Pharmacotherapeutics

Question 1

clinical use of cyanocobalamin (B12)

Answer 1

pernicious anemia, vit B12 deficiency due to diet or malabsorption dz, inadequate secretion of intrinsic factor, inadequate utilization of B12 as seen during neoplastic treatment, increased B12 requirements (pregnancy, thyrotoxicosis, hemorrhage, malignancy, liver or kidney dz)

Question 2

major side effects of cyanocobalamin )B12)

Answer 2

HA, nausea, anxiety, ataxia, diarrhea, pruritus, swelling, anaphylaxis, peripheral vascular thrombosis, hypokalemia, pulmonary edema, CHF

Question 3

clinical use of eopetin/darbepoetin

Answer 3

tx of anemia in pts with cancer receiving therapy

Question 4

major side effects of eopetin/darbepoetin

Answer 4

HTN, fever, HA, pruritus/rash, N/V, injection site rxn, arthralgia, cough

Question 5

clinical use of folic acid (B9)

Answer 5

tx of megaloblastic and microcytic anemias due to folic acid deficiency

Question 6

major side effects of folic acid (B9)

Answer 6

anorexia, nausea, abd pain, flatulence, altered sleep pattern, irritability, overactivity

Question 7

clinical use of ferrous sulfate

Answer 7

prevention and tx of iron-deficiency anemia

Question 8

major side effects of ferrous sulfate

Answer 8

GI symptoms (constipation, epigastric pain, N/V/D, dark stools)

Question 9

clinical use of methotrexate

Answer 9

ALL maintenance, ALL meningeal leukemia, trophoblastic neoplasms, breast cancer, head/neck cancer, cutaneous t-cell lymphoma, lung cancer, advanced NHL, osteosarcoma

Question 10

major side effects of methotrexate

Answer 10

common: elevated LFTs, N/V, stomatitis, malaise/fatigue.
serious: severe ulcerative stomatitis, severe diarrhea, thrombocytopenia, leukopenia, severe anemia, aplastic anemia

Question 11

clinical use of parenteral (IV) iron

Answer 11

intolerance of oral iron, refractoriness to oral iron, GI dz precluding oral iron (usually IBD), blood loss that cannot be corrected (chronic hemodialysis)

Question 12

major side effects of parenteral (IV) iron

Answer 12

new preparations have far fewer AE. Generalized symptoms (arthralgias, skin rash, low grade fever), anaphylaxis

Question 13

clinical use for steroids (as used in liquid tumors)

Answer 13

dexamethasone, prednisone, methylprednisone.
used in tx along w chemo, increase appetite, reduce inflammation, help relieve chemo-associated N/V, reduce immune response after a transplant

Question 14

major side effects of steroids (as used in liquid tumors)

Answer 14

N/V, dyspepsia, fluid retention, HA, diaphoresis, vertigo, insomnia, Cushing syndrome, adrenal insufficiency, steroid psychosis, immune suppression w long term use