ONCOLOGY 2-Misc Flashcards
What degrades asparagine that leukemia cell need to proliferate?
L-asparginas- ADE- Anaphylaxis
What steroid is used to treat ALL, CLL, NHL?
Prednison- , fluid retention (RAAS-cortisol INC retention), immune suppression, INC appetite, insomnia
What agents are Selective estrogen receptor modulators, block hormonal receptors in some tissues not others
Tamoxifen*-breast cancer
What is a selective estrogen receptor down regulator that is antagonist?
Fulvestrant-metastatic breast cancer
This aromatase inhibitor prevents androgen from conversion to estrogen?
Anastrozole, Exemestane
What SERM have these ADEs: hypercalcemia (osteoporosis), bone pain?
Tamoxifen*-breast cancer
What aromatase inhibitor has ADEs of joint pain?
Anastrozole
What Aromatase inhibitor has ADE INC appetite?
Exemestane
What agents block testosterone receptors preventing uptake in tumor?
Flutamide, Bicalutamide-prostate cancer
What gonadotropin releasing hormone agonist that is continuous suppresses LH and FSH, thus DEC steroidogenesis, 1,3, 6 mo implants?
Leuprolide
This GRHA has these ADE: HOT flashes, edema pain, GI upset, respiratory d/o, urinary do, weak?
Leuprolide, goserelin
What hormonal therapy has liver failure and gynecomastia, loss of libido risk?
Flutamide, Bicalutamide-prostate cancer
What agent is selective, irreversible inhibitor of CYP17, dec testosterone precursors?
Abiraterone
What are ADe of Abiraterone?
Edema, HYPERtriglyceridemia, HYPOkalemia and Phos. INC LFT and cough
What is primary use of Abiraterone?
Metastatic prostate cancer
What other agen is for metastatic prostate cancer, inhibits androgen signaling. Major ADE- seizures?
Enzalutamide
What are components of immunotherapy?
Cytokines, Antibodies, Antigen, Lymphocytes- biologic antitumor effects by stimulating immune system
What are proteins secreted from WBC, used for metastatic renal, w ADE- HYPOTN, edema, thrombocytopenia, confusion. Vascular leak syndrome?
Cytokines-Interleukins-2
What agent antitumor by recognizing tumor surface proteins, but is pt on peripheral blood?
Sipuleucel T-well tolerated
What agent bind to CTLA-4 activated T-cell and proliferation?
Ipilimumab-monoclonal antibody
What are the ADEs of ipilimumab?
GI-colitis EMERGENT
What PD-1 inhibitor is a checkpoint that downregulate T-cell activation to reduce immune attack on normal tissues?
Pembrolizumab, Nivolumab- melanoma, NSC Lung Ca, lymphoma, Head
What are PD-1 inhibitor SE?
Colitis, pancreatitis endocrine, rash, Arthralgia
What agents target molecules w/in cancer cells that inhibit cancer growth, new approach, selective, and less ADE?
Bevacizumab- block VEGF- vascular endothelial growth factor- inhibits angiogenesis in tumor
What Molecular targeted therapy affect cancer cell that overexpress human epidermal growth factor receptor 2 (HER2)?
Trastuzumab- metastatic breast cancer
What MTT used for colorectal cancer blocks extracellular epidermal growth factor receptor with Skin and GI ADE?
Cetuximab
What MTT is used for KRAS wild type colorectal cancer?
Panitumumab
What are MTT for Non small cell lung cancer?
Gefitinib-EGFR, Erlotinib-Tyrosine Kinase
What is indicated for B-cell NHL?
Rituximab- hypersensitivity, Ibritumomab
Which agent is Renal Cell CA?
Sunitinib, Pazopanib, Temsirolimus
What agent block BCR-ABL oncogene that is found in CML?
Imatinib- monitor for response to therapy
What BREK and MEK inhibitors are used in NSCLC?
Vemurafenib, Trametinib
These agents are indicated for ALK in NSCLC, MOA is inhibits tyrosine kinase and anaplastic lymphoma kinase?
Alec, Ceri, Crizotinib. ADE; hyperglycemia, HYPOK and CA; GI, LFTs
What are risk factors for chemically induced nausea and vomiting?
Poor control previous cycle. Female, Young, Low ETOH
What is key to CINV?
Prention 1. DDX- bowel obstruction, Gastroparesis, Brain tumors, Electrolytes, Ascites CA, Drug combos w/ opioids, Psyche
What are the high emesis chemo agents?
Carboplatin, Cisplatin, cyclophosphamide, Doxorubicin, Ifosfamide
What agent can be HIGH emesis w/ HIGH Dose?
Methotrexate
Which antiemetic agent are Neurokinin-1 (NK-1) antagonist give 30 min prior to chemo?
: Aprepitant (Emend®) Fosaprepitant (Emend
What antibiotic is antagonist to serotonin receptors in GI tract, combine w/ corticosteroid, ADE- Headache?
Serotonin (5-HT3) antagonists -ESTRON
Which antiemetic agent are Neurokinin-1 (NK-1) antagonist give 30 min prior to chemo?
Corticosteroids -DEXA, decadron. ADE- euphoria, insomnia, INC appetit.
What drug IV administration warning with corticosteroids?
vaginal anal burning
What should be avoid with steroids and other chemo agents?
AVOID PD-1 checkpoint inib-mabs- BC will not be effective if steroid used
What is antagonist to serotonin receptors in GI tract, combine w/ corticosteroid, ADE- Headache?
METOCLOPRAMIDE-Benzamide analogs- explosive diarrhea, NA retention-HTN, impotence, Extrapyramidal renx
What other agen block dopamine for delayed emesis?
Prochlorperazine-Phenothiazine
What benzo is used for emesis to prevent anticipatory n/v, anterograde amnesia, DEC anxiety, DEC akathisia?
Lorazepam
What agent is used for breakthrough n/v, inhibit prostaglandins, with euphor, ataxia, drowsy, hallucinations ADE?
Dronabinol-Cannabinoid
Which chemo are the worse mucositis?
MTX, 5FU- TX - magic mouthwash: lidocaine, diphenhydramine, Al, MG
When should chemo be administered with concerns of bone marrow suppression?
WBC >3k or ANC >1.5k AND platelets .100K.(absolute neutrophil count=WBC x % granulocytes (cell + (%segmented neut + bands%)
What COLONY STIMULATING FACTOR RX can be used to treat febrile neutropenia and neutropenia?
Filgrastim and Pegfilgrastim, Sargramostim IV BBW- may promote growth in LEUKEMIA. AVOID IN ALL, CLL, CML, AML.
When can the CSF grastims be used?
OK for Breast cancer and Small cell lung Cancer w/ Topotecan.
What is discontinued d/t anemia ADE of chemo?
ESA- erythropoietin stimulating agents-darbepoetin, Epoetin
What is ok to treat anemia in Cancer?
Transfuse only if symptoms of anemia. DEC RBC, DEC Hgb <10
What agents can be used to DEc pain in chemo?
Bisphosphonates- Pamidronate, zoledronic acid- USe breast and prostate, multiple myeloma- ADE- osteonecrosis of jaw
What are other agents for pain?
Amitriptyline-SSRI, Anticonvulsant-Gabapentin, Corticosteroids, Benzodiazepines-Diazepam, Lorazepam
What is a chemoprotectant that DEC anthracycline induced free radical damage used in combo with Doxorubicin?
Dexrazoxane- slow IV, breast cancer
What is used for fluorouracil and capecitabine OD?
Uridine triacetate
