Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NAPLEX - OUR cards > Oncology II pt 2 > Flashcards

Oncology II pt 2 Flashcards

1
Q

What phase of the DNA replication cycle to topoisomerase I inhibitors work?

A

S phase

Prevents coiling and uncoiling of double-stranded DNA helix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Irinotecan class, brand, unique concerns, boxed warnings

A

Topoisomerase I inhibitor
Acute cholinergic symptoms (treat with atropine)
Delayed diarrhea (treat with loperamide, up to 24 mg/day)
Pharmacogenomic conerns: patients homozygous for the UGT1A1*28 allele are at increased risk for neutropenia and delayed diarrhea

Boxed warnings for diarrhea lmao ok

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What phase of the DNA replication cycle to topoisomerase II inhibitors work?

A

G2 phase

Blocks coiling and uncoiling of double stranded DNA phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Etoposide class, unique concerns

A

Topoisomerase II inhibitor
Comes IV or capsules

IV: Toposar requires concentration of less than 0.4 mg/mL
Etopophos doesn’t have concentration limits, use in pts on fluid restriction

Etoposide capsules (Vepesid) are refrigerated. IV:PO ratio is 1:2

Boxed warning for myelosuppression, can have hypersensitivity reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

During what phase do pyrimidine analog antimetabolites work?

A 
S phase
Active metabolute (F-UMP) incorporated into RNA to replace uracil and inhibits cell growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fluorouracil class, brand, unique concerns

A

Pyrimidine analog antimetabolite
Adrucil, Efudex

Give leucovorin to increase efficacy
Dihydropyrimidine dehydrogenade (DPD) deficiency increases risk of severe toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Capecitabine class, brand, unique concerns

A

Pyrimidine analog antimetabolite
Xeloda
Oral prodrug of fluorouracil
DPD deficiency increases risk of severe toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Folate antimetabolites act during what phase of the cell cycle?

A

S phase

DNA synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Leucovorin place in therapy

A

Methotrexate, “rescue” must be given with high doses of MTX (> 500 mg/m2)
Also given with 5-FU to increase efficacy

Note: LEVOleucovorin is also available, dosed at 1/2 the dose of leucovorin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Methotrexate brand, unique concerns

A

Trexall, Oltrexup, Rasuvo, Xatmep
May require leucovorin rescue if dose exceeds >500 mg/m2

Doses for cancer much higher than RA or psoriasis

Hydration and IV sodium bicarbonate must be given to alkalinize the urine and decrease risk of nephrotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Drug interactions w MTX

A

NSAIDs, salicylates

Decreases clearance of methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tretinoin unique concerns

A

Absolutely contraindicated in pregnancy
Boxed warning for RA-APL differentiation syndrome “potentially fatal complication of induction chemotherapy in patients with acute promyelocytic leukemia (APL)”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Arsenic trioxide unique concerns

A

QT prolongation

Boxed warning: RA-APL differentiation syndrome, QT prolongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Asparaginase, pegasparagase unique concerns, side effects

A

Hypersensitivity reactions, pancreatitis, prolonged prothrombin time (PT/INR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bleomycin unique concerns

A

Not myelosuppressive
Maximum lifetime dose of 400 units due to pulmonary toxicity risk
Boxed warning for pulmonary fibrosis
Side effects: hypersensitivity reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Everolimus concerns, side effects

A

CYP3A4 major substrate
Side effects dyslipidemia, rash, stomatitis, interstitial lung disease

Note: Brand for cancers Afinitor, Afinitor Disperz. Zortress is indicated for transplantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Temsirolimus unique concerns, side effects

A

Use non-PVC bag and tubing due to leaching of DEHP

Side effects: dyslipidemia, hyperglycemia, myelosuppression, interstitial lung disease

18
Q

Revlimid generic, class, warnings, side effects

A

Lenalidomide
Immunomodulator
Like thalidomide - SEVERE birth defects, only available with restricted distribution, must be registered with REMS program
Consider prophylactic anticoagulation due to risk of DVT/PE and seek medical care if symptoms develop

Boxed warning: fetal risk/pregnancy

Side effects: neutropenia, thrombocytopenia

19
Q

Pomalyst generic, class, warnings, side effects

A

Pomalidomide
Immunomodulator
Like thalidomide - SEVERE birth defects, only available with restricted distribution, must be registered with REMS program
Consider prophylactic anticoagulation due to risk of DVT/PE and seek medical care if symptoms develop

Boxed warning: fetal risk/pregnancy

Side effects: neutropenia, thrombocytopenia

20
Q

Thalomid generic, class, warnings, side effects

A

Immunomodulator
Thalidomide

SEVERE birth defects, only available with restricted distribution, must be registered with REMS program
Consider prophylactic anticoagulation due to risk of DVT/PE and seek medical care if symptoms develop

Boxed warning: fetal risk/pregnancy

Side effects: neutropenia, thrombocytopenia

21
Q

Velcade class, generic, unique concerns, contraindications, side effects

A

Bortezomib
Proteasome inhibitor
Give antiviral (acyclovir, valacyclovir) to prevent herpes (zoster and simplex) reactivation

Contraindications: hypersensitivity to boron or mannitol, intrathecal administration (fatal)

SIde effects: peripheral neuropathy, thrombocytopenia, neutropenia

22
Q

Kyprolis class, generic, unique concerns, contraindications, side effects

A

Proteasome inhibitor
Premedicate with dexamethasone and fluids
Increased alkaline phosphatase = increased efficacy

Side effects: peripheral neuropathy (but less than bortezomib)

23
Q

Different substems in monoclonal antibodies and their meanings

A

ci = circulatory system (bevacizumab, ramucirumab) = inhibits blood vessel growth

tu = tumor (cetuximab, pertuzumab) = targets cells on tumors

li = immune system (ipilimumab, nivolumab) = amps up patients immune system

24
Q

Avastin generic, drug class, concerns, boxed warnings, side effects

A

Bevacizumab

VEGF inhibitor, ci=circulatory, impairs blood vessel growth (therefore can cause HTN, proteinuria, impaired wound healing due to dec blood flow)

Impairs wound healing - do not give 28 days before or after surgery

Boxed warnings = severe/fatal bleeding, GI perforation
Side effects = HTN

25
Q

Cyramza generic, drug class, concerns, boxed warnings, side effects

A

Ramucirumab

VEGF inhibitor, ci=circulatory, impairs blood vessel growth (therefore can cause HTN, proteinuria, impaired wound healing due to dec blood flow)

Impairs wound healing - do not give 28 days before or after surgery

Boxed warnings = severe/fatal bleeding, GI perforation
Side effects = HTN

26
Q

Herceptin generic, drug class, concerns, boxed warnings, side effects

A

Trastuzumab
HER2 inhibitor
tu=tumor

Monitor LVEF at baseline and during treatment (echo or MUGA scan)

Boxed warnings: HF, embryo-fetal death/birth defects - avoid pregnancy x 7 months after receiving

Side effects = none underlined, usual (infusion related rxns, n/v/d, alopecia)

27
Q

Pertuzumab drug class, concerns, boxed warnings, side effects

A

HER2 inhibitor
tu=tumor

Monitor LVEF at baseline and during treatment (echo or MUGA scan)

Boxed warnings: HF, embryo-fetal death/birth defects - avoid pregnancy x 7 months after receiving

Side effects = none underlined, usual (infusion related rxns, n/v/d, alopecia)

28
Q

Kadcyla generic, drug class, concerns, boxed warnings, side effects

A

Ado-trastuzumab emtansine (trastuzumab conjugated to a microtubule inhibitor)
HER2 inhibitor
tu=tumor

Monitor LVEF at baseline and during treatment (echo or MUGA scan)

Boxed warnings: HF, embryo-fetal death/birth defects - avoid pregnancy x 7 months after receiving

Side effects = none underlined, usual (infusion related rxns, n/v/d, alopecia)
Also has additional side effects vs others in its class: myelosuppression, hepatotoxicity, neuropathy, pulmonary toxicity (none underlined)

NOT interchangeable with conventional trastuzumab

29
Q

Erbitux generic, drug class, concerns, boxed warnings, side effects

A

Cetuximab
EGFR inhibitor, tu=tumor

Premedicate 1st dose w diphenhydramine
Test for EGFR expression and KRAS mutation
MUST be KRAS wild type to use (predicts poor response if mutated in colorectal cancer); EGFR expression = better response rates NSCLC

Boxed warnings: severe/fatal infusion-related reactions including cardiac arrest with cetuximab specifically

30
Q

Vectibix generic, drug class, concerns, boxed warnings, side effects

A

Panitumumab
EGFR inhibitor, tu=tumor

Premedicate 1st dose w diphenhydramine
Test for EGFR expression and KRAS mutation
MUST be KRAS wild type to use (predicts poor response if mutated in colorectal cancer); EGFR expression = better response rates NSCLC

Boxed warnings: severe/fatal infusion-related reactions; dermatological toxicities with panitumumab specifically

31
Q

Rituxan generic, drug class, concerns, boxed warnings, side effects

A

Rituximab
CD antigen inhibitor, tu=tumor

Must be CD20 positive to use

No underlined box warnings, side effects
Can reactivate hepatitis B
Rituximab can cause severe/fatal infusion-related reactions (SJS/TEN)

32
Q

Blincyto generic, drug class, concerns, boxed warnings, side effects

A

Blinatumomab (tu=tumor)
CD antigen inhibitor

Must be CD19 nd CD3 positive for use

Nothing underlined but name/generic was bolded?

33
Q

Ketruda generic, drug class, concerns, boxed warnings, side effects

A

Pembrolizumab
li = immune system, activates
PD-2 inhibitor
Nothing underlined, needs med guide….immune-mediated toxicities (bc it activates immune system) so colitis, hepatotoxicity, pulmonary toxicity, etc…

34
Q

Opdivo generic, drug class, concerns, boxed warnings, side effects

A

li = immune system, activates
PD-2 inhibitor
Nothing underlined, needs med guide….immune-mediated toxicities (bc it activates immune system) so colitis, hepatotoxicity, pulmonary toxicity, etc…

35
Q

Yervoy generic, drug class, concerns, boxed warnings, side effects

A

Ipilimumab
CTLA-4 inhibitor, “removes brake” from T-cell activation
Nothing underlined
REMS program

36
Q

Tyrosine kinase - general info, unique concerns

A

Orally administered
Oral bioavailability may be altered with food, very important for patients to follow dosing instructions
Pharmacogenomic testing must be done to determine whic patients will likely respond to these agents

37
Q

Gleevec generic, drug class, concerns, boxed warnings, side effects

A

Imatinib
Must be BCR-ABL (philadelphia chromosome) positive to use
Side effects: fluid retention
HBV reactivation

38
Q

Take with food or within 1 hour after a meal

A

Imatinib
Thalidomide
Capecitabine
Exemestane

39
Q

Take on empty stomach (1 hour before or 2 hours after food)

A 
Nilotinib
Erlotinib
Sorafenib
Temzolomide
Abireterone
Pomalidomide

Pomalidomide take 2 hours before or 2 hours after oof

40
Q

Take without regard to food

A 
Dasatinib
Sunitinib
Tamoxifen
Anastroazole
Bicalutamide
Lenalidomide
Letrozole
41
Q

Oral teratogenic anticancer agents

A

Thalidomide
Pomalidomide
Lenalidomide

NAPLEX - OUR cards (83 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions