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2016 CSO Exam Study Group > Medications > Flashcards

Medications Flashcards

1
Q

Bleomycin (Blenozane)

A

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

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2
Q

Doxorubicin (Adriamycin or Rubex)

A

Classification: antitumor antibiotic, anthracyclines

Indication: breast, liver, lung, ovarian, prostate; NHL, HD, MM, ALL, AML; sq HN

Route: IV

Side Effects: myelosuppression, N/V, mucositis, diarrhea, anorexia

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3
Q

Doxorubicin liposomal (Doxil)

A

Classification: antitumor antibiotic, anthracyclines

Indication: AIDS-related Kaposi’s Sarcoma, ovarian, MM, sarcoma, Heptocellular CA

Route: IV

Side Effects: myelosuppression, N/V, mucositis, diarrhea

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4
Q

Etoposide (VePesid or VP-16)

A

Classification: Epipodophyllotoxins

Indication: small & nonsmall lung CA, HD, NHL, gastric CA, germ cell tumors (testicular)

Route: IV

Side Effects: myelosuppression, N/V, mucositis, diarrhea, metallic taste

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5
Q

Vincristine (Oncovin)

A

Classification: Vinca alkaloids

Indication: ALL, AML, CML, D, NHL, MM, sm cell lung CA, rhabdomyosarcoma, neuroblastoma, Ewing’s sarcoma, Wilms’ tumor, brain & thyroid CA

Route: IV

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

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6
Q

Vinblastine (Velban)

A

Classification: Vinca Alkaloids

Indication: Breast, testicular, HD, sq cell NH, sarcoma

Route: IV

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

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7
Q

Vinorelbine (Navelbine)

A

Classification: Vinca alkaloids

Indication: Breast, ovarian, non-sm cell lung CA

Route: IV

Side Effects: Myelosuppression, N/V, stomatitis, constipation, anorexia, elevated liver function tests

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8
Q

Rituximab (Rituxan)

A

Classification: monoclonal antibody CD20

Indication: B-cell NHL, CLL

Route: IV

Side Effects: infusion reaction, myelosuppression, tumor lysis syndrome, skin reactions, mild N/V

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9
Q

Pertuzumab (Perjeta)

A

Classification: monoclonal antibody Her2/neu

Indication: metastatic breast CA

Route: IV

Side Effects: infusion reaction, myelosuppression, asthenia, infections, mild N/V, cough, dyspnea, sinusitus

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10
Q

Trastuzumab (Herceptin)

A

Classification: monoclonal antibody Her2/neu

Indication: metastatic breast CA, metastatic gastric CA

Route: IV

Side Effects: infusion reaction, myelosuppression (rare), cardio-toxicity, N/V, mild D, pulmonary toxicity

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11
Q

Panitumumab (Vectibix)

A

Classification: monoclonal antibody EGFR

Indication: colorectal CA

Route: IV

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

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12
Q

Cetuximab (Erbitux)

A

Classification: monoclonal antibody EGFR

Indication: colorectal CA, NH

Route: IV

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)

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13
Q

Megesterol acetate (Megace)

A

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

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14
Q

Carboplatin (Paraplatin)

A

Classification: alkylating agent

Indication: bladder, endometrial, germ cell, HN, lung, ovarian

Route: IV

Side Effects: myelosuppression, N/V!, renal toxicity, hypersensitivity reaction, alopecia, peripheral neuropathy

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15
Q

Cisplatin (Platinol or CDDP)

A

Classification: alkylating agent

Indication: bladder, cervical, esophageal, HN, lung, NHL, ovarian, prostate, testicular

Route: IV

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.

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16
Q

Cyclophosphamide (Cytoxan, CTX)

A

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

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17
Q

Dacarbazine (DTIC)

A

Classification: alkylating agent

Indication: HD, MM, neuroblastoma, sarcoma

Route: IV

Side Effects: myelosuppression, N/V (up to 12 hrs), flu-like symptoms, CNS toxicity, photo-sensitivity

18
Q

Oxaliplatin (Eloxatin)

A

Classification: alkylating agent

Indication: colorectal, pancreatic, gastroesophageal

Route: IV

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

19
Q

Fludarabine (Fludara)

A

Classification: anitmetabolics

Indication: CLL, NHL, T-cell Lymphoma, hairy cell leukemia

Route: IV

Side Effects: Myelosuppression, N/V, D, neuro-toxicity, rash

20
Q

Flurouracil (5-FU)

A

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

21
Q

Gemcitabine (Gemzar)

A

Classification: anitmetabolics

Indication: pancreatic, breast, ovarian, NSCLC

Route: IV

Side Effects: myelosuppression, N/V, pulmonary toxicity, rash, flu-like symptoms

22
Q

Methotrexate (Folex, Rheumetrex)

A

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

23
Q

Pemetrexed (Alimta)

A

Classification: anitmetabolics

Indication: mesothelioma

Route: IV

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

24
Q

Paclitaxel (Taxol)

A

Classification: Taxens

Indication: bladder, breast, esophageal, H and N, ovarian, pancreatic, prostate, sm cell Lung, NSCLC

Route: IV

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

25
Q

Docetaxel (Taxotere)

A

Classification: Taxens

Indication: breast, gastric, H and N, ovarian, prostate, NSCLC

Route: IV

Side Effects: myelosuppression, nucositis, diarrhea, neurotoxicity, fluid retention, skin/nail changes

26
Q

Paclitaxel Protein-bound (Abraxane)

A

Classification: Taxens

Indication: Breast, NSCLC

Route: IV

Side Effects: myelosuppression, N/V, Diarrhea, Mucositis, arthralgia, myalgia, sensory neuropathy, alopecia

27
Q

Imatinib (Gleevac)

A

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

28
Q

Bortezomib (Velcade)

A

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

29
Q

Ibritumomab and Yttrium 90 (Zevalin)

A

Classification: radioimmunotherapy agent

Indication: B-cell lymphoma

Route: IV

Side Effects: myelosuppression, infusion-related reactions, mild N/V, diarrhea, infection, cough, decreased appetite, throat irritation, dyspnea.

Long term risk of secondary malignancies

30
Q

radioiodine/Iodine 131

A

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

31
Q

Samarium 153 (Quadramet)

A

Classification: radio-pharmaceutical

Indication: osteoblastic bone lesions that enhance on radionuclide bone scan - to palliate bone pain

Route: IV

Side Effects: myelosuppression, N/V, flushing

Long term risk of secondary malignancies

32
Q

Strontium 89 (Metastron)

A

Classification: radio-pharmaceutical

Indication: relief of painful bony metastases

Route: IV

Side Effects: myelosuppression, temporary increase in bone pain, flushing

Long term risk of secondary malignancies

33
Q

Radium 223 (Xofigo)

A

Classification: radio-pharmaceutical

Indication: castration-resistant prostate CA with symptomatic bone metastasis and no known visceral metastatic disease

Route: IV

Side Effects: meylosuppression, N/V/D, peripheral edema

34
Q

Ibritumomamab tiuxetan (Zevalin)

A

Classification: monoclonal antibody CD20 Target

Indication: relapsed or refractory B-cell NHL

Route: IV

Side Effects: possible infusion reaction, myelosuppression, asthenia, infections, mild N/V, cough, dyspnea, sinusitis

35
Q

Bevacizumab (Avastin)

A

Classification: angiogenesis inhibitor

Indication: metastatic colorectal CA, NSCLC, glioblastoma w/ progressive disease, metastatic renal cell

Route: IV

Side Effects: HTN, arterial thromboembolic event, proteinuria, hemorrhage, GI perf (present with abd pain/N/V/C/fever), hypothyroidism

36
Q

Lenalidomide (Revlimid)

Thalidomide

A

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

37
Q

Gardasil

Cervaric

A

Classification: CA prevention Vaccines

Indication: cervical and oral CA

Approved by FDA
Protects against HPV

38
Q

Hepatitis B

A

Classification: Preventative vaccine

Indication: can prevent hepatocellular CA as well

Approved by FDA

39
Q

Neulasta (pegfilgrastim)

A

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

40
Q

Neupogen (filgrastim)

A

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

2016 CSO Exam Study Group (27 decks)

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