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naplex > Oncology: Chemo/MAb Agents > Flashcards

Oncology: Chemo/MAb Agents Flashcards

1
Q

Ifosfamide

A
  • Alkylating agent
  • Produces acrolein that concentrates in bladder and can cause hemorrhagic cystitis
  • Mesna (Mesnex): chemoprotectant given prophylactically for this risk; ALWAYS co-administered
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2
Q

Cyclophosphamide

A
  • Alkylating agent
  • Produces acrolein that concentrates in bladder and can cause hemorrhagic cystitis
  • Mesna (Mesnex): chemoprotectant given prophylactically for this risk; SOMETIMES co-administered (high-dose regimens)
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3
Q

Carmustine

A

Alkylating Agent

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4
Q

Busulfan

A

Alkylating Agent

-SE: Pulmonary toxicity

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5
Q

Cisplatin

A
  • Platinum-based compound
  • Highest incidence of CINV
  • Causes cumulative nephro and ototoxicity
  • Amifostine (Ethyol) - given as chemoprotectant for nephrotoxicity risk
  • Confirm doses >100 mg/m^2/cycle with prescriber
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6
Q

Carboplatin

A
  • Platinum-based compound

- Uses Calvert formula to calculate dose

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7
Q

Platinum-Containing Compound Information

A
  • Box warning: anaphylactic rxns (increased with repeat exposures), renal and ototoxicity
  • SE: peripheral neuropathy (cumulative, dose-related)
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8
Q

Doxorubicin

A
  • Anthracycline
  • Causes N/V: prescribe antiemetics
  • Potent vesicant
  • Red discoloration of urine/saliva/tears/etc
  • Lifetime Dose: 450-550 mg/m^2
  • Dexrazoxane (Totect): antidote for extravasation and cardioprotectant; Zinecard only used for cardioprotection
  • Myelosuppression risk
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9
Q

Mitoxatrone

A
  • Anthracycline

- Blue discoloration of urine/sclera/etc

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10
Q

Anthracycline

A
  • ALL have cardiotoxicity
  • ALL have box warnings: Myocardial toxicity
  • ALL are strong vesicants (Doxorubicin with specific antidote)
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11
Q

Irinotecan

A
  • Topoisomerase I Inhibitor
  • Acute cholinergic sxs: flushing, sweating, diarrhea
  • Treat DELAYED diarrhea with loperamide
  • ACUTE diarrhea with atropine
  • Box warning: early and late diarrhea
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12
Q

Etoposide

A
  • Topoisomerase II Inhibitor
  • Can cause infusion-related hypotension when given IV
  • Refrigerate capsules
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13
Q

-Bleomycin

A
  • Topoisomerase II Inhibitor
  • Not myelosuppressive
  • Max lifetime dose: 400 units (pulmonary toxicity)
  • Box warning: Pulmonary fibrosis
  • SE: Allergic rxn
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14
Q

Vincristine

A
  • Vinca Alkaloid
  • Associated with more CNS toxicity (neuropathy)
  • Capped at 2mg/dose
  • Intrathecal administration can cause paralysis and death (Prepare in small IV bag instead of syringe)
  • Warm compress and hyaluronidase for extravasation
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15
Q

Vinblastine

A
  • Vinca Alkaloid
  • More bone marrow suppression
  • Intrathecal administration can cause paralysis and death
  • Warm compress and hyaluronidase for extravasation
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16
Q

Vinca Alkaloid Information

A
  • Box warning: vesicants, for IV administration ONLY

- SE: Peripheral sensory neuropathy, autonomic neuropathy

17
Q

Doxetaxel

A
  • Taxane
  • Premedicate for HSR with steroids x3d prior to tx
  • Can cause severe fluid retention
18
Q

Paclitaxel

A
  • Taxane
  • Doesn’t require premedication for HSR
  • Okay to use PVC bag/tubing
  • Use 0.22 micron filter
19
Q

Taxane Information

A
  • Box warning: severe allergic rxn
  • Allergic rxn are due to solvent system, not the drug
  • Use non-PVC bag and tubing
  • Give BEFORE platinum-containing compound (reduces taxane elimination)
20
Q

5-FU

A
  • Fluorouracil, Pyrimidine analog antimetabolite

- Given with leucovorin to increase efficacy

21
Q

Xeloda

A
  • Capecitabine, Pyrimidine analog antimetabolite
  • Oral prodrug of 5-FU
  • DPD deficiency increases risk of severe toxicity
  • Take with food
22
Q

Pyrimidine Analog Antimetabolite SE

A
  • Hand-foot syndrome
  • Diarrhea
  • Mucositis
23
Q

Trexall

A
  • MTX, Folate Antimetabolite
  • Leucovorin used as rescue in high-dose regimens
  • Levoleucovorin is also a rescue option
  • Hydration and IV Na-bicarbonate must be given to alkalize urine and decrease nephrotoxicity risk
  • NSAIDs and salicylates decrease its clearance
24
Q

Glucarpidase

A
  • Antidote for MTX
  • Lowers levels of MTX when toxicity/overdose is occurring
  • Used when hydration/alkalization isn’t adequate
25
Q

Folate Antimetabolite Information

A
  • Box Warning: Myelosuppression, renal damage, hepatotoxicity, GI toxicity, teratogenic
  • SE: Nephrotoxic, hepatotoxic, nausea, mucositis
26
Q

Avastin

A
  • Bevacizumab
  • Targets VEGF
  • Impairs wound healing: don’t administer for 28 days before or after surgery
  • Box warning: severe/fatal bleeding, GI perforation
27
Q

Herceptin

A
  • Trastuzumab
  • Targets HER2
  • Must test for HER2 overexpression to use
  • Monitor LVEF (ECG or MUGA scan)
  • NOT interchangeable between conventional and Ado-formulation
28
Q

Cetuximab

A
  • Targets EGFR
  • Must test for KRAS wildtype to use
  • SE: Acneiform rash
  • Rash usually occurs early and means patient is expected to have better response to drug
  • Avoid sunlight, use sunscreen, topical steroids and abx can be used to reduce skin damage
29
Q

Rituxin

A
  • Rituximab
  • Targets CD antigens, inhibits them
  • Premedicate with Benadryl, APAP, and steroid
30
Q

Gleevec

A
  • Tyrosine kinase inhibitor, used in CML
  • Must be BCR-ABL positive to use
  • SE: Fluid retention
  • Take with food

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