Fitz - Managing Complications Flashcards

1
Q

HL regimen

A

ABVD - Doxorubicin, Bleomycin, Vinblastine, Dacarbazine

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2
Q

Type of activity in the ABVD regimen

A

Doxorubicin - Intercalating Agent
Bleomycin - antibiotic
Vinblastine - Antimitotic, destabilizer of microtubules
Dacarbazine - alkylating

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3
Q

Type of clearance in the ABVD regimen

A

Doxorubicin - hepatic
Bleomycin - renal
Vinblastine - CYP3A4/5
Dacarbazine - hepatic

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4
Q

Toxicity of ABVD regimen

A

Doxorubicin - cardiomyopathy
Bleomycin - pulmonary fibrosis
Vinblastine - neuropathy
Dacarbazine - marrow suppression

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5
Q

NHL regimen

A
CHOP - 
Cyclophosphamide
Doxorubicin
Vincristine
Prednisone
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6
Q

NHL regimen activity

A

Cyclophosphamide - alkylating (N mustard)
Doxorubicin - intercalating
Vincristine - antimitotic, destabilizer of microtubules
Prednisone - CS

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7
Q

NHL Clearance

A

Cyclophosphamide - CYP3A4/5; CYP2D6 prodrug
Doxorubicin - hepatic
Vincristine - CYP3A4/5
Prednisone - 100% bioavailable

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8
Q

NHL toxicity

A

Cyclophosphamide - acrolein (hemorrhagic cystitis)
Doxorubicin - Cardiomyopathy
Vincristine - neuropathy, constipation
Prendisone - hyperglycemia/osteopenia

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9
Q

Antiemetic classes best used for acute cytotoxic emesis

A
  1. 5HT3 receptor antagonists (~setron –> vagal afferent and area postrema)
  2. D-2 R antagonist - METOCLOPRAMIDE
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10
Q

Antiemetic classes best used for delayed cytotoxic emesis - caused by what drug?

A
  1. NK1 R antagonists (in vagal afferent and area postrema) - APREPITANT
    Caused by cisplatin
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11
Q

dronabinol

A

Cannabinoid receptor agonist - used if refractory to other agents

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12
Q

leucovorin used for what?

A

with HDMTX, to replenish folate pool in normal cells - bypasses DHFR

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13
Q

MESNA used for what? Give when?

A

hemorrhagic cystitis caused by acrolein (cyclophosphamide/CHOP or Ifosfamide).

Give prophylactically.

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14
Q

Amifostine used for what?

A

Nephrotoxicity associated with cisplatin.

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15
Q

Five of the worse CINV drugs

A
  1. CARmustine (nitrosourea)
  2. DACARbazine (alkylating agent)
  3. MECHlorethamine (nitrogen mustard)
  4. CYCLophophamide (nitrogen mustard)
  5. Cisplatin
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