Oncology Flashcards
When can live vaccines generally be given after chemo
3 months
Carcinoma
Cancer that starts in skin or in the tissues that line or cover internal organs
Sarcoma
Cancer in connective tissues
Types of skin cancer
Basal
Squamous
Melanoma (most deadly)
Breast cancer screening
45-54 yrs begging yearly mammograms
Cervical cancer screening
21-29 yrs - PAP smears q3yrs
30-65 yrs - PAP smears q5yrs
Colon cancer screening
45 yrs - FIT test q year
Colonoscopy q 10 yrs
Prostate cancer screening
50 years - PSA and digital rectal exam
Bleomycin max dose
400 units
Doxorubicin max doses
450-550mg/m2
Cisplatin max dose
100mg/m2
Vincristine max dose
2mg
Common oncology toxicities: myelosuppression
ALL except
-asparaginase, bleomycin, vincristine
Common oncology toxicities: NV
Cisplatin
Cyclophosphamide
Fosfamide
Common oncology toxicities: mucositis
MTX
Fluorouracil
Common oncology toxicities: Diarrhea
Ironotecan
Capecitabine
MTX
Fluorouracil
Common oncology toxicities: Constipation
Vincristine
Common oncology toxicities: cardiomyopathy
Anthracyclines (doxorubicin)
Common oncology toxicities: QT prolongation
Arsenic trioxide
Many TKIs
Common oncology toxicities: pulmonary fibrosis
Bleomycin, busulfan, carmustine, lomustine
Common oncology toxicities: hepatotoxicity
Antiandrogens (bicalutamide)
Common oncology toxicities: nephrotoxicity
Cisplatin
MTX
Pilocarpine MOA
Cholinergic
-used to dry mouth (xerostomia) and dry eyes
Common oncology toxicities: hemorrhagic cystitis
Ifosfamide
Cyclophosphamide
Common oncology toxicities: neuropathy
Vinca alkaloids
Platinums
Taxanes
What is given with doxorubicin to prevent cardiomyopathy
Dexrazoxane (Zinecard)
What is myelosuppression
Decrease in bone marrow activity, resulting in fewer RBCs, WBC, and platelets
Colony stimulating factors (CSF)
If WBCs dont recover after chemo
Filgastrim (daily)
Pegfilgastrim (once per cycle)
Neutropenia
<1,000 cells/mm3
Severe neutropenia
<500 cells/mm3
Fever
> 38.3 C (101 F) x 1 reading OR
>38.0 C (100.4 F) x 1 hr long
Aromatase inhibitors MOA
Blocks conversion of androgens to estrogens
Raloxifene
SERM
- antagonist in BONE
- not used to tx of breast cancer, but prophylaxis
- used to tx of osteoporosis prevention
1 foot = ___ inches
12
1 inch = ___ cm
2.54
Prostate cancer tx : androgen deprivation therapy
GnRH AGONIST + antiandrogen
-works through neg feedback
-leuprolide (Lupron Dept), goserelin (Zoladex)
+ Bicalutamide, Flutamide, Nilutamide
GnRH ANTAGONIST (alone) -degarelix (Firmagon)
Alkylating Agents
Cyclophosphamide Ifosfamide --both must be given with mesna (chemoprotectant) that inactivates a toxic metabolite in the bladder Carmustine Busulfan
Platinum-Based compounds SE
Neuropathy, ototoxicity, nephrotoxicity
Platinum-Based Compounds
Cisplatin (increased nephrotoxicity, and most CINV)
Carboplatin
Oxaliplatin (neuropathy)
Anthrocyclines SEs
Cardiotoxicity
Vesicants
Anthrocyclines
Doxorubicin (discolours urine red) + dexrazoxane (Zinecard)
Daunorubicin
Mitoxantrone (discolours urine blue)
Cell-cycle independent drugs
All Awesome Pharmacists
- Alkylating Agents
- Anthrocyclines
- Platinum-based compounds
Vinca Alkaloids
IV only
- Vincristine (CNS toxicity-neuropathies, constipation, parasthesia)
- Vinblastine (bone marrow suppression)
Cell Cycle Specific Drugs
Vinca Alkaloids Taxanes Topoisomerase I Inhibitors Topoisomerase II Inhibitors Pyrimidine Analog Antimetabolites Folate Antimetabolites Tyrosine Kinase Inhibitors
Taxanes
Hypersensitivity rxn (premeds), neuropathies
- Paclitaxel
- Docetaxel
Topoisomerase I inhibitors
Irinotecan (D)
Topoisomerase II Inhibitors
Bleomycin - pulmonary toxicity, hypersensitivity rxn (need test dose)
Pyrimidine Analog Antimetabolites
Fluorouracil (hand-foot syndromes)
Capecitabine (oral prodrugs of fluorouracil) take w/ food
Folate Antimetabolites
Nephrotoxicity
MTX - high doses (over 500mg/m2) require levcovarin (folinic acid) rescue
Tyrosine Kinase Inhibitors (TKIs) end in “-nib”
Require pharmacogenomic testing first to see who is likely to respond