Supportive Care Antimetabolites

Question 1

Which drug class do the following fall in?

cyclophospamide/ifosfamide
cisplatin/carboplatin/oxaliplatin

a. alkylating agents
b. antimetabolites
c. antimicrotubules

Answer 1

a. alkylating agents

Question 2

What drug class do the following fall in?

vincristine/vinblastine/vinorelbine

a. antimicrotubules
b. alkylating agents
c. antimetabolites

Answer 2

a. antimicrotubules

Question 3

What drug class do the following fall in?

methotrexate
mercaptopurine
fluorouracil
cytarabine

a. antimicrotubules
b. alkylating agents
c. antimetabolites

Answer 3

c. antimetabolites

Question 4

What metabolite of cyclophosphamide causes toxicity?

Answer 4

acrolein

Question 5

Mesna is given for supportive care with what agents?

Answer 5

cyclophosphamide
ifosfamide

helps with hemorrhagic cystitis

Question 6

Methylene blue is given with what agent as supportive care?

Answer 6

ifosfamide

Question 7

What is dose limiting toxicity of cyclophosphamide?

Answer 7

myelosuppression

Question 8

What is dose limiting toxicity of ifosfamide?

Answer 8

hemorrhagic cystitis

Question 9

What is most emetogenic alkylating agent?

Answer 9

cisplatin

Question 10

Which platinum drug has minimal nephrotoxicity or ototoxicity?

Answer 10

oxaliplatin

Question 11

what agent is given to help with ototoxicity/nephrotoxicity of platinums?

Answer 11

amifostine

Question 12

What drug is 100% fatal if given intrathecally?

Answer 12

vincristine

Question 13

Use __ compress with vincristine

a. warm
b. cold

Answer 13

a. warm

Question 14

Avoid cold temps/drinks, etc with what platinum drug?

Answer 14

oxaliplatin

Question 15

Vincristine does not cause n/v

a. true
b. false

Answer 15

a. true

Question 16

What is main AE of paclitaxel?

Answer 16

peripheral neuroapthies

Question 17

Premedicate with what 3 things to avoid hypersensitivity rxns with paclitaxel?

Answer 17

dexamethasone
diphenhydramine
famotidine

Question 18

The main toxicities of the antifolaxe pemetrexed are bone marrow suppression and __

Answer 18

rash

Question 19

Main toxicity of methotrexate?

Answer 19

nephrotoxicity

Question 20

Glucarpidase is a supportive Tx for what drug?

Answer 20

methotrexate

cleaves anything that looks like folate into inactive form

Question 21

Main toxicity of the antimetabolite mercaptopurine?

Answer 21

hepatotoxicity

Question 22

__ are dose limiting toxicities with continuous infusion 5FU

a. leukopenia, thrombocytopenia, anemia
b. Mucositis, photosensitivity

Answer 22

b. Mucositis, photosensitivity

Question 23

__ are dose limiting toxicities with bolus administration 5FU

a. leukopenia, thrombocytopenis, anemia
b. mucositis, photosensitivity

Answer 23

a. leukopenia, thrombocytopenis, anemia

Question 24

5FU is contraindicated in pts with __ or MI within the past __ months

Answer 24

active infection, 6

Question 25

Leucovorin is a rescue agent for 5FU

a. true
b. false

Answer 25

b. false

not a rescue agent but a primer of cells for greater cytotoxicity

leucovorin primes cells to get into replication phase and helps 5FU kill better

Question 26

Which drug has toxicity of chemical conjunctivitis and fever?

Answer 26

cytarabine

antimetabolite

Question 27

What is supportive care drug for cytarabine?

Answer 27

dexamethasone eye drops q4-6hrs continue 48hrs post completion of last dose

Question 28

If homozygous for UGT1A1, reduce irinotecan dose by __ %

Answer 28

75

Question 29

Use __ compress with anthracyclines

a. warm
b. cold

Answer 29

b. cold

anthracycline is closer to “C” so use cold compress

Question 30

__ can be used as antidote for drug extravasations with anthracyclines (doxorubicin, daunorubicin, idarubicin, mitoxantrone)

Answer 30

dexrazoxane

Question 31

Epipodophyllotoxins are forced into solution with what?

Answer 31

polysorbate 80

causes infusion rxns

Question 32

Main toxicity of bleomycin?

Answer 32

pulmonary fibrosis

antitumor antibiotic

no scuba diving!!

Question 33

Which two drugs do NOT cause n/v?

Answer 33

vincristine

asparaginase