Drugs Flashcards
Bleomycin (Blenozane)
Classification: antitumor antibiotic
Indication: HD, HNL, sq cell HN, melanoma, sq of skin, cervix, vulva, testicular
Route: IV, SC, IM
Side Effects: pulmonary toxicity, renal toxicity
Doxorubicin (Adriamycin or Rubex)
Classification: antitumor antibiotic, anthracyclines
Indication: breast, liver, lung, ovarian, prostate; NHL, HD, MM, ALL, AML; sq HN
Side Effects: myelosuppression, N/V, mucositis, diarrhea, anorexia
Doxorubicin liposomal (Doxil)
Classification: antitumor antibiotic, anthracyclines
Indication: AIDS-related Kaposi’s Sarcoma, ovarian, MM, sarcoma, Heptocellular CA
Side Effects: myelosuppression, N/V, mucositis, diarrhea
Etoposide (VePesid or VP-16)
Classification: Epipodophyllotoxins
Indication: small & nonsmall lung CA, HD, NHL, gastric CA, germ cell tumors (testicular)
Side Effects: myelosuppression, N/V, mucositis, diarrhea, metallic taste
Vincristine (Oncovin)
Classification: Vinca alkaloids
Indication: ALL, AML, CML, D, NHL, MM, sm cell lung CA, rhabdomyosarcoma, neuroblastoma, Ewing’s sarcoma, Wilms’ tumor, brain and thyroid CA
Side Effects: myelosuppression, sensory neuropathy, constipation, jaw pain
Interactions: decrease drug activity - St. John’s Wort, phenobarbital dexamethasone; increase drug activity - grapefruit, ketoconazole, erythromycin
*Omega-3’s may enhance clinical benefit of Vincristine
Vinblastine (Velban)
Classification: Vinca Alkaloids
Indication: Breast, testicular, HD, sq cell NH, sarcoma
Side Effects: myelosuppression, mucositis, stomatitis, constipation, jaw pain, HTN
Interactions: decrease drug activity - St. John’s Wort, phenobarbital dexamethasone; increase drug activity - grapefruit, ketoconazole, erythromycin
Vinorelbine (Navelbine)
Classification: Vinca alkaloids
Indication: Breast, ovarian, non-sm cell lung CA
Side Effects: Myelosuppression, N/V, stomatitis, constipation, anorexia, elevated liver function tests
Rituximab (Rituxan)
Classification: monoclonal antibody CD20
Indication: B-cell NHL, CLL
Side Effects: infusion reaction, myelosuppression, tumor lysis syndrome, skin reactions, mild N/V
Pertuzumab (Perjeta)
Classification: monoclonal antibody Her2/neu
Indication: metastatic breast CA
Side Effects: infusion reaction, myelosuppression, asthenia, infections, mild N/V, cough, dyspnea, sinusitus
Trastuzumab (Herceptin)
Classification: monoclonal antibody Her2/neu
Indication: metastatic breast CA, metastatic gastric CA
Side Effects: infusion reaction, myelosuppression (rare), cardio-toxicity, N/V, mild D, pulmonary toxicity
Panitumumab (Vectibix)
Classification: monoclonal antibody EGFR
Indication: colorectal CA
Side Effects: infusion reaction, acneiform skin rash, pruritis, pulmonary toxicity, hypomagnesemia, Diarrhea, malaise
Interactions/concerns: hypomagnesemia – monitor Mg closely, particularly with elderly or pts with low baseline Mg
Cetuximab (Erbitux)
Classification: monoclonal antibody EGFR
Indication: colorectal CA, NH
Side Effects: infusion reaction, acneiform skin rash, pruritis, pulmonary toxicity, hypomagnesemia, Diarrhea, malaise, N/V, anorexia
Interactions/concerns: hypomagnesemia – monitor Mg closely, particularly with elderly or pts with low baseline Mg and received Oxalipatin (Eloxatin)
Megesterol acetate (Megace)
Classification: progesterone
Indication: breast, endrometrial, renal cell. Also appetite stimulant in CA and AIDS
Route: PO
Side Effects: weight gain (fluid retention), thromboembolic events, N/V, menstral bleeding, hot flashes, sweating, mood change, hyperglycemia
Carboplatin (Paraplatin)
Classification: alkylating agent
Indication: bladder, endometrial, germ cell, HN, lung, ovarian
Side Effects: myelosuppression, N/V!, renal toxicity, hypersensitivity reaction, alopecia, peripheral neuropathy
Cisplatin (Platinol or CDDP)
Classification: alkylating agent
Indication: bladder, cervical, esophageal, HN, lung, NHL, ovarian, prostate, testicular
Side Effects: Acute and delayed N/V, metallic state, myelosuppression, peripheral neuropathy, SIADH, renal toxicity, hypomagnesmia, ototoxicity, infusion reaction
Rigorous hydration is needed to prevent nephrotoxicity (PO and IVF). Monitor renal function/lytes. At risk include elderly, low Mg pts, impaired renal function at baseline
Interactions: Omega-3’s may enhance clinical benefits of Cisplatin; Curcumin - may sensitize cisplatin-resistant cells to cisplatin, improving efficacy. May reduce cisplatin-induced neurotoxicity. Safe to add into diet.
Cyclophosphamide (Cytoxan, CTX)
Classification: alkylating agent
Indication: breast, ovarian, MM, NHL, HD, CLL, Mycosis fungoides, neuroblastoma, sarcoma, Wilm’s tumors
Route: PO, IP, IV. When taken oral - take early in the day with vigorous hydration (3L) throughout the day.
Side Effects: Myelosuppression, N/V, bladder and cardiac toxicity, SIAD, Alopecia
Interaction: may increase effects of anti-coagulation so anticoag meds may need to be reduced
Dacarbazine (DTIC)
Classification: alkylating agent
Indication: HD, MM, neuroblastoma, sarcoma
Side Effects: myelosuppression, N/V (up to 12 hrs), flu-like symptoms, CNS toxicity, photo-sensitivity
Oxaliplatin (Eloxatin)
Classification: alkylating agent
Indication: colorectal, pancreatic, gastroesophageal
Side Effects: Myelosuppression, N/V/D, neurotoxicity, hepatic toxicity, allergic reaction
Interactions: Minimize cold exposure, up to 5 days post-infusion (avoid eating/drinking cold/frozen foods). Use care when handling cold/frozen items. Vit B6 (50-100 mg BID/TID) may help prevent/reduce hand-food syndrome
Fludarabine (Fludara)
Classification: anitmetabolics
Indication: CLL, NHL, T-cell Lymphoma, hairy cell leukemia
Side Effects: Myelosuppression, N/V, D, neuro-toxicity, rash
Flurouracil (5-FU)
Classification: anitmetabolics
Indication: breast, colorectal, GI, HN, pancreatic, ovarian, hepatoma
Route: IV - have pt melt ice chips in mouth 10-15 min pre/post IV bolus infusion to reduce incidence of mucositis
Side Effects: myelosuppression, N/V, D, mucositis, hand-foot syndrome, cardiac toxicity, photo-sensitivity
Interactions: Vit B6 (50-100 mg BID/TID) may help prevent/reduce hand-food syndrome
Gemcitabine (Gemzar)
Classification: anitmetabolics
Indication: pancreatic, breast, ovarian, NSCLC
Side Effects: myelosuppression, N/V, pulmonary toxicity, rash, flu-like symptoms
Methotrexate (Folex, Rheumetrex)
Classification: anitmetabolics
Indication: bladder, breast, H&N, NHL, CNS lymphoma, ALL, sarcoma
Route: IM, IV, IT, PO - Oral: take on empty stomach 1 hr before, 2 hr after meals. Avoid folic acid and derivatives. Avoid alcohol (may increase hepatic toxicity)
Side Effects: myelosuppression, N, mucositis, oral/GI ulcerations, renal toxicity, hepatic toxicity, photo-sensitivity
Interactions: high doses must be followed by Leucovorin and hydration
Pemetrexed (Alimta)
Classification: anitmetabolics
Indication: mesothelioma
Side Effects: myelosuppression, N/V, D, fatigue, rash
Interactions: Often given with cisplatin.
To prevent severe anemia, take dietary supplement prior and during treatment - folic acid (350-1000 ug PO) 1 week prior to treatment, daily and post treatment; B12 (1000ug) IM given every 3 cycles, beginning at first week prior to treatment
Paclitaxel (Taxol)
Classification: Taxens
Indication: bladder, breast, esophageal, H and N, ovarian, pancreatic, prostate, sm cell Lung, NSCLC
Side Effects: myelosuppression, Diarrhea, Mucositis, sensory neuropathy, hypersensitivity reaction, alopecia
Interactions: drink at least 2-3 quarts every 24 hours; omega-3’s may reduce toxicity
Docetaxel (Taxotere)
Classification: Taxens
Indication: breast, gastric, H and N, ovarian, prostate, NSCLC
Side Effects: myelosuppression, nucositis, diarrhea, neurotoxicity, fluid retention, skin/nail changes
Paclitaxel Protein-bound (Abraxane)
Classification: Taxens
Indication: Breast, NSCLC
Side Effects: myelosuppression, N/V, Diarrhea, Mucositis, arthralgia, myalgia, sensory neuropathy, alopecia
Imatinib (Gleevac)
Classification: pro-targeted therapy/small molecule inhibitor
Indication: Philadelphia (PH) + CML, GIST, MDS, refractory PH+ALL
Route: oral - take with meal and full glass of water. if difficult to swallow, ok to dissolve in glass of water/juice. drink immediately and follow with another glass of water
Side Effects: rash, facial erythema, hand-food syndrome, cardiotoxicity, N/V, D, decreased appetite
Interactions: decrease drug activity - St. Johns Wart, phenobarb); increase drug activity - grapefruit, ketoconazole, erythromycin
Bortezomib (Velcade)
Classification: pro-targeted therapy/small molecule inhibitor
Indication: MM, mantle cell lymphoma
Route: Injection or subQ
Side Effects: rash, facial erythema, hand-food syndrome, cardiotoxicity, N/V, D, decreased appetite
Interactions: Avoid green tea in liquid or capsule form. decrease drug activity - St. Johns Wart, phenobarb); increase drug activity - grapefruit, ketoconazole, erythromycin
Ibritumomab and Yttrium 90 (Zevalin)
Classification: radioimmunotherapy agent
Indication: B-cell lymphoma
Side Effects: myelosuppression, infusion-related reactions, mild N/V, diarrhea, infection, cough, decreased appetite, throat irritation, dyspnea.
Long term risk of secondary malignancies
radioiodine/Iodine 131
Classification: radioactive substance
Indication: certain types of thyroid CA (thyroid ablation-destroys thyroid gland function)
Route: oral capsule
Side Effects: requires short hospital stay with isolation. neck tenderness/swelling, N/V, fatigue, salivary gland tenderness/swelling, taste changes, xerostomia
Long term risk of secondary malignancies
Samarium 153 (Quadramet)
Classification: radio-pharmaceutical
Indication: osteoblastic bone lesions that enhance on radionuclide bone scan - to palliate bone pain
Side Effects: myelosuppression, N/V, flushing
Long term risk of secondary malignancies
Strontium 89 (Metastron)
Classification: radio-pharmaceutical
Indication: relief of painful bony metastases
Side Effects: myelosuppression, temporary increase in bone pain, flushing
Long term risk of secondary malignancies
Radium 223 (Xofigo)
Classification: radio-pharmaceutical
Indication: castration-resistant prostate CA with symptomatic bone metastasis and no known visceral metastatic disease
Side Effects: meylosuppression, N/V/D, peripheral edema
Ibritumomamab tiuxetan (Zevalin)
Classification: monoclonal antibody CD20 Target
Indication: relapsed or refractory B-cell NHL
Side Effects: possible infusion reaction, myelosuppression, asthenia, infections, mild N/V, cough, dyspnea, sinusitis
Bevacizumab (Avastin)
Classification: angiogenesis inhibitor
Indication: metastatic colorectal CA, NSCLC, glioblastoma w/ progressive disease, metastatic renal cell
Side Effects: HTN, arterial thromboembolic event, proteinuria, hemorrhage, GI perf (present with abd pain/N/V/C/fever), hypothyroidism
Lenalidomide (Revlimid)
Thalidomide
Classification: angiogenesis inhibitor
Indication: MM, MDS
Route: PO
Side Effects: HTN, arterial thromboembolic event, proteinuria, hemorrhage, GI perf (present with abd pain/N/V/C/fever), hypothyroidism
Gardasil
Cervaric
Classification: CA prevention Vaccines
Indication: cervical and oral CA
Approved by FDA
Protects against HPV
Hepatitis B
Classification: Preventative vaccine
Indication: can prevent hepatocellular CA as well
Approved by FDA
Neulasta (pegfilgrastim)
Used to prevent neutropenia, a lack of certain white blood cells caused by receiving chemotherapy
given 24 hrs post chemo, shouldn’t get chemo for 14 more days
Neupogen (filgrastim)
used to treat neutropenia, a lack of certain white blood cells caused by cancer, bone marrow transplant, receiving chemotherapy, or by other conditions.
given daily for a week between chemo
Bendamustine (Treanda)
Classification: alkylating agents
Indication: B-Cell non-Hod Lymphoma, CLL, mantle cell lymphoma
Side Effects: mild N/V, fatigue, infusion reactions, tumor lysis syndrome
Busulfan (Myleran-PO; Busulfex-IV)
Classification: alkylating agent
Indication: CML, HCT prep
Side Effects: N/V/D, mucositis, hepatic toxicity, adrenal insufficiency, pulm symptoms, insomnia, dizziness, anxiety, alopecia
Carmustine (BCNU)
Classification: alkylating agent
Indication: Brain, HD, NHL, MM, glioblastoma
Side Effects: N/V, hepatic/renal/pulm toxicity
Chlorambucil (Leukeran)
Classification: alkylating agent
Route: PO
Indication: CLL, HD, NHL
Side Effects: N/V, hyperuricemia, pulm toxicity
Ifosfamide (Ifex)
Classification: alkylating agent
Indication: bladdar, cervical, germ cell, HN, lung, ND, NHL, sarcomas
Side Effects: NV, anorexia, Bladder toxicity, SIADH, neurotoxicity, alopecia
*Mesna and hydration given for urological protection
Mechlorethamine (nitrogen mustard)
Classification: alkylating agent
Indication: CLL, CML, HD, NHL, mycosis fungoides
Side Effects: N/V, hyperuricemia
Melphalan (Alkeran)
Classification: alkylating agent
Indication: breast, ovarian, MM, MCT, polycythemia vera
Side Effects: N/V, mucositis, D, hypersensitivity
Temozolomide (Temodar)
Classification: alkylating agent
Route: PO
Indication: astrocytoma, glioblastoma
Side Effects: N/V, fatigue, headache, hep toxicity
Thiotepa (Thioplex)
Classification: alkylating agent
Indication: bladder, breast, and ovarian
Side Effects: N/V, mucositis, renal toxicity, skin changes
Capecitabine (Xeloda)
Classification: antimetabolites
Route: PO
Indication: colon, met breast CAs
Side Effects: N/V/D, fatigue, increased bilirubin, hand-foot syndrome
Cytarabine (ARA-C)
Classification: antimetabolites
Indication: ALL, AML, CML, NHL
Side Effects: N/V, mucositis, anorexia, acute pancreatitis, neurotoxicity, hepatic, pulm toxicity
Fludarabine (Fludara)
Classification: antimetabolites
Indication: CLL, NHL, T-Cell Lymphoma, Hairy Cell Leukemia
Side Effects: N/V/D, pulm toxicity, rash
Mercaptopurine (6-MP)
Classification: antimetabolites
Route: PO
Indication: ALL, AML, CML, NHL
Side Effects: N/V, mucositis, D, Hepatic toxicity
Pemetrexed (Alimta)
Classification: antimetabolites
Indication: bladder, breast, HN, NHL, CNS, lymphoma, ALL, sarcoma
Side Effects: N/V, D, fatigue, rash
Thioguanine (6-TG)
Classification: antimetabolites
Route: PO
Indication: ALL, AML, CML
Side Effects: N/V, mucositis, D, hepatic toxicity, renal toxicity, rash
Dactinomycin (Actinomycin D)
Classification: antitumor antibiotics
Indication: Ewing Sarcoma, rhabdomyosarcoma, Wilm’s tumor, testicular
Side Effects: N/V, mucositis, D, anorexia
Mitomycin-C (Mutamycin)
Classification: antitumor antibiotics
Indication: anus, bladder, breast, esophagus, HN, lung, pancreas, stomach
Side Effects: N/V, mucositis, D, anorexia, pulm/renal toxicity
Daunorubicin (Daunomycin)
Classification: antitumor antibiotics
Indication: ALL, AML
Side Effects: N/V, D, mucositis, anorexia, hyperuremia, cardiotoxicity, red urine
Epirubicin (Ellence)
Classification: antitumor antibiotics
Indication: Breast, gastric
Side Effects: N/V/D, mucositis, red-orange urine, cardiotoxicity, alopecia
Idarubicin (Idamycin)
Classification: antitumor antibiotics
Indication: AML, ALL, CML, MDS
Side Effects: N/V/D, mucositis, red urine, cardiotoxicity, elevated liver enzymes
Teniposide (Vumon, VM-26)
Classification: Epipodophyllotoxins
Indication: Childhood ALL
Side Effects: N/V, hypotension, pulm toxicity
Vinorelbine (Navelbine)
Classification: Vinca Alkaloids
Indication: Breast, Ovarian, NSC lung
Side Effects: N/V, stomatitis, C, anorexia, elevated liver test
Ado-trastuzumab emtansine (Kadcyla)
Classification: Monoclonal Antibodies - Her2/neu
Indication: met breast CA
Side Effects: cardio/hep/pulm toxcity, thrombocytopenia, neuropathy, constipation
Panitumumab (Vectibix)
Classification: Monoclonal Antibodies - EGFR
Indication: colorectal
Side Effects: acneiform skin rash, pulm toxicity, hypomag, D, malaise
Denosumab (Xgeva)
Classification: Monoclonal Antibodies - RANKL
Indication: Bone Mets
Side Effects: N/V/D, hypocal, osteonecrosis of jaw
