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Pharm Exam 3 > Neoplasm 2 > Flashcards

Neoplasm 2 Flashcards

1
Q

How are fixed chemotherapeutic doses determined?

A

finalized based on body surface area (BSA), weight, creatinine clearance, or other adjustments made for each patient

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2
Q

What happens to a tumor’s growth fraction over time?

A

It decreases

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3
Q

Why are CCS and CCNS drugs given together?

A

CCS drugs reduce the tumor growth factor and CCNS drugs help to reduce the tumor burden

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4
Q

Tx combination for Hodgkins lymphoma

A

ABVD

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5
Q

Tx combination for non-Hodgkins lymphoma

A

CHOP +/- R

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6
Q

Tx combination for colorectal CA

A

FOLFOX

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7
Q

Tx combination for small cell CA

A

ICE-V

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8
Q

Tx combination for breast CA

A

TAC

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9
Q

ABVD drugs

A

(doxorubicin) + Bleomycin + Vinblastine + Dacarbazine

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10
Q

CHOP +/- R drugs

A

Cyclophosphomide + Doxorubicin + Oncovin (vincristine) + Prednisone ± Rituximab

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11
Q

FOLFOX drugs

A

5-Flourouracil + Leucovorin + Oxaliplatin

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12
Q

ICE-V drugs

A

Ifosfamide + Carboplatin + Etoposide + Vincristine

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13
Q

TAC drugs

A

Taxotere (docetaxel) + Adriamycin (doxorubicin) + Cyclophosphamide

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14
Q

What determines the type of vascular access devices (VADs) chosen for chemo?

A

based on determining the length of time it will be needed

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15
Q

Midline cath length of use

A

Used when peripheral IV cannot be used, intermediate length of therapy

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16
Q

PICC line use length

A

Several wks or longer

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17
Q

Tunneled central catheter

A

Surgically placed in a large central vein, with a catheter tunneled under the skin

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18
Q

Implantable port

A

a catheter surgically placed under the skin of the chest or arm in a large or central vein

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19
Q

When is intravesical chemo given?

A

Early stage bladder CA - placement of a urinary catheter to give the drug into the bladder

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20
Q

When is Intrapleural and intraperitoneal chemo used?

A

useful for some with mesothelioma, ovarian cancer that has spread to the peritoneum, and lung or breast cancers that have spread to the pleura

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21
Q

Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

A

Involves cutting all visible cancer out of the abdomen and then flooding the cavity with heated chemotherapy drugs

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22
Q

What is HIPEC used in?

A

Used to treat peritoneal metastases resulting from several primary cancers, including colon cancer

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23
Q

How to treat CNS CA?

A

Intrathecal - Most chemotherapy drugs that are given IV are unable to cross the blood-brain barrier

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24
Q

What are irritant drugs?

A

Irritants: drugs that can cause a short-lived and localized/limited cellular damage to a vein

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25
Q

What are vesicant drugs?

A

Vesicants: drugs that cause severe redness, blistering, and severe tissue damage (chemical cellulites) at an injection site

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26
Q

Examples of vesicants

A

5-FU
doxorubicin
paclitaxel
vinblastine
vincristine
vinorelbine

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27
Q

What can be used to tx extravasation caused by Cisplatin?

A

Local injection of sodium thiosulfate

28
Q

What can be used to tx extravasation caused by anthracyclines?

A

Systemic administration of dexrazoxane or topical dimethyl sulfoxide

29
Q

What can be used to tx extravasation caused by Vinca alkaloids, paclitaxel, ifosfamide?

A

Local injection of hyaluronidase

30
Q

Why do cytotoxic drugs damage bone marrow stem cells?

A

Because the cells of the bone marrow are almost always in some phase of cell division

31
Q

What is myelosuppression?

A

Depressed bone marrow function is called myelosuppression

32
Q

Effects of myelosuppression?

A

Anemia
Leukopenia
Thrombocytopenia

33
Q

When are transfusions of packed RBCs needed?

A

Low hematocrit and Hgb - May be required until the bone marrow has recovered its normal ability to produce more blood cells

34
Q

When are transfusions of packed RBCs needed?

A

Low hematocrit and Hgb - May be required until the bone marrow has recovered its normal ability to produce more blood cells

35
Q

When is erythropoietin used to tx anemia?

A

Usually reserved for those with long-standing anemia

36
Q

If neutropenia is severe, what can be done?

A

Abx are given as a preventative measure

37
Q

When is neutropenia most severe with chemo?

A

Neutropenia is most severe with the use of cell cycle–specific drugs, particularly those that are active in the S and M phases

38
Q

Neutropenia + fever tx

A

Cancer patients with neutropenia (ANC <500 or expected to be so within 24 hours) and a fever (>38.5°C or 101.5°F ) are usually treated with broad-spectrum antibiotics and colony-stimulating factors

39
Q

Examples of granulocyte colony stimulating factors (G-CSF)

A

Filgrastim (Neupogen)
Pegfilgrastim (Neulasta)

40
Q

Which drugs can worsen platelet count when combined with chemo?

A

acetylsalicylic acid (aspirin) or NSAIDS can worsen the potential for thrombocytopenia while increasing the risk of GI bleeding

41
Q

What can be done in pts with platelet counts are very low (<10,000) or if a person with moderately low counts has greater than normal bleeding?

A

Transfusion OR platelet growth factor

42
Q

Examples of platelet growth factors

A

Romiplostim (Nplate) - SQ
Eltrombopag (Promacta, Revolade) - PO
Avatrombopag (Doptelet) - PO

43
Q

What determines hair loss with chemo?

A

The extent of hair loss depends on which drugs are given, drug doses, and the length of treatment

44
Q

Chemo hair loss time line?

A

Hair loss usually begins within 2 weeks after chemotherapy begins
After chemotherapy is completed, hair regrowth may take 3-5 months

45
Q

What is a radiation recall rxn?

A

Radiation recall reactions (radiation recall dermatitis) is an inflammatory reaction that occurs in a previously irradiated area precipitated by certain drugs

46
Q

Radiation recall rxn sxs

A

Symptoms: skin reddening, blistering, hyperpigmentation, edema, exfoliation, and ulceration

47
Q

Which meds are associated with radiation recall rxn?

A

bleomycin, cytarabine, doxorubicin, daunorubicin, idarubicin, hydroxyurea, methotrexate, paclitaxel, and vinblastine

48
Q

Which drugs cause acral eruthema?

A

cytarabine, methotrexate, 5-fluorouracil

49
Q

What is “hand foot syndrome”?

A

Acral Erythema - burning, swelling, tingling, and a rash (erythema) on the palms and fingers of the hands and the soles of the feet

50
Q

Drugs used to tx anorexia in chemo pts?

A

Dexamethasone
Prednisolone
Methylprednisolone
Megestrol (Megace)
Canabinoids - not routinely recommended d/t limited data

51
Q

Stomatitis from chemo can lead to what?

A

The tongue may be coated and swollen, leading to difficulty swallowing, eating, and talking

52
Q

Which drugs cause stomatitis?

A

Common drugs associated with stomatitis: antimetabolites (5-fluorouracil and methotrexate) and antitumor antibiotics (doxorubicin)

53
Q

What is used to tx stomatitis?

A

Magic mouthwash

54
Q

Why does chemo cause N/V?

A

Occur because drugs irritate the lining of the stomach and duodenum and stimulate nerves that lead to the vomiting center in the brain

55
Q

Drugs notorious for causing N/V

A

cisplatin, carboplatin

56
Q

Which pts are at higher risk of N/V with chemo?

A

Younger patients, females, and those prone to motion sickness

57
Q

N/V related to chemo tx

A

Behavioral approaches include guided imagery, relaxation, hypnosis, and distraction
Zofran

58
Q

Which chemo drugs cause constipation?

A

vinca alkaloid drugs, vincristine and vinblastine, opioids given for pain relief, and antiemetics (serotonin receptor antagonists)

59
Q

Which chemo drugs cause diarrhea?

A

5-fluorouracil, methotrexate, and docetaxel

60
Q

Which chemo drug is notorious for causing cardiotoxicity?

A

Doxorubicin associated with causing cardiotoxicity

61
Q

What is the max lifetime dose of docxorubicin?

A

the maximum lifetime dose of doxorubicin is 550 mg/m2

62
Q

What drug may be combined with doxorubicin to avoid cardiotoxicity?

A

dexrazoxane

63
Q

Use of which chemo drugs increases the risk of neurotoxicity?

A

vinca alkaloids

64
Q

Which drugs cause pulm damage?

A

bleomycin, busulfan

65
Q

Which drugs are nephrotoxic?

A

ifosfamide, cyclophosphamide, cisplatin, and methotrexate

66
Q

How will direct kidney damage from dysfunction present?

A

Increased Cr

67
Q

What is Amifostine used for?

A

Amifostine is a cytoprotective agent used to reduce potential renal toxicity associated with cumulative doses of platinum-containing medications such as cisplatin.

Pharm Exam 3 (7 decks)

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