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Oncology Therapeutics Flashcards

0
Q

Capecitabine

A

5-FU prodrug

Diarrhea, hand-foot syndrome

Give with food to decrease nausea
Avoid aluminum/magnesium antacids

Sun protection

CYP 2C9 interaction, warfarin concerns

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1
Q

Fluorouracil (5-FU)

A

Dihydropyrimidine dehydrogenase deficiency are more likely to experience toxicity

Mucositis, diarrhea,

Bolus - myelosuppression
Continuous - hand foot, mucositis, diarrhea

Need sun protection

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2
Q

Cytarabine

A

Ocular toxicity, profound myelosuppression, CNS toxicity if they start writing smaller and smaller

Vesicant

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3
Q

Vesicant cause tissue damage

Bendamustine 
CCC
DDD
MM
Taxanes
Vinca alkaloids
A 
Cytarabine
Vinca alkaloids (vincristine, vinblastine, vinorelbine)
Paclitaxel 
Carmustine (BCNU)
Mechlorethamine 
Bendamustine 
Cisplatin 
Doxorubicin, daunorubicin, mitoxantrone 
Dactinomycin
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4
Q

Gemcitabine

Yellow gem

A

Dose limiting myelosuppression
Dose reduce if elevated bilirubin
Elevated LFT enzymes

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5
Q

Azacitidine

Fresh AAA

A

Short stability, so fresh bags must be prepared every 2-3 hours

Fever

Hypoalbuminemia pts caution for hepatic coma

Acyclovir and antifungal prophylaxis

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6
Q

Decitabine

A

AE: thrombocytopenia, neutropenia

Antibiotic prophylaxis
Hematopoietic growth factors needed

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7
Q

Fludrabine

A

Fever
CNS toxicity: blindness, coma, death

Prophylaxis against opportunistic infections

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8
Q

Cladribine

A

Lymphopenia (myelosuppression)
Fever

Prophylaxis against opportunistic infections

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9
Q

Pentostatin

Pen Prophylaxis

A

Immunosuppression expected prophylaxis
Prophylaxis for opportunistic infections

Dose reduction in renal impairment

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10
Q

Methotrexate

A

For high doses of MTX, start sodium bicarbonate drip to alkinalize urine and prevent renal toxicity

Monitor hematology (myelosuppression), renal, hepatic, pulmonary function

DDI with protein bound drugs
NSAIDS decrease renal function and MTX clearance
Common interaction with Bactrim (trimethoprim is an antifolate)

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11
Q

Leucovorin

A

Reduced form of folic acid

Administer 24-48 hours after MTX doses >100mg/m2

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12
Q

Glucarpidase

A

Inactivates methotrexate useful if renal failure

Do not administer with leucovorin, wait 2 hours

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13
Q

Pemetrexed

Trex dex

A

Dose limiting neutropenia

Dexamethasone 4mg BID x 3 days to prevent/improve rash

Folate and Vit B supplement 1 week before and continue throughout therapy to decrease hematologic side effects, mucositis, and diarrhea

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14
Q

Plant derivatives

A

All are 3A4 substrates
affected by 3A4 inhibition

Vincalkaloids
Taxanes 
Epotholones
Camptothecans (irinotecan)
Podophyllotoxins
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15
Q

VinCristine

A

Constipation due to neurotoxicity
Dose limiting neurotoxicity
Do NOT administer intrathecally

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16
Q

VinBlastine

BlastM

A

Bronchospasm

Myelosuppression

Monitor CBC w/differential

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17
Q

Vinorelbine

A

Vinca alkaloids peripheral neuropathy

Myelosuppression

Monitor CBC

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18
Q

Paclitaxel

A

Alopecia, peripheral neuropathy, myalgia, cardiac toxicity, hypotension

Nano - more sensory neuropathy

Use non-PVC(polyvinyl chloride) tubing

Premedicate with diphenhydramine, H2RA, and dexamethasone

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19
Q

Docetaxel

Dose premedicate D C

A

Dose limiting myelosuppression
Mucositis
Increased Liver LFT enzymes
Fluid retention

Corticosteroid and diphenhydramine premedicate to prevent hypersensitivity reaction and fluid retention

Use non-PVC tubing and bags

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20
Q

Cabazitaxel

A

Do not use in hepatic impairment

Premedicate with diphenhydramine and corticosteroids
Muse non-PVC tubing and bags

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21
Q

Ixabepilone

A

Neuropathy

Use DEHP-free tubing/bags
Lactated ringers only

Premedicate with diphenhydramine and steroid

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22
Q

Etoposide

A

Dose limiting myelosuppression

Concentration dependent stability issues

Use non-PVC tubing

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23
Q

Irinotecan

A

Early onset Diarrhea within 24hrs (I ran to can)
And delayed onset

Prevent/Treat early diarrhea with IV atropine NOT lomotil

Treat delayed onset with loperamide 4mg and 2mg q 2h until no bowel movement in 12 hours

Dose limiting myelosuppression and diarrhea
Nausea and vomiting

D5W diluent

Dose reduce with elevated bilirubin

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24
Topotecan TT renal
Dose limiting myelosuppression Anemia: 50% require blood transfusion Dose reduce in renal impairment
25
Erbulin mesylate
Prolongs QT interval NO dextrose in the tubing or lines Use normal saline
26
Carmustine (BCNU)
High dose: severe N/V Dose limiting hepatotoxicity and pulmonary toxicity Neurotoxicity Lifetime dose limit: 1400mg/m2 Non-PVC tubing
27
Lomustine
Delayed myelosuppression (nadir 24-60days) Take on empty stomach
28
Cyclophosphamide
Dose limiting myelosuppression Hemorrhagic cystitis (bladder toxicity) Secondary neoplasm Frequent urination due to acrolein ``` Adequate hydration (3L/day) needed Administer drug in morning ``` Monitor urine output and urinalysis
29
Ifosfamide
Dose-limiting hemorrhagic cystitis CNS toxicity: hallucinations Must be administered with Mesna and continued after ifosfamide
30
Mechlorethamine (nitrogen mustard)
Pain in injection
31
Melphalan MM
Administer orally on empty stomach Mucositis
32
Bendamustine
Lymphocytopenia Metabolized through CYP1A2 Monitor renal function
33
Procarbazine PP carbz food
Dose-limiting N/V Administer with food or after a meal Photo sensitivity DDI: tyramine foods (beer, fermented cheese) SSRI, alcohol
34
Temozolamide TE Time Empty
Take same time daily to decrease N/V Take on empty stomach Dose limiting myelosuppression
35
Thiotepa
Dose limiting cognitive impairment | Ocular toxicity, Fever
36
Cisplatin
SEVERE Nausea/Vomiting Renal toxicity, ototoxicity, peripheral neuropathy, anemia Mix in saline, cis saline Decrease renal toxicity with amifostine
37
Carboplatin
Platelet myelosuppression Ototoxicity, nephrotoxicity Dose = AUC x (GFR+25) 25 is no renal Cl
38
Oxaliplatin
Dose limiting peripheral neuropathy Cold sensitivity Prevention with gabapentin Dilute/flush with Dextrose!
39
Anthracene derivatives
-rubi - red urine And mitoxantrone Vesicant
40
Doxorubicin
Irreversible cardiac damage Total lifetime dose 500mg/m2 Reduce cardio toxicity with dexrazoxane
41
Daunorubicin
Lifetime dose 500mg/m2 Red urine
42
Epirubicin EpiHepiFree
Lines must be flushed with a heparin free solution 5-FU is incompatible with epirubicin Total lifetime dose: 900mg/m2
43
Mitoxantrone
Blue green color majoring urine, sclera, skin, increase CV toxicity Lifetime dose 160mg/m2
44
Bleomycin
Irreversible pulmonary toxicity Lifetime dose 400 units Use test dose, Do not Premedicate Monitor pulmonary function
45
Dactinomycin
Vesicant
46
Pegylated-Aspariginase PegPro
PEG formulation decreases dose and frequency of administration (q2 weeks) Prolonged Prothrombin time Decrease in fibrinogen and clotting factors Test dose recommended Monitor coagulation parameters
47
Hydroxyurea
Discard white powder floating on top Take with food to decrease N/V
48
Corticosteroids
Can kill your lymphocytes and result in opportunistic infections Total WBC may increase AE: GI irritation, hyperglycemia, mood change, muscle weakness, immunosuppression, appetite change, adrenal corticoid insufficiency
49
Tamoxifen, toremifene
``` 1st tamoxifen (also available for prevention) 2nd line toremifene ``` AE: DVT, elevated LFT, hot flashes, endometrial cancer
50
Fulvestrant
For breast cancer resistant to tamoxifen Administer in gluteal muscle monthly
51
Anastrozole, letrozole, exemestane
Used in POSTmenopausal estrogen receptor positive breast cancer AE: bone pain, muscle aches, osteoporosis
52
Abiraterone Inhibit CYP 17 testosterone synthesis
Take on empty stomach 10 fold increase with food 99% protein bound, caution phenytoin AE: peripheral edema, joint pain, hypokalemia, hypertension DDI: inhibitor of 1A2, 2D6, and Pgp Monitor blood pressure, potassium monthly
53
Flutamide, nilutamide
Flutamide- hepatotoxicity Nilutamide - interstitial pneumonitis Decreased libido, hot flashes, gynecomastia
54
Enzalutamide
For castrate resistant Prostate cancer Fatigue, asthenia, seizures
55
GnRH agonists
Decrease LH/FSH to castration levels of testosterone (combo with flutamide)
56
Megestrol
For weight gain
57
Arsenic trioxide
Weight gain secondary to fluid retention Dose-limiting peripheral neuropathy ``` Differentiation syndrome (30-50%), respiratory distress, pulmonary infiltrates, hypotension Treat with steroids ```
58
Retinoids (vitamin A)
``` AE: headache Differentiation syndrome (pulmonary infiltrate, pleural effusion, weight gain, hypotension ) treat with steroids ```
59
Bortezomib
Severe diarrhea | Dose limiting peripheral neuropathy
60
Thalidomide
Teratogenic use double contraception Peripheral neuropathy High rate of DVT with dexamethasone
61
Lenalidomide
Teratogenic use 2 contraception. Condom Dose limiting DVT (increases with dex) Neuropathy Prophylaxis with aspirin for renal function
62
Pomalidomide
Take on empty stomach Neuropathy, DVT DDI: 3A4, pgp
63
Imatinib
Take orally with food and glass of water (to reduce N/V) Periorbital and lower limb edema Severe increase in LFTs, hepatotoxicity DDI: 3A4 metabolism
64
Nilotinib
Take on empty stomach BID QT prolongation Monitor ECG DDI: 3A4, 2C9, pgp
65
Gefitinib
Diarrhea, mucositis Acneform rash Avoid sun 3A4 interactions
66
Erlotinib ER Empty Rash PPI
Take on empty stomach (2 hour buffer) Rash PPI contraindicated! Avoid sun
67
Afatinib
Take on empty stomach Rash DDI pgp Avoid sun
68
Sunitinib
VEGF - think vascular, cardiac, bleeding Take baseline ejection fraction Bleeding Avoid sun
69
VEGF
Sunitinib Sorafenib Pazopanib Bevacizumab Ziv-aflibercept
70
Sorafenib
Take without food Avoid sun DDI: 3A4, UGT1A9 (increases irinotecan) Bleeding, HTN, VEGF
71
Lapatinib LLVEF
Avoid in women with low LVEF ejection Diarrhea Plantar palmar erythrodysethesia Rash Anemia 3A4 Take on empty stomach
72
Pazopanib
Diarrhea, hepatotoxicity Hypertension, change in hair color Take on empty stomach
73
Crizotinib
Nausea/Vom/Diarrhea, vision changes Resistance develops early
74
Ceritinib
Replace if crizotinib resistance Take on empty stomach Hyperglycemia, diarrhea, increased LFT N/V, increased creatinine, abdominal pain QT prolongation Monitor glucose, electrolytes, EKG 3A4, avoid with PPI, H2RA (decrease bioavailability)
75
Vemurafenib and debrafenib
Arthralgia, rash, pyrexia (Fever) Hyperglycemia (dabrafenib) DDI: warfarin, 3A4
76
Trametinib TQT
Take on empty stomach QT prolongation, peripheral edema
77
Ibrutinib IInfection
Take with glass of water at night to decrease diarrhea Infections are common Monitor CBC, infection Avoid sun
78
Indelalisib
Hyperglycemia Monitor blood glucose, CBC, diarrhea/pulmonary symptoms
79
Palbociclib PPE
Neutropenia, pulmonary embolism Take with food Monitor CBC, PE, infection 3A4
80
Everolimus
Hyperglycemia, infections, pneumonitis High fat intake decreases absorption!
81
Vismodegib
Muscle spasms, weight loss Do not donate blood within 7 months of last dose Men use condoms and spermicide Women use contraception Avoid pregnancy! DDI: PPI, H2RA
82
Olaparib
Thrombocytopenia, neutrocytopenia, increased SCr Call MD for bleeding, muscle/joint pain Monitor CBC, SCr, pulmonary function
83
Bacillus Calmettr-Guerin
Patient must have competent immune system Contraindication: those receiving immunosuppressants (chemo, radiation, steroids) AE: flu symptoms: chills, fever, myalgia
84
Interferons
Not absorbed orally Flu-like syndrome Dose limiting fatigue Neurological and psych depression after several weeks (mental slowing, memory loss) Dexamethasone contraindicated
85
Interleukin 2
Proteins, not absorbed orally Toxic, requires vigorous supportive care Hypotension, fluid retention, renal dysfunction Capillary leak syndrome , infections (staph) Monitor renal, cardiac, edema, CBC, BP AE reduced with corticosteroids but don't use prophylactically or routinely (may interfere with IL-2 efficacy)
86
Ziv-afilbercept
VEGF: HTN, bleeding Proteinuria Monitor Urine protein
87
Mab nomenclature
``` Li - immune Tu - tumor Os - bon Vi - virus Les - inflammation ``` O - mouse U - human Xi - chimera Zu - humanized
88
Alemtuzumab HADP prophylaxis
Recognizes CD52 antigen Use within 8 hours if diluting Protect from light Premedicate with 50mg diphenhydramine and 650mg acetaminophen to reduce infusion AE Pneumocystis and HSV prophylaxis and continue until CD4 = 200 cells/liter Avoid if active infection, immunodeficiency
89
Brentuximab
Target CD30 Peripheral neuropathy, anemia, neutropenia, thrombocytopenia Monitor CBC and for peripheral neuropathy Contraindicated with bleomycin due to pulmonary toxicity 3A4
90
Cetuximab
No efficacy in KRAS mutant tumors Acneform, follicular rash, asthenia Wear sunscreen and hat Prophylaxis with antihistamine Administer undiluted using 0.22 micron filter
91
Panitimumab
Dermatologic reactions, ocular toxicity, diarrhea Sunscreen, hat
92
Rituximab
Targets CD20 antigen Premedicate with diphenhydramine and acetaminophen for infusion reactions
93
Tositumomab TThyroid
Give sski the day prior to protect thyroid Radiation mechanism
94
Ibritumomab
A lot of radiation: need to avoid human contact Prolonged neutrocytopenia, thrombocytopenia Human anti-mouse antibody reactions
95
Trastuzumab
Target HER-2 Pulmonary toxicity, cardio toxicity (contraindicated with doxorubicin) No dextrose
96
Trastuzumab emtansine (Kadcyla)
Antibody drug conjugate Cardiopulmonary toxicity, Thrombocytopenia, increase LFTs No dextrose
97
Pertuzumab
LV dysfunction Monitor LV ejection function No dextrose
98
Bevacizumab
VEGF: HTN, hemorrhage, DVT GI perforations, proteinuria Dilute with Normal saline NOT dextrose Protect from light Wait 28 days after surgery before starting Monitor abdominal pain for GI lesions
99
Gemtuzumab
Targets CD33 Last ditch effort Premedicate with diphenhydramine and acetaminophen Neutropenia, thrombocytopenia Diarrhea, stomatitis, fever, chills Protect from light, administer immediately after mixing
100
Nivolumab
Increase LFTs, rash AE related to immunity locations: GI, respiratory, skin, first pass Monitor LFTs, symptoms of pneumonitis and colitis
101
Ipilimumab IIIimmuneitis
Immune mediated complications: colitis, hepatitis, dermatitis Monitor LFTs, bowel changes, abdominal pain
102
Pembrolizumab
Immune mediated reactions GI, liver first pass, skin, respiratory Monitor TSH, LFT
103
Stipuleucel-T
Plasma dialysis, add antigen, boost immune response to Prostate cancer Monitor for infusion reactions
104
Chemo Man
Neurotoxic: nitrosourea (carmustine,lomustine) Ototoxicity/nephrotoxic: CISplatin, carboplatin Peripheral neuropathy: vinca alkaloids Pulmonary fibrosis: bleomycin Cardio toxic: doxorubicin, daunorubicin Cystitis (bladder toxicity): cyclophosphamide Myelosuppression: methotrexate, 5-FU
105
Non-PVC tubing TEC
Paclitaxel Docetaxel Cabazitaxel Etoposide Carmustine
106
CNS toxicity FIMP
``` Cytarabine - write smaller Fludrabine Ifosfamide Methotrexate Procarbazine ```
107
Empty stomach LMN TAPE CAPTinib
``` Lomustine Melphalan Nilotinib Temozolamide Abiraterone Pomalidomide Erlotinib Ceritinib Afatinib Pazopanib Trametinib ```
108
Prolong QT interval
Ceritinib Arsenic trioxide Trametinib Eribulin mesylate
109
Premedicate diphenhydramine and dex PIC DD
Paclitaxel Ixabepilone Cabazitaxel
110
Premedicate with diphenhydramine and APAP
Alemtuzumab | Rituxamab
111
Mix/dilute in saline
CISplatin | BevaCIZumab
112
No dextrose PET
Pertuzumab Eribulin mesylate Trastuzumab
113
Antibiotic prophylaxis
Decitabine Fludarabine Cladribine Pentostatin
114
Antiviral prophylaxis
Azacitidine plus antifungal Alemtuzumab (herpes)
115
High risk emetogenic potential CCDD
Cisplatin Cyclophosphamide Dacarbazine Doxorubicin
116
Chemo Mucositis
``` 5-FU Capecitabine Doxorubicin Methotrexate Melphalan ```
117
Chemo diarrhea
5-FU Capecitabine Irinotecan
118
Premedicate antihistamine only
Cetuximab
119
KRAS wild type
Can use EGFR targeted therapy Cetuximab Panitumumab
120
Flush in dextrose
Oxaliplatin | Irinotecan
121
Lacerated ringers solution
Ixabepilone
122
With food
Capecitabine Abiraterone Procarbazine Imatinib

Pharmacy (63 decks)

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