Oncology Flashcards

1
Q

Bleomycin risk and max dose

A

Pulmonary

400 unit lifetime dose

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2
Q

Doxorubicin risk and max dose

A

Cardio toxicity

450-550 mg/m2 lifetime dose

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3
Q

Cisplatin risk and max dose

A

Nephrotoxicity

100 mg/m2 per cycle

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4
Q

Vincristine risk and max dose

A

Neuropathy

2 mg max single dose

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5
Q

Myelosupression

A

All except: asparginase, bleomycin, vincristine, monoclonals and TKIs

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6
Q

N/V most common

A

Cisplatin, cyclophosphamide, ifosfamide

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7
Q

Mucositis

A

5-FU, MTX

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8
Q

Diarrhea

A

Irinotecan, capecitabine, 5-FU, MTX

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9
Q

Constipation

A

Vincristine

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10
Q

QTC

A

Droperidol, arsenic, TKIs

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11
Q

Pulmonary toxicity

A

Bleomycin, busulfan, carmustine, lomustine

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12
Q

Hepatotoxicity

A

Antiandrogens (bicalutamide, flutamide, nilutamide )

MTX

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13
Q

Nephrotoxic

A

Cisplatin, MTX

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14
Q

Hemorrhagic cystitis

A

Ifosfamide, cyclophosphamide

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15
Q

Peripheral neuropathy

A

Vinca alkaloids, platinums, taxanes

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16
Q

Totect

A

Dexrazoxane

Extravasation from doxorubicin

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17
Q

Zinecard

A

Dexrazoxane

Cardio protection from doxorubicin

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18
Q

Ethyol

A

Amifostine

Give with cisplatin to prevent nephrotoxicity

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19
Q

Uridine triacetate

A

5-FU and capecitabine antidote

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20
Q

Mesnex

A

Mesna

Give with ifosfamide to prevent hemorrhagic cystitis

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21
Q

What to give with MTX to reduce toxicity

A

Leucovorin (fusilev)

Glucarpidase (voraxaze)

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22
Q

When does nadir occur

A

7-14 days after chemo

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23
Q

High emetic risk regimen

A

Dex + 5HT3 + NK-1RA

*can add or substitute with olanzapine

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24
Q

Aprepitant alone?

A

No, always add on

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25
Q

Can 5HT3 antagonists cause seratonin syndrome

A

Yes

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26
Q

Does cesamet require refrigeration?

A

No

*drinabinol does

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27
Q

TLS

A

Allopurinol (400-800 mg/d)
Or rasburicase
Start both IV

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28
Q

Hypercalcemia of malignancy tx

A

Mild: hydration w/ NS and loop diuretics

Mod-severe;

 - calcitonin (miacalcin)
 - iv bisphosphonates (zometa, pamidronate) * zometa is 4 mg while reclast is 5 mg iv yearly 
 - xgeva 120 mg sc (prolia is 60 mg Q6 months)
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29
Q

Dimethyl sulfoxide

A

For anthracycline extravasation

Can also use dexrazoxane (Toltect)

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30
Q

Hyaluronidase

A

Vinca alkaloid or etoposide extravasation

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31
Q

How to prepare vincristine

A

Don’t make in syringe! To avoid accidental intrathecal administration

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32
Q

Vaccine and chemo timing

A

Vaccines should precede chemo by 2+ weeks

-live at least 3 months after chemo

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33
Q

Who gets aromatase inhibitors for breast CA?

A

Only post menopausal! (Or no uterus)

*doesn’t affect ovarian estrogen production

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34
Q

Who gets tamoxifen for breast cancer?

A

Premenopausal!

Can give in post menopausal if did not tolerate AI

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35
Q

Herceptin

A

Traztuzumab

Her-2 positive breast CA

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36
Q

Tamoxifen

A

SERM

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37
Q

Fulvrstrant

A

SERM

IM injection

38
Q

Toremifene

A

SERM

39
Q

Arimidex

A

Anastrazole

AI

40
Q

Femara

A

Letrozole

AI

41
Q

Exemestane

A

AI

42
Q

Tx of tamoxifen induced hot flashes and night sweats

A

Venlafaxine

*Not estrogen!!

43
Q

Evista

A

Raloxifene
SERM
For breast CA ppx not tx!!
Osteoporosis and in post menopausal women

44
Q

Gnrh agonist info

A

Prostate CA

  • ADRs: decreases BMD, impotence, gynecomastia
  • Give with antiandrogen to prevent tumor flare!
  • works by negative feedback!
45
Q

Zoladex

A

Goserelin

Gnrh agonist

46
Q

Lupron

A

Leuprolide

Gnrh agonist

47
Q

Casodex

A

Bicalutamide

Antiandrogen- given with gnrh agonist to prevent tumor flare

48
Q

Flutamide

A

Antiandrogen- given with gnrh agonist

49
Q

Cytoxan

A

Cyclophosphamide
Alkylating agent
Give mesnex
Hemorrhagic cystitis

50
Q

Ifex

A

Ifosfamide
Alkylating agent
-give Mesnex
-hemorrhagic cystitis

51
Q

Busulfan

A

Alkylating agent
Hemorrhagic cystitis
Pulmonary toxicity

52
Q

Carmustine

A

Alkylating agent
Hemorrhagic cystitis
Pulmonary toxicity

53
Q

Lomustine

A

Alkylating agent
Hemorrhagic cystitis
Pulmonary toxicity

54
Q

Mitomycin

A

Alkylating agent
Vesicant
DMSO is antidote

55
Q

Cisplatin toxicity

A

Nephrotoxic, ototoxic, highly emetigenic,

peripheral neuropathy

56
Q

Doxorubicin

A
Anthracycline 
Cardiotoxic- max 450-550mg/m2
Vesicant 
Myelosuppression 
N/V
57
Q

Daunorubicin

A

Anthracycline

Cardio toxicity

58
Q

Mitoxantrone

A

Anthracycline
Cardio toxicity
Blue urine

59
Q

Vinca alkaloids toxicity

A

IV only!!!

  • neuropathy
  • vesicants- use WARM compress and hyaluronidase
  • constipation
  • bone marrow suppression- more with vinBlastine
60
Q

Taxanes toxicity

A
  • hepatic metabolism
  • give BEFORE platinums
  • hypersensitivity-premeditate
  • non-PVC!!!
61
Q

Abraxane

A

Paclitaxel

Albumin bound

62
Q

Camptosar

A

Irinotecan
Topo-1 inhibitor
Cholinergic ADRs

63
Q

Etoposide

A

Topo-2 inhibitor

64
Q

Bleomycin

A

Topo-2 inhibitor

Pulmonary tox- 400units/life

65
Q

Adrucil

A

Fluorouracil
Hand-foot, diarrhea, mucositis
-give with leucovorin
-antimetabolite

66
Q

Xeloda

A

Capecitabine
Prodrug if fluorouracil
Diarrhea, mucositis, hand and foot
-antimetabolite

67
Q

Cytarabine

A

Antimetabolite

68
Q

Gemcitabine

A

Antimetabolite

69
Q

Arsenic trioxide

A

Qtc prolongation

70
Q

Afinitor

A

Everolimus

  • mtor inhibitor
  • mouth ulcers, rash, interstitial lung dx
71
Q

HER-2 toxicity

A

Cardio toxicity- don’t give with anthracycline

72
Q

Avastin

A

Bevacizumab
VEGF
-impair wound healing-don’t give within 28 d of surgery

73
Q

Herceptin

A

Traztuzumab
HER-2 inhibitor
-watch echo for HF

74
Q

Cetuximab

A

EGFR inhibitor
Must be KRAS wild type, NOT kras mutation
-rash correlates with response!

75
Q

Rituxan

A

Rituxumab
Premeditate with diphen, APAP, steroid
Hep B reactivation
PML

76
Q

Gleevec

A

Imatinib
TKI
Take with food!!
Must be Philadelphia chromosome positive to use BCR-ABL

77
Q

Capecitabine food?

A

With food

78
Q

TKI toxicity

A

Qtc, hypothyroidism, rash, HTN, hand-foot syndrome, diarrhea, hepatotoxicity

79
Q

SERMs vs AI

A

SERMs: tamoxifen, toremifene
Evista (raloxifene), fulvestrant (faslodex)

AI: femara (letrozole), arimidex (anastrizole), exenastane (aromasin)

80
Q

zytiga

A

Abiraterone

Prostate cancer

81
Q

Zoladex

A

Goserelin

Prostate cancer

82
Q

Casodex

A

Bicalutamide

Prostate cancer

83
Q

Eulexin

A

Flutamide

Prostate cancer

84
Q

Lupron

A

Leuprolide

Prostate cancer

85
Q

Velcade

A

Bortezomib

86
Q

Nexavar

A

Sorafenib

TKI

87
Q

Sutent

A

Sunitinib

TKI

88
Q

Tasigna

A

Nilotinib

TKI

89
Q

Sprycel

A

Dasatinib

TKI

90
Q

Tarceva

A

Erlitinib

TKI

91
Q

Gleecev, glivec

A

Imatinib

TKI

92
Q

Yervoy

A

Ipilimumab

Cancer