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Oncology > Side Effects and Warnings > Flashcards

Side Effects and Warnings Flashcards

1
Q

What chemotherapy drugs DONT have risk of myelosuppression?

A

Bleomycin
Vincristine
Asparaginase

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2
Q

Which chemo drugs have the highest risk for nausea and vomiting?

A

Cisplatin
Cyclophosphamide
Ifosfamide
Doxorubicin
Epirubicin

ICCED

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3
Q

Which chemo drugs have the hightest risk of mucositis?

A

FLUOROURACIL
Methotrexate

FML I have mucositic

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4
Q

What chemo drugs have the highest risk of diarrhea?

A

IRINOTECAN
Capecitabine
Fluorouracil
Methotrexate

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5
Q

What chemo has the highest risk of cardiomyopathy?

A

Anthracyclines (Doxorubicin)
HER2 inhibitors (trastuzumab, pertuzumab)
Fluorouracil

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6
Q

What chemo has the higheset QTc risk?

A

Arsenic trioxide
Leuprolide
TKI

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7
Q

What chemo has the highest risk for pulmonary fibrosis?

A

Bleomycin
Busulfan
Carmustine
Lomustine

Blue Car is Low

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8
Q

What chemo has the highest risk for pneumonistis?

A

Methotrexate
MAbs

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9
Q

What chemo has the highest risk of hepatotoxicity?

A

Antiandrogens (bicalutamide, flutamide, nilutamide)
Folate antimetabolites

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10
Q

What chemo has the highest risk of nephrotoxicity?

A

Cisplatin
Methotrexate

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11
Q

What chemo has the highest risk of hemorrhagic cystitis?

A

Ifofamide
cyclophosphamide (higher doses)

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12
Q

What chemo has the highest risk of neuropathy?

A

vinca alkaloids (vincristine, vinblastine)
Platinums (cisplatin, oxaliplatin)
Taxanes (Paclitaxel, Docetaxel)
Proteasome inhibitors (Bortezomib)

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13
Q

What cancer agents have the highest risk of thromboembolism?

A

Aromatase inhibitors (anastrozole)
SERMs (tamoxifen, raloxifene)

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14
Q

Tamoxifen

A

BW: risk of uterine and endometrial cancer
THROMBOEMBOLIC EVENTS

SE: host flashes, night sweats, vaginal bleeding, vaginal itching, decrease libido, edema, DECREASE bone density

TERATOGENIC!!!!

Prodrug converted by CYP2D6 - use venlafaxine for hot flashes since fluoxetine is a CYP2D6 inhibitor

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15
Q

Raloxifene

A

BW: risk of uterine and endometrial cancer, THROMBOEMBOLIC EVENTS

SE: hot flashes, vaginal bleeding or itching, decreased libido

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16
Q

Arimidex

A

Anastrozole
SE: hot flashes, arthralgia/myalgia

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17
Q

Lupron Depot

A

Leuprolide (GnRH Agonist)
CI: pregnancy
SE: hot flashes, impotence, gynecomastia, bone pain

** used with AI for treatment of breast cancer

**used with antiandrogens initially for prostate cancer

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18
Q

Zoladex

A

Goserelin
CI: pregnancy
SE: hot flashes, impotence, gynecomastia, bone pain

** used with AI for treatment of breast cancer

**used with antiandrogens initially for prostate cancer

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19
Q

Apalutamide

A

Antiandrogen 2nd gen
warning: QTc

20
Q

Degarelix

A

GnRH Antagonist

Osteoporosis risk
CI: pregnancy
SC inj = hypersensitivity rxns

21
Q

Flutamide

A

Antiandrogen 1st gen
BW: hepatotoxicity
SE; hot flashes, gynecomastia

22
Q

Carmustine

A

Pulmonary toxicity
Blue Car Pressure Low

23
Q

Lomustine

A

Pulmonary toxicity
Blue Car Pressure Low

24
Q

Cyclophosphamide

A

Hemorrhagic cystitis **may need to use Mesna at HIGH doses

Nausea and Vomiting
SIADH
Myelosuppression

25
Ifosfamide
Hemorrhagic cystitis === use Mesna Nausea and Vomiting Neurotoxicity Myleosuppression
26
Cisplatin
Ototoxicity* Nephrotoxicity* CINV Neuropathy (peripheral) Myleosuppression *cumunulative dose related
27
Carboplatin
Myelosuppression dose related CINV Neuropathy (peripheral)
28
Oxiliplatin
Neuropathy (sensitive to COLD) QT prolongation
29
Doxorubicin
Cardiotoxicity Vesicant Myleosuppression RED discoloration of urine and tears CINV DO NOT EXCEED 450 - 550 lifetime dose
30
Irinotecan
Topo 1 (block S phase) DIARRHEA - use atropine or loperamide Myelosuppression
31
Bleomycin
Topo 2 (G2 phase) NOT myleosuppressive pulmonary fibrosis MAX life dose 400 units **increasesd risk of pulmonary fibrosis when given with G-CSF
32
Vincristine
Vinca Alkaloids (M phase) Not myleosuppressive (: Neuropathy Vesicant Constipation ONLY IV === no intrathecal!!!!! *major CYP3A4 substrate
33
Vinblastine
Vinca Alkaloid (M phase) Bone marrow suppression :( Vesicant Neuropathy *ONLY IV
34
Paclitaxel
Taxane (M phase) Neuropathy Hepatotoxicity Myleosuppression hypersensitivity rxn = premedication
35
Docetaxel
Taxane (M phase) Neuropathy Hepatotoxicity Myleosuppression hypersensitivity rxn = premedication
36
Fluorouracil
Pyrimidine analog antimetabolites that block the S phase of cell cycle because it is incorporated into RNA as uracil BW: increase INR Hand-foot syndrome Myelosuppression Diarrhea! Mucositis
37
Capecitabine
Pyrimidine analog antimetabolites that block the S phase of cell cycle because it is incorporated into RNA as uracil ***prodrug of fluorouracil DPD deficiency increase risk of toxicity!!!! BW: increase INR Hand-foot syndrome Myelosuppression Diarrhea! Mucositis
38
Trexall
Methotrexate requires leucovirin at high doses > 500 mg/m2 BW: myelosuppression nephrotoxicity hepatotoxicity GI toxicity (mucositis) TERATOGENICITY CINV ***use preservative pree formulation for intrathecal administration ** HYDRATION needed to decrease nephrotoxicity DI: NSAIDs, salicyclates, PPI, beta lactams, salfonamide === all decrease clearance of methotrexate IV drug is orange-yellow!
39
Everolimus
mTOR inhibitor mouth ulcers peripheral edema DLD hypertension
40
Bortezomib
Peripheral neuropathy Proteasome inhibitor "zomib"
41
TrasTUzumab (Herceptin)
HER2 dimerization blocker for breast cancer Cardiotoxicity TERATOGENIC
42
Bevacizumab (Avastin)
VEGF inhibitor GI peroration and fatal bleeding
43
Cetuximab
EGFR inhibitor Acniform rash === indicates better response
44
Rituximab (Rituxan)
CD20 inhibitor BW: hep B reactivation SJS
45
Imatinib (Gleevec)
TKI oral For Philadelphia chromosone (BCR-ABL) in CML QTc prolongation myleosuppression fluid retention
46
Common side effects of TKI "nib"
Hypothyroidism QTc Rash === indicative of better response Hepatici toxicity Diarrhea hand-foot syndrome

Oncology (3 decks)

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