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Clinical Pharmacology Exam 3 > Specific Chemo Agents > Flashcards

Specific Chemo Agents Flashcards

1
Q

Cyclophosphamide Pharmacology/Metabolism

A
  • Alkylating agent
  • Converted to aldophosphoramide and then its active metabolite in the liver (acrolein)

-Acrolein = Bladder toxic

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2
Q

Cyclophosphamide MOA and indications

A

-MOA: Prevents cell division by cross linking DNA strands

  • Cancer
  • Non-cancer: Nephrotic syndrome, GPA, SLE
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3
Q

Cyclophosphamide Monitoring

A
  • CBC q 2 wks
  • BMP q 2 wks
  • LFTs q month
  • UA q month

***Hematuria needs to be evaluated very aggressively

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4
Q

Cyclophosphamide ADRs

A
  • May cause sterility

- Severe, potentially fatal hemorrhagic cystitis*

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5
Q

Cisplatin MOA/Indications

A
  • Alkylating agent
  • Inhibits DNA synthesis by formation of DNA cross-links

Indications
-Cancer

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6
Q

Cisplatin Drug Monitoring

A
  • BMP –> Renal function***
  • Audiography** (baseline and at every subsequent dose)
  • LFTs
  • CBC
  • UA
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7
Q

Cisplatin ADRs

A
  • Nephrotoxicity***
  • Ototoxicity***: Tinnitus and SNHL

“Acts like an aminoglycoside in terms of ADRs”

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8
Q

Methotrexate MOA and Indications

A
  • Antimetabolite agent
  • MOA: Folate antimetabolite that inhibits DNA synthesis

(look at slide for full paragraph MOA lol)

Indications

  • Cancer
  • Non-cancer: Autoimmune diseases like RA
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9
Q

Methotrexate unique interactions

A
  • PPIs decrease renal clearance of MTX

- Hold PPIs a couple days before & after high-dose MTX

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10
Q

Methotrexate ADRs

A
  • Stomatitis** (oral mucositis)

- May be slowed with folate supplementation

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11
Q

Methotrexate Special ADRs

A
  • Pulmonary Toxicity**
  • Hepatotoxicity**
  • Lymphoproliferative cancer
  • Nephrotoxicity
  • May present with acute or chronic pulmonary symptoms
  • Should get CXR prior to initiating MTX treatment
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12
Q

Managing Toxic MTX Levels

A
  • Leucovorin with aggressive IV hydration & alkalization of urine
  • Administer glucarpidase for toxic MTX patients with delayed clearance
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13
Q

5-Fluorouracil (5-FU) MOA and Indications

A
  • Antimetabolite
  • MOA: Pyrimidine antimetabolite that interferes with DNA synthesis by blocking methylation of deoxyuridylic acid

Indications

  • Cancer
  • Topically for actinic keratosis or BCC
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14
Q

5-FU ADRs

A
  • Stomatitis/mucositis*
  • Enterocolitis
  • Hyperpigmentation
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15
Q

Antidote to 5-FU

A
  • Uridine triacetate
  • Approved for emergency treatment of a 5-FU OD or severe toxicity

$$$$

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16
Q

Cytarabine MOA and indications

A
  • Antimetabolite
  • Inhibition of DNA synthesis
  • Incorporates cytosine triphosphate incorporated into DNA

Indications
-Cancer

17
Q

Cytarabine drug monitoring

A
  • CBC
  • CMP
  • Serum uric acid
18
Q

Cytarabine ADRs

A
  • Cytarabine syndrome**: fever, myalgia, bone pain, chest pain, maculopapular rash, conjunctivitis, malaise
  • Cerebellar toxicity
19
Q

Doxorubicin MOA and indications

A
  • Anthracycline ABX
  • MOA: Inhibition of DNA/RNA synthesis by intercalation between DNA base pairs by inhibiting topoisomerase
  • Powerful iron chelator

Indications
-Cancer

20
Q

Doxorubicin Monitoring

A
  • CBC
  • CMP
  • Baseline cardiac evaluation (ECG, MUGA, +/- ECHO***)
21
Q

Doxorubicin special ADRs

A
  • Cardiotoxicity (HF) ***

- Radiation recall**: Noticed in patients who had prior XRT –> Warmth, erythema, dermatitis

22
Q

Bleomycin MOA and indications

A
  • Antibiotic
  • MOA: Inhibits synthesis of DNA by binding to DNA leading to single and double-strand breaks

Indications: Cancer

23
Q

Bleomycin Monitoring

A
  • PFTs**
  • CMP
  • CBC
24
Q

Bleomycin Special ADRs

A
  • Striae*
  • Hyperkeratosis, vesiculation, skin peeling
  • Acute or chronic interstitial pneumonitis > pulmonary fibrosis ***
  • Febrile rxn
  • Myelosuppression
25
Q

Vinblastine MOA and indications

A

-Vinca alkaloid
MOA: Binds tubulin & inhibits microtubule formation (disrupting the formation of the mitotic spindle***)

Indications
-Cancer

26
Q

Vinblastine Monitoring

A
  • CBC
  • CMP
  • Serum uric acid
27
Q

Vinblastine ADRs

A
  • SIADH
  • Hyperuricemia
  • Myelosuppression
28
Q

Paclitaxel MOA and indications

A
  • Plant alkaloid
  • Promotes microtubule assembly by enhancing action of tubulin dimers, with the end result of inhibition of cell replication

Indications
-Cancer

29
Q

Paclitaxel Monitoring

A
  • CBC
  • CMP
  • Monitor for hypersensitivity rxn* (monitor VS frequently)
  • Continuous cardiac monitoring
30
Q

Paclitaxel ADRs

A
  • Myelosuppression
  • Peripheral neuropathy*
  • Arthralgia/myalgia
  • Hypersensitivity rxn*
  • Rhythm abnormalities

Clinical Pharmacology Exam 3 (19 decks)

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