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Hematology Oncology > Pharm 25 Drug List > Flashcards

Pharm 25 Drug List Flashcards

1
Q

List the Alkylating Agents: Nitrogen Mustard drugs

A

Cyclophosphamide

Ifosfamide

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2
Q

Cyclophosphamide and Ifosfamide unique ASEs?

A

Hemorrhagic cystitis

CNS toxicity - confusion, AMS, encephalopathy

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3
Q

Why is Mesna used in conjunction with Ifosfamide?

A

Binds to acrolein to prevent hemorrhagic cystitis

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4
Q

List the Alkylating Agents: Platinum Analogues drugs

A
  1. Carboplatin
  2. Cisplatin
  3. Oxaliplatin
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5
Q

ASEs of Platinum Analogue: Carboplatin?

A

Myelosuppression - thrombocytopenia

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6
Q

ASEs of Platinum Analogue: Cisplatin?

A

Ototoxicity

Highly emetic: acute (18-24hrs post tx) and delayed (48-72 hrs post tx)

Nephrotoxicity

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7
Q

ASEs of Platinum Analogue: Oxaliplatin?

A

Cold sensitivity - pharygolaryngeal dysethesia

Peripheral neuropathy

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8
Q

List the Topoisomerase Enzyme Inhibitor drugs

A
  1. Irinotecan
  2. Doxorubicin
  3. Etoposide
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9
Q

List the Topoisomerase Enzyme Inhibitor: Camptothecins drug

A

Irinotecan

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10
Q

List the Topoisomerase Enzyme Inhibitor: Anthracycline drug

A

Doxorubicin

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11
Q

List the Topoisomerase Enzyme Inhibitor: Epipodophyllotoxin drug

A

Etoposide

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12
Q

ASEs of Camptothecins: Irinotecan?

A

When taking Irinotecan pts with UGT1A1 allele can experience life threatening diarrhea

Hepatic impairment

Neutropenia (UGT1A1 28)

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13
Q

What adjunct therapies do you use to avoid both acute and delayed diarrhea when taking Irinotecan?

A

Acute: use atropine

Delayed: use loperamide

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14
Q

ASEs of Anthracycline: Doxorubicin?

A

Cardiotoxicity (dilated cardiomyopathy)

Urine discoloration

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15
Q

What medication is often given with Doxorubicin to reduce cardiotoxicity?

A

Dexrazoxane

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16
Q

MOA of Dexrazoxane + Doxorubicin?

A

Inhibits free radical formation —> limiting cardiotoxicity

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17
Q

What potential ASE occurs with using Dexrazoxane + Doxorubicin?

A

Potential decreases the chemo drug effectiveness.

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18
Q

ASEs of Epipodophyllotoxin: Etoposide?

A

Infection related rxn: HypoTN, fever/chills

Hypersensitivity rx: Anaphylaxis, tachy, bronchospasm, dyspnea

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19
Q

List the Antimicrotubule drugs

A
  1. Vincristine
  2. Docetaxel
  3. Paclitaxel
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20
Q

List the Antimicrotubules: Vinca Alkaloid drug

A

Vincristine

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21
Q

List the Antimicrotubules: Taxanes drugs

A

Docetaxel

Paclitaxel

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22
Q

ASEs of Vinca Alkaloid: Vincristine?

A

Neurotoxicity: sensor, motor, peripheral neuropathy

Fatal if administered intrathecally - irreversible

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23
Q

What is best practice to avoid causing fatality when administering Vincristine?

A

Use IV mini infusion bags not syringes

24
Q

ASES of Taxanes: Docetaxel

and Paclitaxel?

A

Cardiovascular - peripheral edema, flushing

Neurotoxic- cumulative peripheral neuropathy

25
Q

List the Antimetabolites

A
  1. Capecitabine
  2. Fluorouracil (5-FU)
  3. Cytarabine
  4. Methotrexate (MTX)
26
Q

List the Antimetabolites: Pyrimidine Analogue dugs

A
  1. Capecitabine
  2. Fluorouracil (5-FU)
  3. Cytarabine
27
Q

ASEs of Pyrimidine Analogues: Capecitabine and Fluorouracil (5-FU)

A

Continuous infusion:

  • Mucosal damage
  • Palmar - plantar erythrodysesthia (“hand-foot syndrome”)

Genetic polymorphism defect (DPD)

28
Q

List the Antimetabolites: Antifolate drug

A

Methotrexate (MTX)

29
Q

ASEs of Antifolate: Methotrexate (MTX)

A

Mucosal damage

Hepatotoxicity and Nephrotoxicity

30
Q

What are 2 drug interactions with Methotrexate (MTX)?

A
  • NSAIDs (decreased clearance of MRX –> increased toxicity)

- PPIs (elevate and prolong serum MTX levels (high dose MTX)

31
Q

What medication is used as a chemotherapy rescue agent and a chemotherapy modulating agent?

A

Leucovorin (Folinic Acid)

32
Q

How is Leucovorin used as a chemotherapy rescue agent?

A

Used in MTX toxicity

Actively competes with and displaces MTX from intracellular binding sites

Restores active folate stores required for DNA/RNA synthesis.

33
Q

How is Leucovorin used as a chemotherapy modulating agent?

A

Fluorouracil efficacy

Enhances FdUMO (metabolite of 5-FU) binding to thymidylate synthesis —> inhibiting thymidylate enzyme causing DNA damage.

34
Q

List the Antitumor antibiotic drug

A

Bleomycin

35
Q

ASEs of Antitumor antibiotic: bleomycin?

A

Pulmonary fibrosis “Bleo Lung”

36
Q

List the Proteosome inhibitor drug

A

Bortezomib

37
Q

ASEs of Proteosome inhibitor: Bortezomib?

A

Peripheral neuropathy (less if given SubQ vs IV)

Herpes reactivation

38
Q

List the Immunomodulator

A

Lenalidomide

39
Q

BB warning of Immunomodulator: Lenalidomide?

A

Arterial/venous thromboembolic events (w/ dexamethasone)

Severe birth defects, embryo-fetal death (extensive REMS program)

40
Q

List the Monoclonal antibodies drugs

A
  1. Rituximab
  2. Trastuzumab
  3. Cetuximab
  4. Bevacizumab
  5. Pembrolizumab
41
Q

General ASEs of Monoclonal antibodies drugs?

A

Infusion related—> need to titrate d/t how large the molecules are

Immune-mediated —> toxic epidermal necrolysis, enterocolitis, hepatitis, progressive multifocal leukoencephalopathy, mucocutaneous rxn.

42
Q

List the Monoclonal antibodies: Anti-CD20 drug

A

Rituximab

43
Q

ASEs of Anti-CD20: Rituximab

A

Hep B reactivation

High lymphocytes count = high infusion reaction potential

CCL pts- pneumocystis jiroveccii (PCP) and antiherpetic viral prophylaxis

44
Q

List the Monoclonal antibodies: Anti-HER2 drug

A

Trastuzumab

45
Q

ASEs of Anti-HER2: Trastuzumab

A

Cardiotoxicity (reversible t1/2=30 days)

  • HF
  • Arrythmia
  • Cardiomyopathy
46
Q

List the Monoclonal antibodies: Anti-PD drug

A

Pembrolizumab

47
Q

ASEs of Anti-PD: Pembrolizumab

A

Immune-mediated:

  • Colitis
  • Dermatitis
  • Hyperglycemia
  • Hyperthyroidism
  • Nephritis
  • Pneumonitis
48
Q

List the Monoclonal antibodies: EGFR Inhibitor

A

Cetuximab

49
Q

ASEs of EGFR Inhibitor: Cetuximab

A

Dermatological: acneiform rash, other skin rashes

Electrolyte abnormality - hypomagnesemia (may be d/t high expression of EGFR in kidneys)

50
Q

List the Monoclonal antibodies: VEGF Inhibitor

A

Bevacizumab

51
Q

ASEs of VEGF inhibitor: Bevacizumab

A

Impaired wound healing
GI perforation
Proteinuria/nephrotic syndrome

52
Q

List the Tyrosine Kinase Inhibitor (TKI) drugs

A
  1. Imatinib
  2. Ibrutinib
  3. Sorafenib
  4. Erlotinib
53
Q

MOA of Tyrosine Kinase Inhibitor (TKI) drugs?

A

Shuts down TK activity preventing the transfer of a phosphate group from ATP to tyrosine residues in proteins.

Targets extracellular and intracellular TK receptors and ligands and intracellular fusion proteins

54
Q

Advantaged of Tyrosine kinase inhibitor drugs?

A

Single compound targeting multiple kinases

Efficacy in multiple tumor types

Oral therapy = convenient and less complex

55
Q

Disadvantages of Tyrosine Kinase Inhibitor drugs?

A

Lots of drug-drug interactions

Toxicities

Pts if monitored less frequently

Hematology Oncology (9 decks)

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