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NAPLEX 2022 > Oncology II: Common Cancer Types & Treatments > Flashcards

Oncology II: Common Cancer Types & Treatments Flashcards

1
Q

Arimidex generic/drug class/SE

A

Anastrozole
Class: Aromatase inhibitors
S/SX: DVT, PE, hot flashes

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2
Q

PO chemotherapy medication that is refrigerated

A

Etoposide

pg. 829

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3
Q

Red Devil Drugs

A

Doxorubicin*

“Ruby = Red”

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4
Q

Smurf Drugs

A

Mitoxantrone
IV Methylene Blue
Amiodarone
Doxycycline

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5
Q

Rituximab carries a high risk for what severe adverse reaction?

A

Severe/fatal infusion-related reactions

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6
Q

Which Mab requires an over-expression of HER2 gene to be used?

A

trastuzumab (Herceptin)

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7
Q

Brand name of rituximab

A

Rituxan

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8
Q

A patient received a cumulative dose > 300 mg/m^2 of doxorubicin. What agent can the patient receive to reduce the risk of cardiomyopathy?

A

dexrazoxane

Totect: extravasation
Zinecard/Totect: cardioprotection at high doses

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9
Q

Body Surface Area Equation

A

BSA (m^2) = square root of [Ht (in) x Wt (lb)] / 3131

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10
Q

What is required prior to starting an immunomodulator? Name the immunomodulators.

A

Pregnancy test [Boxed Warning: fetal risk/pregnancy]

–Immunomodulators–
lenalidomide (Revlimid)
pomalidomide (Pomalyst)
thalidomide (Thalomid)

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11
Q

What drug can be used in premenopausal women and in men with breast cancer?

A

Tamoxifen

Drug Class: SERM

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12
Q

ADR of raloxifene use

A

Hot flashes/night sweats & DVT/PE

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13
Q

What drug class blocks the enzyme responsible for the conversion to estrogen?

A

Aromatase inhibitors

anastrozole, letrozole, exemestane

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14
Q

A patient has chronic myelogenous leukemia (CML). What drug requires that the patient be positive for Philadelphia chromosome (BCR-ABL)? (generic/brand)

A

imatinib (Gleevec)

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15
Q

Boxed warning for IV MTX

A

Stomatitis, diarrhea, myelosuppression, & teratogenicity

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16
Q

Audiograms are performed at baseline and before each dose of which chemotherapeutic agent?

A

Cisplatin

Nephrotoxic & Ototoxic

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17
Q

mesna (Mesnex) is given prophylactically with ________ and with high doses of ___________. This is to prevent what?

A

ifosfamide (Ifex) and HD of cyclophosphamide (Cytoxan) to prevent hemorrhagic cystitis

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18
Q

Principle toxicities of cisplatin

A

Nephrotoxicity
Ototoxicity
CINV

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19
Q

Which agent is least likely to cause neutropenia?

A

Bleomycin because it doesn’t cause myelosuppression

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20
Q

Pyrimidine Analog Antimetabolites

Agents

A

Fluorouracil “5-FU” - given with leucovorin to increase efficacy

capecitabine (Xeloda) - prodrug of 5-FU; Dihydropyridine dehydrogenase (DPD) deficiency increase risk of severe toxicity

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21
Q

Alkylating Agents

A

cyclophosphamide
ifosfamide
carmustine
busulfan

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22
Q

What is the metabolite that cyclophosphamide and ifosfamide produce called?

A

acrolein

*concentrates in the bladder and causes hemorrhagic cystitis**

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23
Q

Warning signs of melanoma skin cancer

A 
A - asymmetry
B - border
C - color: uneven
D - diameter: > 6mm
E - evolving size/shape
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24
Q

Aromatase inhibitors side effects

A

Hot flashes/night sweatings
Arthralgia/myalgias
Osteoporosis
DVT/PE

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25
Q

Generic name of Avastin

A

bevacizumab

impairs wound healing: do not administer 28 days before or after surgery

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26
Q

What aromatase inhibitor agent is ONLY approved for post-menopausal women? Formulations (generic/brand)

A

anastrozole (Arimidex) - PO

fulvestrant (Faslodex) - IM

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27
Q

Hormone therapy targets which receptors and how long is treatment?

A

HER2/NEU receptors

5-10 years to suppress cancer recurrence

28
Q

What drug is used first-line in premenopausal women with breast cancer? MOA?

A

Tamoxifen

Drug Class: SERMs

MOA: Tamoxifen binds to estrogen receptors on tumors

29
Q

What drug class is used first-line in post menopausal women with breast cancer? MOA?

A

Aromatase inhibitors block the aromatase enzyme that catalyzes the conversation from androgens to estrogens.

30
Q

What drug is used as prophylaxis in post menopausal women who have osteoporosis and breast cancer? Drug class? Side effects?

A

Raloxifene

Drug class: SERM

SE: hot flashes & has a risk for blood clots

31
Q

What other drugs is used as an alternative in unique circumstances when tamoxifen is not a reasonable option? Generic/Brand? Drug class? Side effects?

A

fulvestrant (Faslodex)

  • Drug class: SERD
  • SE: Increase LFTs, injection site. pain & hot flashes

toremifene (Fareston)

- Drug class: SERM
- SE: hot flashes, vaginal bleeding, decrease libido
32
Q

What drug needs a pharmacogenomic testing of the HER2 gene expression prior to using? Generic/Brand? MOA? Monitoring?

A

trastuzumab (Herceptin)

MOA: binds to the HER2 receptor, preventing dimerization (test positive for HER2 overexpression)

Monitoring: LVEF at baseline & during treatment

33
Q

What type of drugs require premedications of steroids, acetaminophen and diphenhydramine?

A

Monoclonal antibodies

34
Q

Monoclonal antibodies were designed to do what?

A

Attach to specific antigens

35
Q

That drug class is used first-line in combination with hormone treatment in metastatic breast cancer? Side effects?

A

Mammalian Target of Rapamycin (mTOR) inhibitors

SE: mouth ulcers, rash, interstitial lung disease, peripheral edema, dyslipidemia, high BP

36
Q

Name the aromatase inhibitor.

A

anastrozole (Arimidex)

*increase risk of osteoporosis & CVD

37
Q

Hormone Treatments used in Prostate Cancer are called?

A

Androgen deprivation therapy (ADT)

“AKA Chemical castration”

ADRs: impotence, weakness, hot flashes & loss of bone density

38
Q

Name the Gonadotropin-Releasing Hormone (GnRH) Agonists

Generic/Brand? SE?

A

leuprolide (Lupron Depot)
goserelin (Zoladex)

SE: hot flashes, bone pain, impotence, gynecomastia, tumor flare (give with concurrent antiandrogen ‘bicalutamide’ for several weeks)

*calcium/vitamin D supplementation

39
Q

How are combination chemotherapy regimens administered?

A

In 2 - 6 week cycles, followed by days or weeks without treatment for patient to recover from myelosuppression.

40
Q

Name the chemotherapy classes that inhibit the S-phase of the cell cycle.

A

Antimetabolites (MTX, 5-FU, capecitabine)

Topoisomerase I (irinotecan & topotecan)

** AT the S-phase, the DNA replicATes**

41
Q

Name the chemotherapy classes that are cell cycle independent.

A

Alkylating agents (cyclophosphamide & ifosfamide)

Anthracyclines (doxorubicin & mitoxantrone)

Platinum Compounds (Cisplatin, Carboplatin & Oxaliplatin)

42
Q

Name the chemotherapy classes that inhibit the M-phase of the cell cycle.

A

Taxanes (paclitaxel & docetaxel)

Vinca Alkaloids (Vincristine & Vinblastine)

43
Q

Name the chemotherapy class that inhibit the G2-phase of the cell cycle.

A

Topoisomerase II (Etoposide & Bleomycin)

44
Q

GFR is commonly “capped” at what ____ mL/min/1.73 m^2 for which chemo agent?

A

125

Carboplatin

45
Q

Which chemotherapy agent can be exacerbated by exposure to cold and causes acute sensory neuropathy?

A

Oxaliplatin

46
Q

Which chemo agent can cause delayed diarrhea? What is the DOC for delayed diarrhea?

A

Irinotecan - loperamide ~ 24 mg/day

47
Q

Which vinca alkaloid is associated with more bone marrow suppression?

A

vinblastine

B - bone marrow suppression (myelosupression)

48
Q

Which vinca alkaloid is associated more with CNS toxicity (neuropathy)?

A

vincristine

C - CNS

49
Q

How is vincristine prepared?

A

small IV bag “piggyback” rather than syringe

50
Q

Which chemo agent causes severe fluid retention (pleural effusion, cardiac tamponade and/or edema)?

A

Docetaxel

51
Q

Which taxane does NOT require premedication?

A

Paclitaxel albumin-bound (Abraxane)

*does NOT require non-PVC bag/tubing & NO hypersensitivity reactions**

52
Q

Which pyrimidine analog antimetabolite comes in an oral formulation?

A

capecitabine (Xeloda)

oral prodrug of 5-FU

53
Q

Leucovorin is the active form of what?

A

folic acid

*hence why it’s given with MTX to bypass the enzyme block of dihydrofolate reductase causes by MTX

54
Q

What is the antidote given that will rapidly lower methotrexate levels that remain high despite adequate hydration and urinary alkalinization with bicarb?

A

glucarpidase (Voraxaze)

55
Q

What chemo drug class, when taken orally may alter if taken with food?

A

Tyrosine kinase inhibitors (imatinib - Gleevec)

56
Q

Common toxicities of TKIs

A 
Hypothyroidism
QT prolongation
Hepatic metabolism - hepatic toxicity
Diarrhea
HTN
Hand and Foot Syndrome 
SJS/TEN
57
Q

Which chemo oral agents must be taken with food?

A

Imatinib (Gleevec)

Capecitabine (Xeloda)

58
Q

Which chemo oral agents can be taken without regard to food?

A

Tamoxifen

Anastrozole

59
Q

Which chemo agents should be prepared in a non-PVC container and infused with non-PVC tubing?

A

Docetaxel & Paclitaxel

*can cause leaching of DEHP when placed in PVC containers

60
Q

Arsenic trioxide, often used as 2nd-line therapy for acute promyelocytic leukemia, has what concern?

A

QT prolongation - Boxed Warning

**Tretinoin (all-trans retinoic acid) is 1st-line

61
Q

Casodex

generic/drug class/SE

A

Generic: bicalutamide

Drug class: 1st generation antiandrogen

SE: hot flashes & impotence

62
Q

A patient undergoes pharmacogenetic testing and is found to be KRAS-negative (wild type). What chemo agent can this patient receive?

A

Cetuximab

pg. 835

63
Q

A patient undergoes pharmacogenomic testing and is found to have eGDR-positive expression. What chemo agent can this patient receive?

A

Cetuximab

64
Q

What receptor does rituximab target?

A

CD20 antigen on the B-cells

65
Q

What medication carries a boxed warning that encompasses epistaxis and hemoptysis?

A

Bevacizumab

NAPLEX 2022 (25 decks)

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