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NAPLEX 2022 > Oncology I: Side Effect Management > Flashcards

Oncology I: Side Effect Management Flashcards

1
Q

Risk factors for CINV

A
  1. Female gender
  2. Age < 50 years
  3. Anxiety
  4. Depression
  5. Dehydration
  6. Hx of motion sickness
  7. Hx N/V
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2
Q

What medication can be given to prevent hemorrhagic cystitis in patients receiving high doses of cyclophosphamide & all doses of ifosfamide?

A

Mesnex

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3
Q

High emetic risk chemotherapy agent

A

Cisplatin

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4
Q

Side effects of 5HT3-RAs

A

Migraine-like headaches and constipation

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5
Q

Advantage of using darbepoetin over epoetin alfa

A

Less frequent dosing

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6
Q

What is recommended to alleviate hand-foot syndrome symptoms (painfully dry, red hands)?

A
  1. Emollient moisturizer

2. Cold compresses, systemic steroids & pain medications for the pain

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7
Q

Rationale for using leucovorin

A
  1. Decrease toxicity of MTX

2. Increase efficacy of drugs like fluorouracil

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8
Q

Myelosuppression with chemotherapy

A
  1. Thrombocytopenia treatment is platelet transfusions
  2. Nadir (lowest point of WBCs & Platelets) occurs 7-14 days post chemo; recover 3-4 weeks after treatment
  3. Neutropenia increases risk of infection
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9
Q

Max dose of vincristine

A

2 mg

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10
Q

Prophylaxis of doxorubicin-induced cardiomyopathy & treatment of anthracycline extravasation

A

Dexrazoxane

Pg. 802

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11
Q

Medications can cause pulmonary fibrosis

A

Bleomycin
Busulfan
Carmustine
Lomustine

B.B.C.L

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12
Q

Chronic use of MTX causes what

A

Pneumonitis

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13
Q

Mucositis is a toxicity of which chemotherapy agent(s)?

A

Fluorouracil & MTX

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14
Q

MTX boxed warning

A

Stomatitis & mucositis

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15
Q

Brand name of arepitant

A

Emend

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16
Q

High emetic risk anti-emetic regimens

A

—-4 drug regimen—-
NK1-RA + 5HT3-RA + Olanzapine + Dex***

—–3 drug regimen——
“Same regimen minus NK1-RA or Olanzapine”

Palonosetron + Olanzapine + Dex

NK1-RA + 5HT3-RA + Dex

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17
Q

Medications used to increase the hemoglobin level (Brand/Generic)

A

Procrit (Epoetin alfa)
Aranesp (darbepoetin)

Hg < 10 g/dL

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18
Q

Drugs that can be given intrathecally

A

Cytarabine
MTX
HC
Thiopeta

“MUST BE Preservative-free”

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19
Q

Neupogen generic

A

Filgrastim

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20
Q

Which chemotherapy agent administered intrathecal is fatal?

A

Vincristine

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21
Q

Zofran MOA

A

5HT3 receptor antagonist

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22
Q

Palonosetron Brand

A

Aloxi

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23
Q

Why is ESA agents considered limited use in cancer patients?

A

Shortened survival & increased tumor progression

24
Q

Medications used to treat chemotherapy-induced diarrhea

A

Loperamide
Atropine
Diphenoxylate-atropine

25
Q

Medication associated with the highest risk of hand-foot syndrome

A

Fluorouracil

Capecitabine (prodrug of fluorouracil)

26
Q

Which chemotherapy agent is most likely to cause a reduced left ventricular ejection fraction?

A

Doxorubicin

27
Q

Ondansetron film formulation - Brand name

A

Zuplenz

28
Q

Sancuso

Generic/Formulation/Dosing

A

Generic: Granisetron
Formulation: patch
Dosing: applied 24-48 hours prior to chemo and can be left in place for up to 7 days

29
Q

Neurokinin-1 Receptor Antagonists drugs

A

Aprepitant PO, Fosaprepitant IV (Emend)

30
Q

Bone pain is a side effect of

A

filgrastim (Neupogen)

pegfilgrastim (Neulasta)

31
Q

Drug class of choice for anticipatory N/V associated with chemotherapy

A

Benzodiazepines

32
Q

Extravasation of chemotherapy non-pharmacologic therapy

A

Cold compresses for all chemotherapy agents except vinca alkaloids & etoposide, which require warm compresses

33
Q

Treatment(s) for hypercalcemia of malignancy

A 
Hydration with NS & loop diuretics 
Calcitonin (Miacalcin) 
IV bisphosphonate 
    - zoledronic acid (Zometa) 
Mab blocks RANKL 
    - denosumab (Xgeva)
34
Q

Antidote for fluorouracil or capecitabine overdose

A

Uridine triacetate (Vistogard)

35
Q

Prodrug of fluorouracil (Brand/Generic)

A

Xeloda - capecitabine

36
Q

Adjunctive treatment for proohylaxis to prevent toxicity of doxorubicin

A

Dexrazoxane

37
Q

Adjunctive treatment for proohylaxis to prevent toxicity of for cisplatin

A

Ethyol - amifostine & hydration

38
Q

Chemotherapeutic class that causes constipation

A

Vinca alkaloids

39
Q

Screening tests used to screen for colon cancer

A

Stool DNA test
Flexible sigmoidoscopy
Colonoscopy
Fecal occult blood test

40
Q

Risks associated with prochlorperazine

A

Sedation & lethargy
Decrease seizure threshold
Acute extrapyramidal symptoms

MOA: blocks dopamine receptors

41
Q

When should colony-stimulating factors (CSF) be given to prevent neutropenia?

A

Given IV/SC, starting no sooner than 24 hours after chemotherapy

prevent neutropenia –> decrease risk of infections

42
Q

Long-acting colony-stimulating factor agent

A

Neulasta (pegfilgrastim) > Neupogen (filgrastim)

43
Q

What chemo agent has a lifetime cumulative dose of 400 units & causes what toxicity?

A

Bleomycin

Pulmonary fibrosis

44
Q

What chemo agent has a lifetime cumulative dose of 450 - 550 mg/m^2 & causes what toxicity?

A

Doxorubicin

Cardiomyopathy

45
Q

What chemo agent dose should not exceed 100 mg/m^2 & causes what toxicity?

A

Cisplatin

Nephrotoxicity

46
Q

What chemo agent has a single dose “capped” at 2 mg & causes what toxicity?

A

Vincristine

Neuropathy –> constipation

47
Q

Absolute neutrophil count (ANC) equation

A

WBC × (Segs + Bands)

48
Q

A patient is taking allopurinol to control hyperuricemia resulting from chemotherapy. Which of the following would have to have its dose reduced to prevent toxicity?

A. 5-FU 
B. 6-MP
C. 6-TG
D. Fludarabine 
E. Cytarabine
A

B. 6-MP

Mercaptopurine is metabolized to 6-thiouric acid by xanthine oxidase.

49
Q

What chemotherapy drugs do NOT cause myelosuppression?

A

Asparaginase
Bleomycin
Vincristine

50
Q

What type of drugs require premedications of Tylenol & diphenhydramine?

A

Monoclonal antibodies (Mabs)

51
Q

Hand-foot syndrome frequently occurs following treatment of which chemotherapy agents?

A

Capecitabine

Fluorouracil

52
Q

Hyaluronidase is the antidote for extravasation which what chemotherapy agent(s)?

A

Vina alkaloids

Etoposide

53
Q

Describe intrathecal route of administration

A

Injecting drug into the cerebrospinal fluid by performing a lumbar puncture

54
Q

What medications are recommended to treat chemo-induced appetite weight loss?

A 
Megestrol (Megace)
Dronabinol (Marinol)
Dexamethasone (Decadeon)
Metoclopramide (Reglan) 
Olanzapine (Zyprexa)
55
Q

What drug classes have to be monitored for signs and symptoms of DVT/PE, stroke and MI (thromboembolic risks)?

A

Aromatase inhibitors (anastrazole/letrozole) & SERMs (tamoxifen/raloxfiene)

NAPLEX 2022 (25 decks)

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