Drugs

Question 1

What is All-trans retinoic acid used to treat? What are some SE?

Answer 1

Treats APL

• emesis (common
• anxiety
• Gerd
• Increased intra-abdominal pressure
• Increased ICP
• Intraperitoneal bloods
• Biliary and reteral colic
• pregnancy

Question 2

Hypercoagulability is common in cancer what cancers is it most common and what causes the hypercoag?

Answer 2

Prostate, breast, lung, CNS, Pancreatic Bladder

- elevated D-dimer and elevated INR

Question 3

What is a high DVT score and what cancers are very high risk? How would you manage this?

Answer 3

> 3

• and stomach and pancreas get a score of 2
• Low molecular weight heparin
• clots continue with warfarin

Question 4

What 2 cancer most affect bone?

Answer 4

Prostate and breast

Question 5

What would you give to cause anti-resorptive therapy for bone?

Answer 5

Biphosphates

- Zoledronic acid most potent and presently used

Question 6

What drugs cause GI sluggishness and Diarrhea respectively?

Answer 6

Vinca Alkaloids

- 5-FU and Irotecan

Question 7

What is the treatment for constipation?

Answer 7

Polyethylene glycol

Mineral oil is important to prevent tearing

Question 8

What can be used to treat diarrhea?

Answer 8

Tincture of opium

Somatostatin analogues

Question 9

What does long acting form of myelosuppressive therapy cause?

Answer 9

Lower back pain in young people

- really bad pain

Question 10

What is FDA approved to treat ITP?

Answer 10

Eltrobopag

Romiplostim

Question 11

What are 2 EGFR antibodies and which is no longer used?

Answer 11

Cetuximab- no longer used
Panitumumab
- against colon, HPV squamous and squamous of head and neck

Question 12

What drugs should not be mixed with Rituximab and why?

Answer 12

Fludarabine and cylclophosphamide

- immunosuppresive and dangerous

Question 13

What is a common BTK inhibitor and what is its MOA?

Answer 13

Ibrutinib

- Covalent modifier of ATP binding stie (Cysteine 481) on Burtons kinase

Question 14

What is Ibrutinibs resistance?

Answer 14

Most common is C481S by changing from nucleophilic -SH to -OH
- PLC gamma which is phosphorylated by BLK

Question 15

What is Idelalisib used for?

Answer 15

CLL

- blocks BTK’s downstream affects

Question 16

What is Venetoclax and what is it used to treat?

Answer 16

CLL

- First BLC-2 modulator to reset apoptotic threshold

Question 17

What is Dasatinib and bosutinib?

Answer 17

active against BCR-ABL1 and Src family

- but not against T315I point mutation

Question 18

30% of plp failing on Imatinub have what mutation and what drug fights against this?

Answer 18

T315I

- Ponitinib

Question 19

What is Rituximab and how does it work?

Answer 19

Antibody against CD20 (mouth Ab)

• induces Ab-dependent cellular cytotoxicity
• induces Complement dependent cytotoxicity

Fights against most B cell malignancies and most auto-immune Dzs

Question 20

What are Ofatumumab and Obinutuzamab?

Answer 20

Humanized CD20 Antibodies

- outperform RItuximab notably with low grade lymphomas

Question 21

What is a CTLA-4 Blockade and how does it work?

Answer 21

Fights great against melanoma

• Blocks the T cell interacting with APC by blocking B7 to CD28
• thus T Cell is not activated
• drugs fights against this blockade

Ipilimumab

Question 22

What are some side effects of this Ipilimumab?

Answer 22

AI phenomena
Rash
Colitis
Endocrinopathies
Pulmonary toxicity 
Severe and long standing SE

Question 23

What are the PD-1 and PD-1L blockers?

Answer 23

Pembrolizumab

Nivolumab

Question 24

Why are these PD-1 Blockers better?

Answer 24

They are better tolerated with less toxicity

• colitis rash and thyroid problems
• out performed Ipi in melanoma