Oncology Flashcards

1
Q

Bleomycin

A

Lifetime cumulative dose: 400 units–> pulmonary toxicity

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2
Q

Doxorubicin

A

lifetime cumulative dose: 450-550mg/m2–> cardiotoxicity

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3
Q

Cisplatin

A

dose per cycle not to exceed 100mg/m2–> nephrotoxicity

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4
Q

vincristine

A

single dose “capped” at 2mg–> neuropathy

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5
Q

Drugs that commonly cause myelosuppression

A

Almost all except: Asparaginase, bleomycin, vincristine

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6
Q

Drugs that commonly cause nausea/vomiting

A

Cisplatin, cyclophosphamide, ifosfamide

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7
Q

Drugs that commonly cause Mucositis

A

Fluorouracil and methotrexate

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8
Q

Drugs that commonly cause Diarrhea

A

Irinotecan, capecitabine, fluorouracil, and methotrexate

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9
Q

Drugs that commonly cause constipation

A

Vincristine

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10
Q

Common causes of Xerostomia

A

Caused by radiation to the head or neck region

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11
Q

Drugs that commonly cause cardio toxicity

A

Cardio myopathy: Anthrcyclines

QT prolongation: arsenic, trioxide, many TKIs

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12
Q

Drugs that commonly cause pulmonary toxicity

A

Pulmonary fibrosis: bleomycin, busulfan, carmustine, lomustine
Pneumonitis:methotrexate and MABs

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13
Q

Drugs that commonly cause hepatotoxicity

A

Antiandrogens (bicalutamide, flutamide, nilutamide)

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14
Q

Drugs that commonly cause nephrotoxicity

A

Cisplatin and methotrexate (in high doses)

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15
Q

Drugs that commonly cause hemorrhagic cystitis

A

Ifosfamide (all doses) cyclophosphamide (higher doses)

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16
Q

Drugs that commonly cause neuropathy

A

Peripheral neuropathy:
Vinca alkaloids (vincristine, vinblastine, vinorelbine)
platinums (cisplatin, oxaliplatin)
Taxanes (paclitaxel, docetaxel, cabazitaxel)
Autonomic neuropathy: Vinca alkaloids

17
Q

Drugs that commonly cause thromboembolic risks

A

Aromatase inhibitors (anastrazole and letrazole), SERMs (tamoxifen, raloxifene

18
Q

Screening for breast cancer

A

Female age 40-44yrs–> screening optional
45-54yrs–> yearly mammograms
55 and older–> mammograms every 2 years and annually

19
Q

Screening for Cervical cancer

A

Female age 21-29–> PAP every 3 yrs

30-65–> PAP and HPV test every 5 yrs

20
Q

Screening for Colon cancer

A

Males and females age 45 and older–> colonoscopy every 10 yrs

21
Q

screening for lung cancer

A

Males and females 55-74 CT scan of chest if all of the following: in good health, have at least a 30ppy smoking history, and still smoking or quit within the past 15 years

22
Q

Screening for prostate cancer

A

Males 50 and older if the patient opts to be tested it involves: Prostate specific antigen (PSA) test +/- a digital rectal exam (DRE)

23
Q

Management of myelosuppression

A
  • Neutropenia: colony-stimulating factors (CSFs)
  • Anemia: RBC-transfusions and ESAs (in palliation only)
  • thrombocytopenia: platelet transfusions (when very low, especially when bleeding
24
Q

Management of N/V

A
  • Neurokinin-1 receptor antagonist (NK1-RA)
  • serotonin-3 receptor antagonist (5HT3-RA)
  • dexamethasone
  • IV/PO fluids hydration
25
Q

management of mucositis

A

symptomatic treatment (lidocaine viscous)

26
Q

Management of diarrhea

A
  • IV/PO fluid hydration, antimotility agents (loperamide)

- irinotecan: atropine for early onset diarrhea

27
Q

Management of constipation

A

stimulant laxatives: (PEG 3350 and Miralax)

28
Q

Management of Xerostomia

A

artificial saliva substitutes, pilocarpine

29
Q

management of cardio toxicity

A

Do not exceed recommended lifetime cumulative dose of 450-550 for doxorubicin. give dexrazoxane prophylactically in certain patients getting doxorubicin

30
Q

management of pulmonary toxicities

A

symptomatic management, stop therapy, or corticosteroids

31
Q

management of hepatotoxicity

A

symptomatic management, stop therapy, or corticosteroids if an auto immune mechanisms for PD-1 immunotherapy agents

32
Q

management of nephrotoxicity

A

Amifostine (ethyol) can be given prophylactically with Cisplatin, ensure adequate hydration do not exeeed max Cisplatin dose of 100mg/m2/cycle

33
Q

management of hemorrhagic cystitis

A

Mesna is always given prophylactically with ifosfamide and sometimes with cyclophosphamide to reduce the risk of hemorrhagic cystitits; always ensure adequate hydration

34
Q

management of neuropathy

A

systematic treatment with drugs for neuropathic pain.
Vincristine: recommended to limit dose to 2mg per week
Oxaliplatin: causes an acute cold-mediated sensory neuropathy–> avoid cold temps and beverages
Bortezomib: SC is associated with less neuropathy than IV

35
Q

management of thromboembolic risk

A

Consider thromboembolic prophylaxis based on pt risk factors