Oncology ADRs

Question 1

Purine Anti-metabolites (cladribine, fludarabine etc.)

Answer 1

Bone marrow suppression

Question 2

Cytarabine

Answer 2

Occular toxicity

Question 3

5-FU + capcitabine

Answer 3

NVD, BMS

Question 4

Gemcitabine

Answer 4

Post-infusion fever

Question 5

Folate Antimetabolites (methotrexate, pemetrexid etc)

Answer 5

BMS, Folic acid deficiency, N/V (pem> meth), mouth sores (meth> pem).

Question 6

Other antimetabolites (Azacitidine, decitibine)

Answer 6

Generally mild but SEVERE BMS, extremely active in bone marrow.

Question 7

Anthracyclines (doxorubucin, danorubucin etc).

Answer 7

Acute and delayed cardiotoxicity, BMS, hand-foot syndrome, vesicant (treat with COLD compress)

Question 8

Vinca Alkaloids (vincristine, vinblastine etc).

Answer 8

CIPN, Autonomic neuropathy (severe constipation), vesicant (treat with WARM compress).

Question 9

Taxanes (paclitaxel, docetaxel, etc.)

Answer 9

CIPN, Edema, myalgias, BMS, Hypersensitivity (pac>doc)

Question 10

TOPO I inhibitors (irinotecan, topotecan)

Answer 10

Diarrhea (irin), BMS (topo > irin)

Question 11

Topo II inhibitors (etoposide)

Answer 11

BMS, hypotension during infusion (slow infusion), hypersensitivity rxn

Question 12

Nitrogen Mustards (cyclophosphamide, Iphosphamide)

Answer 12

hemorrhagic cystitis, BMS

Question 13

Nitrogen Mustards (Bendamustine)

Answer 13

Rash, vesicant, BMS, secondary malignancies

Question 14

Nitrosoureas (carmustine, etc)

Answer 14

BMS, Ocular toxicity, pulmonary toxicity, secondary malignancies, N.V.D

Question 15

Procarbazine

Answer 15

BMS, CNS toxicity, disulfiram like reaction (no alcohol!), secondary malignancies

Question 16

Carboplatin

Answer 16

BMS

Question 17

Cisplatin

Answer 17

N/V, kidney damage

Question 18

Oxaliplatin

Answer 18

CIPN

Question 19

Bleomycin

Answer 19

Pulmonary toxicity, hand-food syndrome (different than other hand-foot syndroms, sausage digits.) Ew.

Question 20

Hydroxyurea

Answer 20

Severe BMS (often therapeutic reason its discontinued), vasculitis

Question 21

Mitomycin C

Answer 21

BMS, HUS (hemolytic uremia syndrome), diarrhea

Question 22

Erlotinib (oral) (EGFR)

Answer 22

Rash that correlates with efficacy, diarrhea

Question 23

Lapatinib (oral), EGFR and HER 2

Answer 23

QTC prolongation, CYP interactions, diarrhea

Question 24

BCR-ABL (imatinib, ponatinib etc)

Answer 24

fluid retention, rash, N/V, HTN

Question 25

Kinase inhibitors (sunitinib, etc)

Answer 25

very agent specific, but in general: hepatotoxicity, rash, Qtc prolongation, N/V/D

Question 26

Proteosome inhibitors (Bortezomib, Carfilzomib)

Answer 26

Peripheral neuropathy, BMs

Question 27

Cicotinib and Ceritinib

Answer 27

Bradycardia, N/V/D, hepatotoxicity, ocular toxicities, QTc prolongation

Question 28

Ruxolitinib

Answer 28

Thrombocytopenia, anemia, dyspnea, HA, N/D

Question 29

Anti-CD 20 (Rituxan, Azerra)

Answer 29

Infusion rxn, reactivation of hepatitis B

Question 30

Anti-CD 52 (alemtuxumab)

Answer 30

BMS, infections (prophylaxis with Bactrim)

Question 31

EGFR (cetuximab)

Answer 31

rash (correlates with efficacy), diarrhea, infusion rxn

Question 32

HER 2 (trastuzumab, pertuzumab)

Answer 32

cardiotoxicity, infusion rxns

Question 33

VEGF (bevacizumab)

Answer 33

HTN, fistula, clotting, bleeding, impaired wound healing

Question 34

CTLA-4 (Ipilimumab)

Answer 34

immune-mediated reaction secondary to enhance T-cell activity, guillain-barre syndrome, dermatologic toxicity, endocrine disorders, opthalmic toxicity, hepatotoxicity

Question 35

Interferons (aldesleukin)

Answer 35

Extreme hypotension, fluid retention, renal dsyfunction, capillary leak syndrome, neuropsychiatric changes, infections and many many more.