myelosuppression
RvD treatment includes
Bortezomib (Velcade) plus lenalidomide (Revlimid) and dexamethasone (VRd) (1 g q month)
xgeva generic name
denosumab
revlimid generic name
lenalidomide
zometa generic name
zoledronic acid
PDL-1 inhibitors
atezolizumab, avelumab, durvalumab,
hereditary breast cancer syndromes
Approximately 80%–90% of hereditary breast cancer cases are caused by mutations in the BRCA1 and BRCA2 genes. Other important clinical genetic predispositions include Cowden syndrome, Li-Fraumeni syndrome, Peutz-Jeghers syndrome, and ataxia-telangiectasia.
BRCA2 cancers
breast, ovarian, prostate, pancreatic
BRCA1 cancer predispositions
breast, ovarian, bowel, prostate
what is leucovorin
folinic acid
irinotecan class
topoisomerase inhibitor
R-CHOP
rituximab, cyclophosphamide, hydroxydaunorubicin hydrochloride (doxorubicin hydrochloride), vincristine, prednisone
erlotinib mechanism
TKI that inhibits EGFR
gnrh agonists
Short-acting injection (once per day): buserelin, histrelin, leuprorelin, triptorelin
Long-acting depot injection or injected pellet (once every one to six months): leuprorelin, triptorelin
Injected implant (once every one to three months): buserelin, goserelin, leuprorelin
Surgically implanted pellet (once per year): histrelin, leuprorelin
Nasal spray (two to three times per day): buserelin, nafarelin
enzalutamide, apalutamide, and darolutamide mechanism
Second generation androgen receptor blocker. block signaling at androgen receptor, block AR nuclear translocation
why you have to give prednisone with abiraterone
Simply put, Zytiga (abiraterone) can actually lower blood levels of cortisol in many patients, so the prednisone is considered cortisol “replacement”, which can help reduce side effects from Zytiga treatment.
abiraterone mechanism
works by inhibiting production of testosterone
abiraterone SE’s
fluid retention, hypokalemia, and hypertension
xeloda generic name
capecitabine
folfiri SE’s
leukopenia, diarrhea, neutropenia, proteinuria, AST increased, stomatitis, fatigue, thrombocytopenia, ALT increased, hypertension, weight decreased, decreased appetite, epistaxis, abdominal pain, dysphonia, serum creatinine increased,
and headache.
Avelumab mechanism
PD-L1 inhibitor
Nivolumab trade name
Opdivo
Iplimumab trade name
Yervoy
Nivo is approved for what cancer types
kidney cancer dMMR CRC Melanoma NSCLC head and neck cancer Bladder
basic concept of CAR therapy
CELL THERAPY
T cells are collected from a patient’s blood, genetically engineered to recognize certain proteins on cancer cells, and infused back into the patient’s bloodstream.
which cancer types is CAR therapy be used for
Certain types of NHL (relapsed B cell ALL, follicular, mantle)
basic concept of epigenetic therapy
Rather than destroy cancer cells, the therapies seek to set the cells on a path back toward normal growth and development.
AG-221 mechanism
Novel epigenetic therapy being tested in people with acute myeloid leukemia (AML) and myelodysplastic syndromes.
Concept of an mRNA vaccine
The vaccines are given in the form of messenger RNA, a molecule that gives cells the instructions to create a particular protein, in this case a cancer antigen that primes the immune system against the tumor. Unlike with gene editing, the vaccines do not directly edit human DNA, but just provide the message.
Results of CAR-T cell therapy trials in general
clinical trials have shown impressive results in patients that relapse and have exhausted other treatment options. However, the technology has also shown some severe side effects that led to patient deaths.
Basic function of PD-1 gene
Produces a protein that tumor cells can use to evade an immune attack.
apixaban dosing
Always LOAD with 10 mg PO BID for a week and then 5 mg PO BID
Management of NOAC prior to surgery
Hold for 1 day if low bleeding risk
Hold for 48 hours if moderate bleeding risk
Indications for lower dose of eliquis
IF Cr <1.5 + over age 80 and weight less than 60 kg
IF Cr >1.5 2.5 mg BID if also at least 80 or older, wt less than 60 kg.
Atezolizumab mechanism
monoclonal antibody that binds to PD-L1
Darvulumab MOA
PD-L1 inhibitor
NK1 receptor antagonists
Aprepitant
Foseprepitant
Pemetrexed MOA
Folate antimetabolite
When is neulasta administered
24-48 hours after last day of the first cycle
most common nivolumab ADRs
fatigue, rash, musculoskeletal pain, pruritus,
diarrhea, nausea, asthenia, cough, dyspnea, constipation, decreased
appetite, back pain, arthralgia, upper respiratory tract infection, pyrexia,
headache, and abdominal pain.
most common pembro ADRs
fatigue, musculoskeletal pain,
decreased appetite, pruritus, diarrhea, nausea, rash, pyrexia,
cough, dyspnea, constipation, pain, and abdominal pain.
what is carbotaxol regimen?
carboplatin
paclitaxel
BEAM regimen
carmustine (BCNU), etoposide, aracytin and melphalan
Use of EPOCH regimen
various aggressive B-cell and T-cell non-Hodgkin lymphomas
EPOCH is
etoposide, prednisone, vincristine (Oncovin), cyclophosphamide and doxorubicin hydrochloride (hydroxydaunorubicin hydrochloride)
hyperCVAD regimen contains
cyclophosphamide, vincristine sulfate, doxorubicin hydrochloride (Adriamycin), and dexamethasone
hyperCVAD uses
acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL)
ibrutinib MOA
small molecule inhibitor of bruton’s tyrosine kinase
venetoclax MOA
blocks the anti-apoptotic B-cell lymphoma-2 (Bcl-2) protein, leading to programmed cell death of CLL cells
