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PHRM 864 > E2 unique things to look out for ig > Flashcards

E2 unique things to look out for ig Flashcards

1
Q

enterochromaffin

A

cells in lining of GI tract with lots of serotonin

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2
Q

substance P

A

one of two important neurotransmitters for CINV

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3
Q

metoclopramide or prochlorperazine

A

low emetogenic regimen choices

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4
Q

haloperidol

A

breakthrough option

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5
Q

cannibinoids

A

breakthrough option

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6
Q

acupuncture

A

prevention of anticipatory

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7
Q

5Ht3 antag common toxicities (3)

A

headache, ekg changes, constipation

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8
Q

hiccups

A

common tox of substance P antag

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9
Q

topical anesthetics

A

relief for mucositis

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10
Q

sucralfate

A

pain management mucositis

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11
Q

< 0.5 x 103/µL

A

WBC value for neutropenia

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12
Q

< 100 x 103/µL

A

platelet value for thrombocytopenia

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13
Q

nadir

A

lowest absolute neutrophil count during a cycle of chemo

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14
Q

WBC > 3 x103/µL OR
Absolute neutrophil count (ANC) of > 1.5 x103/µL AND
Platelet count > 100 x103/µL

A

guidelines to administer chemo safely

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15
Q

ANC < 0.5 x 103/µL and a single oral temperature > 101F

A

febrile neutropenia

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16
Q

when give CSF

A

chemo regimens with >20% incidence of febrile neutropenia or 10-20% for neutropenic fever. pretty sure this is just dose dense AC

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17
Q

CSF with non-linear shit

A

pegfilgrastim

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18
Q

20-kD and N-terminus

A

pegfilgrastim

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19
Q

Tbo-Filgrastim

A

not a biosimilar

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20
Q

start at least 24 hours after chemo

A

pegfilgrastim

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21
Q

flu-like sxs, bone and joint pain, DVT

A

adverse effects of CSF

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22
Q

loratidine

A

treatment of bone or joint pain from CSF

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23
Q

splenic enlargement

A

rare adverse effect with long terme CSF use

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24
Q

connect renal dysfunction and anemia

A

decreased erythropoietin production causes it

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25
Q

Hgb ≤ 11 g/dL or ≥ 2 g/dL

A

patients under this criteria should have a work-up before chemo for anemia

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26
Q

CKD and perisurgery

A

esa’s increase risk of these

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27
Q

peripheral neuropathies

A

taxanes, vinka, platinums

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28
Q

morphine

A

metabolized in liver
renal excretion

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29
Q

hydromorphone

A

renally excreted
caution in liver dysfxn

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30
Q

oxycodone

A

cyp2d6
caution in liver dysfxn
no iV form

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31
Q

fentanyl

A

safe in liver and renal
head/neck/esophageal

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32
Q

opioid with rems

A

fent

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33
Q

true morphine allergy

A

methadone

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34
Q

neuropathic pain opioid

A

methadone

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35
Q

excreted urine and feces

A

methadone

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36
Q

opioid with qtc risk

A

methadone

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37
Q

low dose nalaxone

A

respiratory depression

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38
Q

hot flashes
endometrial cancer
DVT

A

toxicities of tamoxifen

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39
Q

ovarian suppression

A

required for use of aromatase inhibitors in pre meno women

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40
Q

toxicities aromatase inhibitors

A

osteoporosis
hot flashes
muscle aches

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41
Q

dose dense treatment follow up

A

36 months

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42
Q

trastuzumab duration of therapy

A

1 year

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43
Q

ado-trastuzumab

A

residual breast cancer

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44
Q

keynote

A

triple negative

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45
Q

pembrolizumab in breast cancer

A

triple negative
positive score >10

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46
Q

fam-trastuzumab deruxtecan

A

HER2 low

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47
Q

CDK4/6 inhibitors

A

in hormonal therapy metastatic breast cancer

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48
Q

monitoring parameter all CDK4/6

A

complete blood count

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49
Q

Ribociclib

A

qtc prolongation
also cdk

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50
Q

cdk4/6 all cause

A

diarrhea

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51
Q

tamoxifen
raloxifene
exemestane

A

prevention breast cancdr

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52
Q

gleason score

A

scale 2-10
prostate cancer

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53
Q

psa >10ng/ml

A

highly sus for cancer

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54
Q

external beam or brachytherapy

A

radiation therapy in localized prostate cancer

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55
Q

ADT (prostate)

A

LHRH agonist +/- anti-androgene or orchiectomy

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56
Q

goal for inducing castrate levels of testosterone

A

<50 after 1 month of therapy

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57
Q

LHRH agonists irreversible or reversible

A

reversible

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58
Q

acute LHRH toxicity

A

tumor flare

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59
Q

long term LHRH agonists toxicities

A

increase fat
increase insulin
increase cholesterol

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60
Q

oral LHRH agonist

A

Relugolix

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61
Q

Relugolix

A

oral LHRH
less cardiovascular events

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62
Q

anti androgens (drugs)

A
  • lutamides
    abiraterone
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63
Q

side effect of all anti-androgens

A

diarrhea

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64
Q

2 orchiectomy toxicities

A

impotence
hot flashes

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65
Q

men with biochemical failure only

A

able to consider intermittent ADT

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66
Q

abiraterone

A

not used in M0

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67
Q

decrease warfarin conc
avoid cyp2c8
caution in pts with seizure history

A

enzalutamide

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68
Q

non-steroidal
qt prolongation
thyroid dysfunction
cyp shit

A

apalutamide

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69
Q

less adverse effects than other androgen receptor antagonists

A

darolutamide

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70
Q

high volume m1HSPC

A

multiple organ systems

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71
Q

abiraterone + prednisone

A

added to regimen for m1HSPC

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72
Q

CYP17

A

abiraterone

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73
Q

must give with predisone

A

abiraterone

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74
Q

cyp3a4
take on empty stomach

A

abiraterone

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75
Q

first line chemo drug m1HSPC

A

docetaxel

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76
Q

cabazitaxel

A

2nd line m1CRPC

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77
Q

mdr proteins

A

cabazitaxel

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78
Q

radium 223

A

prostate cancer
CRPC with bone metasteses

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79
Q

pembrolizumab in prostate cancer

A

expressing dMMR or MSI-H

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80
Q

DRE and TRUS

A

screening prostate

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81
Q

annual prostate screen

A

psa >2.5

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82
Q

every 2 years screen prostate

A

psa <2.5

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83
Q

finasteride

A

prostate cancer prevention

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84
Q

increases gleason score

A

finasteride

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85
Q

FAP HNPCC

A

haha
hereditary syndrome risk factor for colorectal

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86
Q

jaundice
hepatomegaly
weight loss

A

presentation of colorectal

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87
Q

dMMR or MSI-H tumor colorectal

A

decreased benefit from 5-FU in stage II

can benefit from 5-FU in stage III

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88
Q

surgery alone is definitive therapy

A

stage I and II colorectal

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89
Q

when chemo will not work in stage II colorectal

A

MSI-H or dMMR

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90
Q

paresthesia
neutropenia
GI

A

toxicities oxaliplatin

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91
Q

requires port

A

folfox

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92
Q

KRAS mutation colorectal

A

lack of response to anti-EGFR mabs
(dont use cetuximab and panitumumab)

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93
Q

KRAS and BRAF

A

predictive biomarkers for colorectal

94
Q

KRAS WT metastatic colorec tal

A

use cetuximab or panitumumab

95
Q

dMMR/MSI-H in colorectal

A

pembro OR
use Nivolumab + ipilimumab

96
Q

bevacizumab in colorectal

A

its VEGF (falls under no targetable mutations)
metastatic in combo with FOLFIRI or FOLFOX

97
Q

FOBT and FIT

A

primarily detect colon cancer

98
Q

detects hemoglobin

A

fecal immunochemical test (FIT)

99
Q

1st degree relative with colon cancer

A

screen at 40 or 10 years younger than youngest age of diagnosis in family

100
Q

thymidylate synthase
DPD

A

5-FU

101
Q

early and late onset diarrhea

A

irinotecan

102
Q

give atropine

A

with irinotecan for early onset diarrhea

103
Q

SN-38
UGT1a1

A

irinotecan

104
Q

cold intolerance

A

oxaliplatin

105
Q

cross-links DNA, inhibiting dna replication

A

oxaliplatin

106
Q

hand-foot syndrome and diarrhea

A

capecitabine

107
Q

binds to extracellular domain of EGFR

A

Cetuxima b

108
Q

only used in KRAS WT pts colorectal

A

cetuximab + panitumumab

109
Q

acneform rash
hypomagnesemia

A

cetuximab and panitumumab

110
Q

premedicate with H1 antagonist

A

cetuximab

111
Q

recombinant igG2 mab

A

panitumumab

112
Q

bleeding and hypertension

A

bevacizumab + many black box warnings

113
Q

metabolic derangements
from death of malignant cells

A

tumor lysis syndrome

114
Q

urine output 80-100 ml/hr

A

hydration for TLS

115
Q

urate oxidase and allantoin

A

hyperuricemia -> TLS

116
Q

causes direct tubular injury

A

hyperuricemia from tls

117
Q

pt cant take allopurinol what do you give

A

rasburicase

118
Q

rasburicase Ci

A

pregnant or breastfeed

119
Q

electrolyte changes TLS

A

everything hyper except hypocalcemia

120
Q

MSCC diagnosis

A

MRI

121
Q

immediately start what if sus of MSCC

A

steroids

122
Q

Kyphoplasty

A

balloon in spine

123
Q

bone cement injected into fractured bone

A

vertbroplasty

124
Q

bisphosphonates in MSCC

A

offered in pts w/ vertebral involvement to reduce fracture or collapse

125
Q

SVC

A

superior vena cava syndrome

major blood vessel from head to neck and arms to heart and lungs and whatever

126
Q

extrinsic compression

A

svs syndromee

127
Q

adjunctive therapies svc syndrome

A

elevation of head
steroids
diuretics

128
Q

malignant pleural effusion common in

A

lung
breast
lymphoma

129
Q

CXR (chest x-ray)

A

diagnosis of MPE

130
Q

thoracentesis

A

needle aspiration of fluid from pleural effusion

131
Q

thoracentesis vs pleurodesis

A

thora -> <1-3 months to live
pleuro -> >1-3 months

132
Q

pleurodesis drugs and administration of said drugs

A

talc
doxycycline
bleomycin
intrathecal (gross)

133
Q

lynch II syndrome

A

risk factor ovarian

134
Q

ascites

A

presenting symptom ovarian

135
Q

debulking

A

ovarian cancer surgerey

136
Q

optimally debulked

A

<1 cm of disease

137
Q

sub-optimally debulked

A

> 1 cm disease

138
Q

AUC x (GFR+25)

A

carboplatin dosing * absolutely on exam

139
Q

anaphylaxis
itching
rash
chest tightness

A

type I hypersens

140
Q

erythema, induration

A

type IV hypersens

141
Q

MHC and APC

A

t cells recognize antigens
something about type IV hypersens

142
Q

pretty common drug for hypersens reaction

A

paclitaxel
mostly type I

143
Q

cremophor EL

A

paclitaxel diluent -> hypersens

144
Q

facial flushing
back pain
chest or throat tightness

A

taxane infusion reactions

145
Q

premedicate paclitaxel with

A

dexamethasone
benadryl
famotidine

146
Q

cutaneous sxs
vomiting
htn

A

carboplatin hypersens symptoms

147
Q

parp inhibitors use

A

ovarian cancer

148
Q

platinum sensitive

A

ovarian cancer
treat with initial regimen again

149
Q

platinum resistant

A

salvage regimen

150
Q

platinum progressive

A

ovarian cancer
no response or progression

151
Q

effective screening tool ovarian cancer

A

none you fool

152
Q

oral contraceptives

A

ovarian cancer prevention

153
Q

NSCLC histology

A

mostly adenocarcinoma

154
Q

SCLC

A

rapid proliferation
super common to cause brain metasteses

155
Q

lung cancer:
highly sensitive to radiation and chemo

A

SCLC

156
Q

cisplatin + etoposide

A

SCLC every time

157
Q

prophylactic cranial radiation

A

limited stage SCLC

158
Q

extensive stage SCLC shit

A

without radiation
rarely curable

159
Q

Atezolizumab and Durvalumab seen where

A

extensive stage SCLC

160
Q

pemetrexed

A

see only in NSCLC

161
Q

pembro in NSCLC

A

unresectable
PD-L1 >1%
not candidates for surgery

162
Q

exon 19 or 21

A

osimertinib

163
Q

fevers
secondary skin cancers

A

dabrafenib

164
Q

visual changes
retinal detachment
fevers
rash

A

trametinib

165
Q

sotorasib

A

KRAS G12C mutation in NSCLC

166
Q

albumin bound paclitaxel

A

seen in squamous NSCLC

167
Q

nivolumab in melanoma

A

stage 3

168
Q

pembro with low dose ipilimumab

A

metastatic 2nd line option in melanoma for those that progressed on prior anti pd-1 therapy

169
Q

unique tox vemurafenib

A

development of squamous cell carcinoma

170
Q

pro of encorafenib and binimetinib

A

less fevers

171
Q

CTLA-4

A

ipilimumab

172
Q

Reed-sternberg cells

A

hodgkins

173
Q

90% are B cell

A

non-hodgkins

174
Q

epstein-barr virus

A

global risk factor for myelomas

175
Q

Ann arbor staging A and B

A

A-> asymptomatic
B -> B symptoms

176
Q

ABVD

A

HL regimen
doxo, bleo, vinblastine, dacarbazine

177
Q

relapsed hodgkins

A

brentuximab
stem cell transplant

178
Q

malignant B or T lymphocytes and precursors

A

non hodgkin’s lymphoma

179
Q

PTHrp

A

increased parathyroid
part of HCM (calcium and bone shit)

180
Q

severe HCM main sx

A

heart shit

181
Q

corrected calcium

A

serum calcium + 0.8 (4-serum albumin)

normal calc is 8.5-10

182
Q

<12
12-14
>14

A

degrees of hypercalcemia
mild moderate severe

183
Q

T or F
hydration reduces calcium faster than bisphosphonates

A

true

184
Q

calcitonin

A

used in severe HCM

185
Q

refractory HCM

A

denosumab

186
Q

RANK-L
kappa B

A

something with bone in cancer patients idk HCM shit

also denosumab has affinity for

187
Q

men with prostate cancer
women with breast cancer
both risk factors for

A

fractures

188
Q

drugs off top of my head that need renally adjusted

A

bisphosphonates
capecitabine

189
Q

osteonecrosis of jaw

A

bisphos and deno

190
Q

IPI >/= 2

A

NHL
use Pola-R-CHP instead of RCHOP

191
Q

HepB anything

A

rituximab in NHL

192
Q

entacavir

A

give to people that get hepB from rituximab in NHL

193
Q

bendamustine

A

part of regimen for relapsed DLBCL/Aggressive NHL

with rituximab and polatuzumab

194
Q

when to use CAR-T

A

relapsed DLBCL/Aggressive NHL

195
Q

-leucel

A

car-t cells in NHL all end with

196
Q

when to use bites NHL

A

third line after failing 2 lines of systemic, progressed on car-t or stem cell transplant

197
Q

IL-6

A

tocilizumab
bite for NHL

198
Q

bone marrow biopsy

A

required for CML diagnosis

199
Q

allogenic hematopoetic stem cell transplant

A

only way to cure CML / leukemic clone i cant tell

200
Q

avoid acid reducers

A

dasatinib

201
Q

metabolic syndrome and qtc prolongation

A

nilotinib

202
Q

t315 can be used in resistant cml

A

asciminib

203
Q

deep molecular response

A

discontinue TKI
bcr-abl <0.1%

204
Q

translocation chromosomes 9 and 22

A

CML
bcr-abl
philly

205
Q

fludarabine

A

CLL
del(11q)
add alkylating agent

206
Q

reflects loss of tp53

A

Del17p in CLL

207
Q

Monoclonal B lymphocytes > 5 x 109 /L in peripheral blood

A

CLL diagnosis

208
Q

RAI staging

A

CLL

209
Q

treatment in CLL

A

stage III or IV
organ dysfunction

210
Q

you see any BTK (-brut) what do you think

A

CLL first line option solo or add chemoimmuno

211
Q

BLC-2 and BIM and PUMA

A

venetoclax
CLL

212
Q

CYP3a4 and PGP

A

venetoclax drug interactions

213
Q

venetoclax in CLL

A

when they have del 17p or p53 mutation

214
Q

main toxicity with venetoclax*

A

tumor lysis syndrome

215
Q

transient increase in absolute lymphocyte count

A

associated with btk inhibitors

216
Q

FTL3 mutations

A

AML
TKIS can target this

217
Q

induction and consolidation

A

AML, MM

218
Q

cytarabine

A

intensive induction in AML

219
Q

pyrimidine analog

A

cytarabine

220
Q

cerebellar side effects
chemical conjunctivitis

A

cytarabine

221
Q

t(15;17)

A

APL (subset of AML)

222
Q

crowd out normal cells

A

ALL and maybe the other too idk

223
Q

hide in balls and brain

A

ALL

224
Q

HyperCVAD

A

ALL
cyclophosphamide, vincristine, doxorubicin, dexamethasone

225
Q

hypomethylating agent

A

azacitidine

226
Q

cd19 and cd3

A

blinatumomab

227
Q

cytokine release syndrome
immune effector cell-associated neurotoxicity syndrome

A

blinatumomab?

228
Q

asparaginase

A

ALL only?

229
Q

IgG

A

MM pathology

230
Q

lenalidomide
dexamethasone
bortezomib

A

MM 3 drug regimeen

231
Q

crab

A

lymphoma lecture
hypercalcemia
renal dysfunction
anemia
bone lesions

PHRM 864 (28 decks)

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