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Cancer Predispositions > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Radiation Sensitizers

A

Doxorubicin Dactinomycin Gemcitibine

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2
Q

Gross total volume

A

volume occupied by tumor at diagnosis

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3
Q

Clinical Target Volume

A

GTV + sires of suspected occult disease and involved adjacent lymph nodes

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4
Q

Planning Target Volume

A

CTV + area getting dose accounting for variability (less for protons)

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5
Q

Cranial irradtion for ALL

A

includes posterior half of eye and C2

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6
Q

Flank irradiation

A

includes whole vertebral bodies

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7
Q

tumor spillage irradation

A

includes pelvis

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8
Q

Spinal irradiation

A

includes thecal sac to S3

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9
Q

Radiation dose for brain necrosis

A

60 Gy

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10
Q

Radiation dose for IQ defects

A

12 Gy

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11
Q

Radiation dose for GH deficiency

A

18 Gy

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12
Q

Radiation dose for precocious puberty

A

20 Gy

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13
Q

Radiation dose for TSH/FSH/ACTH deficiency

A

40 Gy

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14
Q

Doxorubicin extravisation

A

Cold compress, dexrazoxane

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15
Q

Vinblastine extravisation

A

Warm compress, hyluronidase

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16
Q

Vincristine extravisation

A

warm compress, hyaluronidase

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17
Q

Alkylating agents

A

temozolomide, melphalan, ifosfamide, cclophosphamide, thiotepa, carmustine, busulfan, cisplatin, carboplatin

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18
Q

Platinums

A

Cisplatin, Carboplatin

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19
Q

Platinum SE

A

Peripheral nueropathy, NV, Nephrotoxicity, myelosuppression, hepatoxicity, hypersenitivity, ototoxicity (cisplat>carbo)

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20
Q

Cisplatin ototoxicity

A

High frequency sensioneural hearing loss >4,000 hz

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21
Q

Cyclophosphamide nephrotoxicity

A

water retention with hyponatremia from direct tubular damage not ADH

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22
Q

Ifosfamide nephrotoxicity

A

proximal tubular fanconi syndrome with glucosuria, phosphaturia, amino aciduria, riscketts, RTA distal tubular damage

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23
Q

Mesna

A

chelates acrolein

24
Q

Antidote for ifosfamide neurotoxicity

A

methylene blue

25
Q

Late effects for alkylators

A

Reproduction, pulmonary fibrosis for Busulfan nitrogen mustards, renal dysfunction, ototoxicity, secondary cancers

26
Q

Antimetabolites

A

Methotrexate, mercaptopurine, thioguanine, fludarabine, cladribine, clofarabine, nelarabine, cytarabine, gemcitabine, flurorouracil

27
Q

Antimetabolite SE

A

myelosuppression, hepatotoxicity, mucositis, NV, neurotoxicity, rash, pulmonary toxicity
HD MTX nephrotoxic
Radiation Recall gemcitabine

28
Q

Methotrexate neurotoxicity

A

10-14 day onset
resolves 1-7 days
10-50% recur???
can cause chronic encephalopathy

29
Q

Cytarabine neurotoxicity

A

acute cerebellar syndrome
ataxia
nystagmus
dysmetria
dysarthria
3-8 day onset
resolves 1 wk
30% have residual effect

30
Q

Nelarabine neurotoxicity

A

solmnolence, seizures
Guillan Barre like syndrome
gradually reversible

31
Q

Fludarabine neurotoxicity

A

progressive leukoencephalopathy
can be fatal
delayed onset demyelination

32
Q

HD methotrexate nephrotoxicity

A

High output renal failure antidote glucarpidase

33
Q

Glucarpidase

A

cleaves circulating Mtx into DAMPA and glutamic acid

34
Q

Mercaptopurine interaction

A

Allopurinol

35
Q

Methotrexate interaction

A

Aspirin, penicillin, NSAIDs, ciprofloxacin, sulfas, L-Asp (give 24h after MTX)

36
Q

Topoisomerase

A

I Topotecan/irinotecan
II Doxorubicin, daunorubicin, idarubicin, etoposide, mitoxantrone, dactinomycin

37
Q

Topoisomerase SE

A

NV myelosuppression, mucositis, diarrhea, anthrcyclines - cardiac, hepatic, vesicants, radiation sensitizers (doxo, dactino, dauno, ida) etop infusion reaction

38
Q

Inrinotecan diarrhea

A

prodrug metablized to SN-38
Hyperacture <8H - atropine
Acute >8 hours - octreotide
prophy cefixime

39
Q

Tubulin binding (microtubule inhibitors)

A

Vinca alkyloids paclitaxel docetaxel erlibulin

40
Q

Microtubule inhibitor SE

A

Myelosupression except VCR
Neuropathy
SIADH
Vinblastine - mucositis
Vesicants (warm compress)

41
Q

Steroids

A

Dex not bound to transcortin so crosses BBB

42
Q

Steroid SE

A

centipedal obesity
growth failure
immunosuppression
myopathy
avascular necrosis
gastric ulcers
pancreatitis
diabetes
psychiatric disorders
hypertension
impaired wound healing

43
Q

Asparginase

A

leukemic blasts are deficient in aspargine synthase
Peg-asparginase T1/2 5-7 days
Erwinea T1/2 10-15 hours
Calaspargase T1/2 16 days

44
Q

Asparginase SE

A

Hypersensitivity
Coagulopathy
pancreatitis
hepatic toxicity
neurotoxicity

45
Q

Bleomycin

A

Chlates metals that bine DNA and produce double stranded breaks

46
Q

Bleomycin SE

A

interstitial pneumonitis
hyperpigmentation
hypersensitivity
raynaud

47
Q

Arsenic Trioxide

A

apoptosis
SE prolonged QTc
leukocytosis, APL differentiation
Hepatotoxicity
dermatitis
low mag, ca, hyperglycemia

48
Q

ATRA

A

differentiation syndrome
chelitis
headache, psuedotumor cerebri
bone and joint pain
hypertriglyceridemia
venous thrombosis

49
Q

13-cis retinoic acid

A

skin sensitivity
headache
hypertryglyceridemia
hypercalcemia
epiphyseal changes
pseudotumor cerebri
visual changes
psychiatric disorders

50
Q

BCR-ABL inhibitors TKIs

A

Imatinib - NV fatigue dh hepatoxicity hemorrhagic pleural effusions
Dasatinib dh headache hypokalemia poor bone growth pleural and pericardial effusion
nolatinib same with arthralgias, constipation, nasopharyngitis, pyrexia

51
Q

Axitinib, Pazopanib

A

VEGF PDGF C-Kit
RCC

52
Q

Sorafinib

A

VEGF PDGF c-KIT
HCC
AML FLT3
RCC

53
Q

ALK inhibitors

A

Lorlatinib
Large cell anaplasctic lymphoma
NBL

54
Q

NTRK inihibitors

A

Larotrectinib

55
Q

DNA methylation inihibitors

A

Azacitidine and decitabine
activates tumor suppressor genes silences by hypermethylation

56
Q

Gemtuzumab

A

Anti CD33

57
Q

Brentuxumab

A

Anti CD30

Cancer Predispositions (4 decks)

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