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IHOP > IHOP Drug Review FINAL > Flashcards

IHOP Drug Review FINAL Flashcards

1
Q

What is the MOA of Cisplatin?

Alkylating agent

A
  1. Cl(-) leaves the molecule
  2. DNA cross-linking
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2
Q

What are the side effects of Cisplatin?

A

-N/V !!! (causes the most N/V of cancer drugs)

-Neuropathy (chronic)

-Nephrotoxicity (acute and chronic)
Hypokalemia and Hypomagnesemia

-Ototoxicity

-Gonadal toxicity (risk of infertility)

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3
Q

What should be given with Cisplatin to prevent Nephrotoxicity?

A

IV normal saline (1L) before and after treatment

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4
Q

What is the brand name of Capecitabine?

A

Xeloda

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5
Q

What is the MOA of Capecitabine?

A

-inhibits Thymidylate-Synthase
-RNA false base pair

it is a prodrug of 5-FU

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6
Q

What are the side effects of Capecitabine?

A

-Hand-foot syndrome
-Diarrhea
-Photosensitivity

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7
Q

What is a common DDI of Capecitabine? BBW

A

DDI with Warfarin (CYP2C9 inhibition)

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8
Q

What is the MOA of Cytarabine?

A

inhibits DNA polymerase in the S-phase
-pyrimidine false base pair

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9
Q

What are the side effects of Cytarabine?
Which pre-med is required?

A

HiDAC (high-dose Ara-C)

-Cerebellar dysfunction
-chemical conjunctivitis/keratitis
-> Prophylactic corticosteroid eyedrops

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10
Q

What is the brand name of Bevacizumab?

A

Avastin

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11
Q

What is the MOA of Bevacizumab?

A

VGEF blockage

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12
Q

What are the side effects of Bevacizumab?

A

Bleeding
clotting
impaired wound healing
proteinuria
HTN

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13
Q

What is the MOA of Carboplatin?

A

DNA crosslinks

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14
Q

What is a common side effect of Carboplatin?

A

Bone marrow suppression

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15
Q

How is the dose of Carboplatin determined?

A

Calvert equation

dose (mg) = AUC x (GFR (CrCl) + 25)

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16
Q

What is the MOA of Carmustine?
(Mustard agent, Alkylating agent)

A
  1. Cl(-) leaves the molecule
  2. DNA cross-linking -> covalently
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17
Q

What is a side effect of Carmustine and other alkylating agents?

A

Secondary leukemias

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18
Q

What is the brand name of Cetuximab?

A

Erbitux

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19
Q

What is the MOA of Cetuximab?

A

EGFR blockage

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20
Q

What are the side effects of Cetuximab?

A

Rash
Diarrhea
Infusion reaction
Hypomagnesemia

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21
Q

What is the brand name of Pembrolizumab?

A

Keytruda

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22
Q

What is the MOA of Pembrolizumab?

A

PD-1 blocker
Immune checkpoint inhibitor

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23
Q

What are the side effects of Pembrolizumab?

A

LEGS
L: liver - hepatitis
E: endocrinopathies - hypothyroid, hyperthyroid, low cortisol (adrenal insufficiency)
G: GI - diarrhea, colitis
S: skin - dermatitis

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24
Q

What is the MOA of Oxaliplatin?

A

DNA crosslinks

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25
What are the side effects of Oxaliplatin?
acute: cold-exacerbated neuropathy chronic: peripheral neuropathy
26
What is the brand name of Doxorubicin?
Adriamycin
27
What is the MOA of Doxorubicin?
1. Topoisomerase II inhibition 2. DNA intercalation 3. Free radical production
28
What are the side effects of Doxorubicin?
-red tears and urine -Cardiomyopathy (decrease in LVEF) -Secondary leukemias it is a Vesicant (causes necrosis after extravasation)
29
What should be monitored before starting Anthracyclines?
Echocardiogramm (for LVEF)
30
Which drug is used to treat Vesicant injuries (extravasation)?
Dexrazoxane (Totect)
31
What is the maximum accumulative lifetime dose of Anthracyclines?
400-550 mg/m2
32
What is the brand name of Vincristine?
Oncovin (the O in CHOP)
33
What is the MOA of Vincristine?
it inhibits microtubule assembly
34
What safety precautions are necessary when handling Vincristine?
prepare it in a bag to prevent confusing it with an IT syringe -intrathecal administration can be fatal -auxiliary label is required: "Fatal when given intrathecally)"
35
What are the side effects of Vincristine?
peripheral neuropathy autonomic neuropathy -> constipation -> need Bowel regimen -NO Myelosuppression
36
What is the MOA of Etoposide?
inhibits Topoisomerase II
37
What are the side effects of Etoposide?
Secondary leukemias (mutation in the MLL gene) -when given too fast it can cause Hypotension
38
What is the brand name of Cyclophosphamide?
Cytoxan
39
What is the MOA of Cyclophosphamide? Alkylating agent
inter and intrastrand crosslinks
40
What are the side effects of Cyclophosphamide? How do we prevent/treat?
Hemorrhagic cystitis (caused by Acrolein) give fluids to prevent it consider Mesna for high doses of Cyclophosphamide
41
What is the brand name of Imatinib?
Gleevec
42
What is the MOA of Imatinib?
inhibits Tyrosine kase of BCR-ABL prevents ATP binding to the pocket of the BCR-ABL fusion protein (the BCR-ABL needs ATP to work)
43
What is the brand name of Trastuzumab?
Herceptin
44
What is the MOA of Trastuzumab?
Her2 blockade
45
What are the side effects of Trastuzumab?
-Cardiomyopathy (reversible LVEF reduction) - need an ECHO every 3 months -myelosuppression (thrombocytopenia) -LFT -arthralgia (joint pain) -myalgia
46
What is the brand name of Methotrexate?
Trexall, Rheumatrex
47
What is the MOA of Methotrexate?
Dihydrofolate reductase (antifolate)
48
What are the side effects of Methotrexate?
Mucositis Myelosuppression
49
What needs to be given with Methotrexate?
-Leucovorin (with high dose Mtx) -IV fluids with an alkylating agent (sodium bicarbonate) -> increases solubility and urine excretion monitor urine output and urine pH
50
What is Leucovorin?
reduced folic acid -it rescues healthy cells when ha igh dose of Mtx is given
51
What is the antidote of Methotrexate?
Glucarpridase (Voraxaze) -hydrolyzes methotrexate
52
What are the DDI with Methotrexate?
drugs that are also eliminated through the kidney -Penicillin -Bactrim, Sulfonamides -NSAIDs -PPIs -Probenecid (used for gout) -> Increase in Methotrexate concentration
53
What is the MOA of 5-Fluorouracil?
-inhibits Thymidylate-Synthase -RNA false base pair
54
What are the side effects of 5-FU?
-Myelosuppression (more false DNA base pair) -N/V
55
Which drug increases the effect of 5-FU?
Leucovorin
56
What is the MOA of Leuprolide?
-they cause a negative feedback loop leading to suppression of LH and FSH secretion -> NO Testosterone secretion by the testes
57
What are the side effects of Leuprolide?
-tumor flare with the first dose, in the first 2 weeks (due to LNRH stimulation -> later negative feedback) -hot flashes -metabolic syndrome -Erectile dysfunction -prostate pain -libido goes down -BMD decline -depression
58
What is the brand name of Irinotecan?
Camptosar
59
What is the MOA of Irinotecan?
Topo I inhbition
60
What are the side effects of Irinotecan?
-early diarrhea -> cholinergic storm (SLUD: salivation, lacrimation (tears), urination, defecation) -late diarrhea (12-24h after infusion)
61
Which drugs are used for Irinotecan-induced diarrhea?
early diarrhea: treat with anticholinergic atropine 0.25 to 1 mg IV late diarrhea: Loperamide 4mg, then 2 mg q2h until no loose stools for 12h (may exceed the OTC max dose (16mg/day))
62
What is the brand name of Gemcitabine?
GEmzar
63
What is the MOA of Gemcitabine?
Pyrimidine false base pair
64
What are the side effects of Gemcitabine?
-Thrombocytopenia -Hemolytic uremic syndrome (thrombotic thrombocytopenic purpura, rare)
65
What is the MOA of 6-MP?
Purine false base pair
66
What are the side effects of 6-MP?
-Myelosuppression -Hepatoxicity DDI with Allopurinol (increases 6-MP concentration)
67
Before using 6-mercaptopurine and 6-thioguanine patients need to be tested for what?
TPMT and NUDT15 PGx testing counsel: avoid taking with milk
68
What is the brand name of Paclitaxel?
Taxol
69
What is the MOA of Paclitaxel?
prevents microtubule disassembly
70
What are the side effects of Paclitaxel?
-Hypersensitivity reactions to the Cremophor (diluent) in the formulation -Peripheral Neuropathy
71
What premeds are required for Paclitaxel?
Dexamethasone, diphenhydramnie, H2RA
72
What has to be considered for the administration of Paclitaxel?
-Special “Taxol” tubing required -has to be DHEP-free and In-line (0.22 micron) filter -Vesicant precautions
73
What is the brand name of Dexamethasone?
Decadron
74
What is the role of Dexamethasone in cancer therapy?
CINV (N/V treatment -often used as premedication -kills lymphoma, myeloma and acute lymphocytic leukemia
75
What is the brand name of Bortezomib?
Velcade
76
What is the MOA Bortezomib?
Protease inhibitor
77
What are the side effects of Bortezomib?
peripheral neuropathy (given SC bc if this) need HSV/VZV prophylaxis Acyclovir or Valacyclovir
78
What is the MOA of Ibrutinib?
Bruton's Tyrosine kinase inhibitors (B-cells) Bru in the name
79
What are the side effects of Ibrutinib?
-Infections (bc we inhibit B-cell activation) -HTN -Afib -increased bleeding
80
What is the brand name of Docetexel?
Taxotere
81
What is the MOA of Docetexel?
Prevents microtubule disassembly
82
What are the side effects of Docetaxel?
-edema (use dexamethasone) -Hypersensitivity (less common than paclitaxel) -Peripheral neuropathy (less severe than paclitaxel)
83
Which premeds are needed for Docetexel?
Dexamethasone for edema
84
What is the brand name of Lenalidomide?
Revlimid
85
What are the side effects of Lenalidomide?
-VTE !!! -peripheral neuropathy -myelosuppression -somnolence -rash -REMS program (teratogenicity)
86
What is the brand name of Rituximab?
Rituxan
87
What is the MOA of Rituximab?
binds to CD20 (on B-cells)
88
What are the side effects of Rituximab?
-infusion reactions (Tylenol, Benadryl, infuse slowly) -reactivating of Hep B virus check Hep serum !!! -also decreases vaccine response for 6-12 after treatment
89
What is the brand name of Palbociclib?
Ibrance
90
What is the MOA of Palbociclib? has cicl in the name -> CDK
CDK 4/6 inhibitor
91
What are the side effects of Palbociclib?
Minichemo: -Myelosuppression (21 days on, 7 days off to allow the bone marrow to recover) -nausea -alopecia -diarrhea -Qt prolongation
92
What is the brand name of Pemetrexed?
Alimta
93
What is the MOA of Pemetrexed?
blocks multiple enzymes in the folate pathway -most important: blocks Thymidylate-Synthase
94
What are the required premeds for Pemetrexed?
to prevent myelosuppression -Folic acid 400-1000 mcg daily -Vit B12 100 mcg every 9 weeks to prevent skin reaction: -Dexamethasone
95
Pemetrexed has lower efficacy in what type of cancer?
squamous cancer in the lungs because it has higher levels of Thymidylate synthetase enzymes (TS) -> greater resistance to the drug (cant block it enough)
96
What is the brand name of Tamoxifen?
Soltamox
97
What is the MOA of Tamoxifen?
SERM blocks estrogen receptors in the breast (acts like estrogen in other tissues)
98
What are the toxicities of Tamoxifen (SERM) and AIs?
-Hot flashes, night sweats !!! -risk of endometrial cancer -thrombotic risk -arthralgia, myalgia
99
What is the dose of Tamoxifen?
20 mg daily
100
What is the brand name of Anastrozole?
Arimidex
101
What is the MOA of Anastrozole?
Aromatase inhibitor
102
What are the side effects of Anastrozole?
-Hot flashes -arthralgia, myalgia -BMD decline
103
What is the dose of Anastrozole?
1 mg
104
At what age do we screen for Breast cancer? What is the screening method?
40 mammography
105
At what age do we screen for prostate cancer? What is the screening method?
at 55 PSA (prostate-specific antigen test)
106
At what age do we screen for colon cancer? What is the screening method?
age 45 -Colonoscopy /gold stanadard) -DNA stool test -DNA blood test -fecal occult test -sigmoidoscopy
107
At what age do we screen for cervical cancer? What is the screening method?
age 21 Pap smear (cytology) Pap smear for HPV screen
108
At what age do we screen for lung cancer? What is the screening method?
age 55-80 if 30 year-pack history and smoked for the last 15 years

IHOP (33 decks)

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