Fitz - Managing Complications Flashcards
HL regimen
ABVD - Doxorubicin, Bleomycin, Vinblastine, Dacarbazine
Type of activity in the ABVD regimen
Doxorubicin - Intercalating Agent
Bleomycin - antibiotic
Vinblastine - Antimitotic, destabilizer of microtubules
Dacarbazine - alkylating
Type of clearance in the ABVD regimen
Doxorubicin - hepatic
Bleomycin - renal
Vinblastine - CYP3A4/5
Dacarbazine - hepatic
Toxicity of ABVD regimen
Doxorubicin - cardiomyopathy
Bleomycin - pulmonary fibrosis
Vinblastine - neuropathy
Dacarbazine - marrow suppression
NHL regimen
CHOP - Cyclophosphamide Doxorubicin Vincristine Prednisone
NHL regimen activity
Cyclophosphamide - alkylating (N mustard)
Doxorubicin - intercalating
Vincristine - antimitotic, destabilizer of microtubules
Prednisone - CS
NHL Clearance
Cyclophosphamide - CYP3A4/5; CYP2D6 prodrug
Doxorubicin - hepatic
Vincristine - CYP3A4/5
Prednisone - 100% bioavailable
NHL toxicity
Cyclophosphamide - acrolein (hemorrhagic cystitis)
Doxorubicin - Cardiomyopathy
Vincristine - neuropathy, constipation
Prendisone - hyperglycemia/osteopenia
Antiemetic classes best used for acute cytotoxic emesis
- 5HT3 receptor antagonists (~setron –> vagal afferent and area postrema)
- D-2 R antagonist - METOCLOPRAMIDE
Antiemetic classes best used for delayed cytotoxic emesis - caused by what drug?
- NK1 R antagonists (in vagal afferent and area postrema) - APREPITANT
Caused by cisplatin
dronabinol
Cannabinoid receptor agonist - used if refractory to other agents
leucovorin used for what?
with HDMTX, to replenish folate pool in normal cells - bypasses DHFR
MESNA used for what? Give when?
hemorrhagic cystitis caused by acrolein (cyclophosphamide/CHOP or Ifosfamide).
Give prophylactically.
Amifostine used for what?
Nephrotoxicity associated with cisplatin.
Five of the worse CINV drugs
- CARmustine (nitrosourea)
- DACARbazine (alkylating agent)
- MECHlorethamine (nitrogen mustard)
- CYCLophophamide (nitrogen mustard)
- Cisplatin