Question Bank Flashcards
Max dose zofran I’m hepatic impairment
8 mg/day
Busulfan
-Alkylating agent
-pulmonary damage/ lung fibrosis
-commonly used for HCT in CML
Marker of choice for choriocarcinoma
HCG
Which enzyme metabolizes 5FU
Dihydropyimidine dehydrogenase
Nabilone moa
Binds CB1 and CB2
CB1 causes the psychoactive effects
CNS and non-competitive binding
Cancer pain tips
-avoid opioids in elderly
-avoid opioids in asthma
-nsaids can be used for moderate pain
Interferon alpha adr
Thyroid
Denosumab fx
Atypical femoral fx from reduced osteoclast activity- prevents bone remodeling and result in fxs
Note: bone meta fx are d/t inc osteoclast and Dec osteoblast activity
Familial adenomatousus polyposis
Polys on colon, can become cancerous
Give celecoxib
Vincristine contraindication
Charcot Marie tooth disease
Acquired angioedema
-from B-cell lymphoproloferative disorders
-Tx with C1 inhibitor concentrate or bradykinin blocker icatibant if resistant to c1 inhibitor
Carcinoid syndrome
-large releases of 5HT3 and other peptides
-can happen with Neuroendocrine tumors
-flushing, diarrhea, heart dx
-tx with octreotide
-dx with 5-HIAA elevation
Burkitts
Translocation if C-MYC gene and most common variant is t(8;14)
Megestrol adr
Hyper cortisol
Initial increase in tumor size with checkpoint inhibitor
This can happen in the first month due to influx of immune cells, just continue therapy
Bisphosphonates moa
Binds hydroxyapatite crystals within eared if remodeling bone
Bisphosphonate weird ADR
Uveitis, conjunctivitis, scleritis
Noisy breathing at death
Give anticholinergics
Doxorubicin weird contraindication
Hyperbaric oxygen therapy
Delayed complication of anthracycline
-co-enzyme Q10 deficiency, can lead to cerebellar ataxia
NTRk
Neurotrophic tyrosine kinase
Imiquimod
-minimal systemic absorption
-excreted in urine
-flu like symptoms, fatigue, headache
Common mechanism of tumor cell resistance
P-glycoprotein
Pancreatic cancer itching
-due to high bilirubin
-use bile acid sequestrant
Contraindication to CBD
-allergy to sea same oil or dronabinol
Note CBD modulated effects of thc
Adrenal crisis
-can be caused by tki
-persistent hypotension, tachy, hyponatremia, hyperkalemia
-aggressive fluids, pressors, and IV hydrocortisone high dose
Treating diarrhea pearl
Get stool cultures before starting loperamide
Weird vincristine ADRs
-Vocal cord palsy: tx with pyridoxime or pyridostigmine
-jaw pain, trigeminal neuralgia
-VOD
-intestinal necrosis
Gastrinoma
Goal is to treat symptoms and prevent complications of peptic ulcer disease: give high dose PPI
I think associated with pancreatic cancer
Development of skin tumors while on BRAF/MEK
Don’t have to stop the drug, just continue and get biopsy
Dexrazoxane adr
Testicular atrophy and infertility
PegFilgrastim dosing is low body weight
Use wt based dosing if <45 kg
Velcade rare adr
Hearing loss
Mesna contraindication
Breastfeeding- benzyl etoh
Calculating chemo doses in pediatrics
If BSA is less than 0.5 m2, use body weight instead
Vincristine weird adr
VOD
How might a peripheral neuropathy present
Foot drop
Which 5HT3 antagonist is contraindicated in renal impairment
Granisetron if crcl<30
Interferon weird adr
Suicidal ideation
What does perechiae indicate
Myelosuppression/thrombocytopenia-plt<20k.
Drug of choice for pheochromocytoma
Phenoxybenzamine
Weird tamoxifen adr
Hepatotoxicity- peliosis hepatis
When I say putting edema, dyspnea, shortness of breath, you say….
Cardiotoxicity- trastuzumab or anthracycline!
5HT3 metabolism
2D6
Hiccups drug combo
Cisplatin + dex
Rare cetuximab adr
Aseptic meningitis
Bleomycin AUC goal
78-101 mg*h/L
Pyogenic granuloma
Pyrimidine analogs, taxanes, and EGFRs
Cancer related fatigue
-Ritalin
-modafinil
-corticosteroids
Fulvestrant weird adr
-Toxic epidermal necrosis (TEN)
-does NOT increase risk of endometrial cancer
-DOES increase risk of clots
Hypertrophic pulmonary osteoarthropathy with bronchgenic carcinoma drug of choice
Pamidronate or zolendronate
Gorlin syndrome
Nervous basal cell carcinoma syndrome
Hedgehogs
Cisplatin adr
Salt wasting from renal damage, Fanconi syndrome
Carmustine or lomustine adr
“Hypoxia”- think pulmonary toxicity
Topical 5FU for which type of basal cell carcinoma
Superficial
Could also use imiquimod
Biggest risk factor for severity of CRS in bite therapy
Disease burden
Absolute contraindication
Don’t jump at relative CI or precautionary stuff
Major tamoxifen ADR
Warfarin! Tamoxifen is cyp2C9 inhibitor- increases INR
Weird taxane adr
Immune mediated pneumonitis / pulmonary toxicity
Breast cancer in black women
-worse outcomes
-more TNBC
Which antifungal has negative regulation of hedgehog pathway
Itraconazole
Which SRRI is a 2D6 inhibitor
SEETRALINE!
ICI concerns
-HCT- NO! GVHD
-Worsen myasthenia gravis
-don’t give with thalidomide
Bsa equation
Square Root of [(ht x wt)/3600]
Other drugs with infusion rxns
-Etoposide
-liposomal doxorubicin
-Asparginase
-iv iron
