Test type questions for this test Flashcards
What is Methotrexate and Pemetrexed’s MOA?
What phase do the antifolates and the antipyrimidine’s work in and are they schedule or dose dependent?
What is MTX and Pemetrexed’s DLT?
Inhibit DHFR
S phase, Schedule.
Myelosuppresion.
What is Methotrexate’s notable 4 ADE’s?
What is Pemetrexed’s notable ADE?
What are the notable drug interactions for the antifolates?
Renal Dysfunction, Mucositis, CNS toxicity, Hepatoxicity.
Rash.
NSAIDs, PPIs, Penicillins.
What 5 special things to know about MTX?
What 3 special things to know about Pemetrexed including what to premedicate with?
What is 5-FU and Capecitabine’s MOA?
Distributes into 3rd spaces, Renally Eliminated, Requires MTX level monitoring, Lecuvorin rescue and sodium bicarb with high doses.
Requires folic acid and vitamin B12 to prevent myelosuppresion. Use Dexamethasone to prevent rash.
Uracil analog inactivate TS, incorporates into DNA/RNA as false nucleotide.
What are 5-FU’s DLT’s and Capecitabine’s DLT’s?
What are 5-FU and Capecitabine’s ADE’s and what drug are they a strong inhibitor of?
What 2 special things to know about 5-FU and Capecitabine?
Bolus= Myelosuppresion(5-FU only), IV= diarrhea hand-foot syndrome, mucositis.
Skin toxicities, Photosensitivity. Inhibitor of CYP2C9(warfarin).
5-FU needs Leucovorin and Capecitabine is a pro drug of 5-FU.
What is Cytarabine and Gemcitabine’s MOA and DLT?
What is Cytarabine’s ADE’s and what do you pretreat with?
What is Gemcitabine’s side effect(one of note) and what do you pre treat with?
cytosine analogue that inhibits DNA polymerase, myelosuppresion.
Flu like symptoms, high doses cause cerebellar toxicity and conjunctivitis. Corticosteroids prevent flu like symptoms and topicals prevent conjunctivitis.
Rash, Pre treat with topical corticosteroids to help with rash.
What are the antipurine’s and what is their phase, schedule type, and DLT?
What is 6-MP’s MOA, side effect of note, drug interactions?
What are the other antipurine’s MOA, side effects of note?
6-MP, Fludarabine, Cladribine, Clofarabine. S-phase, Schedule, Myelosuppresion.
Guanine analogue that incorporates as a false purine. Hepatoxicity. Allopurinol and Warfarin since it is metabolized by xanthine oxidase.
Incorporates as a false purine, watch for opportunistic infections in Fludarabine and Cladribine(require prophylaxis against PCP and HSV(Fludarabine only), Clofarabine has increased LFT’s.
What is Hydroxyurea’s MOA, phase, schedule, and DLT?
What phase, schedule, and DLT( all have same except one Vinka) do the Vinka Alkaloids and Taxanes have?
Which drugs are LETHAL if adminstered intraethically?
Inhibits ribonucleotide DHR, S phase, schedule, Myelosuppresion.
M phase, Schedule, and Myelosuppresion except Vincristine is peripheral neuropathies and constipation.
The Vinkas, Doses capped at 2 mg typically for Vincristine.
What is the big ADE to know for Vinblastine and Vinorelbine?
What are the ADE’s to know for Paclitaxel and what causes them?
What do we premedicate with for the Taxanes?
Peripheral neuropathies.
Hypersensitivity reaction, peripheral neuropathies. Contains Cremophor(very oily).
Dexamethasone, Diphenhydramine, and Ranitidine for Paclitaxel. Dexamethasone(day before, of, and after) for Docetaxel for Edema.
What are Docetaxels ADE’s?
What are Irinotecan and Topotecan’s MOA, phase, schedule, and DLT?
What is another big ADE for Irinotecan and how do we treat the diarrhea and who is at a big risk for this?
Edema, Pleural effusions, peripheral neuropathies, ascites. Contains polysorbate 80.
Inhibits Topo 1, S Phase, Schedule, Diarrhea for Irinotecan and myelosuppresion for Topotecan.
Myelosuppresion. Acute diarrhea is treated with Atropine, Delayed is treated with Loperamide. Patients with UGT1A1 deficiencies are at a high risk for diarrhea.
What is Etoposide’s MOA, phase, schedule, DLT, side effects?
What is Bleomycin’s MOA, phase, schedule, DLT?
What is Bleomycin’s ADE’s and life time max dose?
Inhibits Topo 2, G2 phase, schedule, Myelo is DLT, N/V, alopecia, mucositis, and secondary malignancies, also comes oral or IV.
Generates oxygen free radical leading to DNA strand breaks. G2 phase, schedule, DLT is Pulmonary toxicity.
Anaphylaxis/hypersensitvity reactions, fever, flulike symptoms. PFT required for pulmonary toxicity and max lifetime dose is >360 units.
What are the aspargase’s MOA, phase, schedule, and DLT’s?
What are the Aspargase’s ADE’s and special things to note on where they are made?
What is Everolimus and Tacrolimus’s MOA, phase, schedule and side effects, which one requires pre medication with diphenhydramine?
Inactivate asparagine formation starting leukemic cells. G1 phase, schedule, DLT is hypersensitivity reactions.
Pancreatitis, decreased synthesis of proteins and clotting factors, hyperglycemia, and hepatoxicitiy. L is derived from E.coli and is discontinued, Peg is from E.coli and prolongs duraion of action, Erwinia is from erqinia chysanthemi and was made for people who suffered from L type.
Targets mTOR, G1 phase, schedule, hyperglycemia, lipidemia, triglyceridemia, hypophosphatemia, liver, kidney, myleosuppresion. Tacrolimus.
What are your Nitrogen Mustards and their MOA, schedule or dose, and DLT?
What are the big ADE’s with the Nitrogen Mustards?
Which Nitrogen mustards require MESNA and which require Methylene Blue?
Chlorambucil, Cyclophosphamide, Ifosfamide. Covalently binds to DNA. Dose. Myelosupp.
Secondary maglinancies, Hemmorhagic cystitis with the last 2 and Neuro toxicity with Ifosfamide. Take Chlorambucil on an empty stomach?
Cyclophosphamide and Ifosfamide require MESNA and proper hydration, Methylene blue used for Ifosfamide.
What are the platinums, MOA, schedule or dose, and DLT?
What are the ADE’s to know with the platinums?
How do you dose Carboplatin and what is the formula?
Cisplatin, Carboplatin, Oxiplatin. Covalently binds to DNA. Dose. Cisplatin is N/V, Carbo is myelo, Oxa is peripheral neuropathies made worse by the cold.
Secondary malignancies, nephro, oto, peripheral neuropathies, K/Mg wasting(supplementation may help with myelosuppresion), myelosuppresion. Take Cisplatin with proper hydration before and after.
CALVERT formula, Dose= AUC x (CrCl + 25). Cap CrCl at 125.
What is Danorubicin’s MOA, schedule or dose, DLT and side effects, and lifetime dose?
What is Doxorubicin, Idrarubicin, and Eparubicin’s MOA, schedule or dose, DLT and side effect. and life time dose?
What things to know about Rituximab?
Inhibits Topo 2, Dose, myelo. is DLT, cardiac toxicities and mucositis. LVEF of >50% required, lifetime dose of <550 mg/m2.
Intercalates between base pairs and also generates free oxygen radicles. Myelo is DLT, watch for alopecia and cardiac toxicities. Doxorubicin’s dose is 450-550 and may discolor urine red. Idrarubicin dose is<150 and Eparubicin’s dose is <900.
CD20, Chimeric, Hypersensitivity rxs, myelosuppresion, tumor lysis syndrome. Watch for Hep B and premedicate with acetaminophen and diphenhydramine. Infusion related reactions are DLT for all the MAB’s.
What things to know about Trastuzumab?
What things to know about Cetuximab?
What things to know about Bevacizumab?
HER-2, Humanized, Cardiac Toxicity, monitor LVEF, dosed as mg/kg.
EGFR, Chimeric, Skin rash and electrolyte wasting, premedicate with diphenhydramine and minocycline(if acneiform rash occurs).
VEGF ligand, Humanized, watch for blood problems and hypertension, monitor blood pressure and urine protein.
What are Imatinib, Dasatinib, Nilotinib, Bosutinib, and Erlotinib target and SDE’s?
How do you take imatinib?
How do you take Dasatinib and Nilotinib?
BCR-ABL. N/V, edema, arthralgias, rash, myelosuppresion, increased LFT’s, diarrhea.
Daily with food, watch for QT prolongation, Acites, CHF, pleural effusions.
Dasatinib is daily and no antacids or PPI’s. Watch for same side effects as Dasatinib. Nilotinib is twice daily on empty stomach, watched for increased lipase and hyperglycemia
