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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
Q

Ifosfamide

A

Hemorrhagic cystitis === use Mesna

Nausea and Vomiting
Neurotoxicity
Myleosuppression

26
Q

Cisplatin

A

Ototoxicity*
Nephrotoxicity*
CINV
Neuropathy (peripheral)
Myleosuppression

*cumunulative dose related

27
Q

Carboplatin

A

Myelosuppression dose related
CINV
Neuropathy (peripheral)

28
Q

Oxiliplatin

A

Neuropathy (sensitive to COLD)
QT prolongation

29
Q

Doxorubicin

A

Cardiotoxicity
Vesicant
Myleosuppression
RED discoloration of urine and tears
CINV

DO NOT EXCEED 450 - 550 lifetime dose

30
Q

Irinotecan

A

Topo 1 (block S phase)
DIARRHEA - use atropine or loperamide
Myelosuppression

31
Q

Bleomycin

A

Topo 2 (G2 phase)
NOT myleosuppressive

pulmonary fibrosis
MAX life dose 400 units
**increasesd risk of pulmonary fibrosis when given with G-CSF

32
Q

Vincristine

A

Vinca Alkaloids (M phase)

Not myleosuppressive (:
Neuropathy
Vesicant
Constipation

ONLY IV === no intrathecal!!!!!

*major CYP3A4 substrate

33
Q

Vinblastine

A

Vinca Alkaloid (M phase)
Bone marrow suppression :(
Vesicant
Neuropathy

*ONLY IV

34
Q

Paclitaxel

A

Taxane (M phase)
Neuropathy
Hepatotoxicity
Myleosuppression
hypersensitivity rxn = premedication

35
Q

Docetaxel

A

Taxane (M phase)
Neuropathy
Hepatotoxicity
Myleosuppression
hypersensitivity rxn = premedication

36
Q

Fluorouracil

A

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
Q

Capecitabine

A

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
Q

Trexall

A

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
Q

Everolimus

A

mTOR inhibitor
mouth ulcers
peripheral edema
DLD
hypertension

40
Q

Bortezomib

A

Peripheral neuropathy
Proteasome inhibitor “zomib”

41
Q

TrasTUzumab (Herceptin)

A

HER2 dimerization blocker for breast cancer

Cardiotoxicity
TERATOGENIC

42
Q

Bevacizumab (Avastin)

A

VEGF inhibitor
GI peroration and fatal bleeding

43
Q

Cetuximab

A

EGFR inhibitor
Acniform rash === indicates better response

44
Q

Rituximab (Rituxan)

A

CD20 inhibitor
BW: hep B reactivation
SJS

45
Q

Imatinib (Gleevec)

A

TKI oral
For Philadelphia chromosone (BCR-ABL) in CML

QTc prolongation
myleosuppression
fluid retention

46
Q

Common side effects of TKI “nib”

A

Hypothyroidism
QTc
Rash === indicative of better response
Hepatici toxicity
Diarrhea
hand-foot syndrome

Oncology (3 decks)

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