TRADITIONAL CHEMOTHERAPY AGENT SPECIFICS Flashcards
WHICH CHEMO CLASSES ARE CELL CYCLE INDEPENDENT AGENTS
ALKYLATING AGENTS
PLATINUM-BASED COMPOUNDS
ANTHRACYCLINES
WHICH AGENTS ARE IN THE ALKYLATING AGENTS CLASS?
CYCLOPHOSPHAMIDE, IFOSFAMIDE
CARMUSTINE, LOMUSTINE
BUSULFAN
WHICH AGENTS ARE PLATINUM BASED COMPOUNDS?
CISPLATIN
CARBOPLATIN
OXALIPLATIN
WHICH ARENTS ARE ANTHRACYCLINES
DOXORUBICIN, DAUNORUBICIN
MITOXANTRONE
WHICH CHEMO CLASSES ARE CELL CYCLE SPECIFIC AGENTS
TOPOISOMERASE INHIBITORS (1 AND 2)
VINCA ALKALOIDS
TAXANES
PYRIMIDINE ANALOG ANTIMETABOLITES
FOLATE ANTIMETABOLITES
ALKYLATING AGENT MOA
CROSS LINKING DNA STRANDS, INHIBITING PROTEIN SYNTHESIS AND DNA SYNTHESIS
HOW DOES MESNA WORK
INACTIVATES TOXIC METABOLITE ACROLEIN THAT CONCENTRATES IN THE BLADDER
WHAT IS THE TOXIC METABOLITE OF CYCLOPHOSPHAMIDE AND IFOSFAMIDE
ACROLEIN
PLATINUM BASED COMPOUNDS MOA
CROSS LINK DNA, INHIBITING DNA SYNTHESIS AND CELL REPLICATION
PLATINUM BASED COMPOUND WARNING
PLATINUM COMPONENT CAN CAUSE TOXICITIES RELATED TO HEAVY EMTAL POISONING, LIKE NEUROPATHY, OTOTOXICITY, AND NEPHROPATHY
CARBOPLATIN CALVERT FORMULA
USED TO CALCULATE DOSE FOR TARGET AUC
DOSE = (TARGET AUC)X(GFR+25)
AUC CAN RANGE FROM 2-8
GFR IS CAPPED AT 125
PLATINUM BASED COMPOUND BOXED WARNING
ANAPHYLACTIC LIKE REACTIONS
RISK INCREASES WITH REPEATED EXPOSURE
WHICH ANTHRACYCLINES HAVE A UNIQUE COLOR
DOXORUBICIN IS RED
MITOCANTRONE IS BLUE
TOPOISOMERASE 1 INHIBITOR INHIBITS WHICH PHASE
S PHASE
TOPIOSOMERASE 2 INHIBITORS INHIBIT WHICH PHASE
BLOCK G2 PHASE
VINCA ALKALOIDS MOA
WHICH PHASE?
INHIBIT FUNCTION OF MICROTUBULES IN M PHASE
VINCA ALKALOIDS THAT ARE ASSOCIATED WITH MORE BONE MARROW SUPPRESSION THAN VINCRISTINE
VINBLASTINE AND VINOREBLINE
BOTH HAVE B IN NAME
TAXANES MOA AND PHASE
INHIBIT FUNCTION OF MICROTUBULES IN M PHASE
TAXANE BOXED WARNING
INFUSION RELATED HYPERSENSITIVITY REACTIONS AND FATAL ANAPHYLAXIS WITH ALL TAXANES
TAXANE DRUG INTERACTION WITH ANOTHER CHEMO CLASS
TAXANE ELIMINATION REDUCED WHEN GIVE AFTER CISPLATIN/CARBOPLATIN
GIVE TAXANES BEFORE
WHICH TAXANE DOES NOT CAUSE HYPERSENSITIVITY AND DOES NOT NEED PREMEDICATION
PACLITAXEL
PYRIMIDINE ANALOG ANTIMETABOLITES MOA AND PHASE
INHIBIT PSYRIMIDINE SYNTHESIS DURING S PHASE
WHAT METABOLITES IS INCORPORATED INTO RNA WHEN PYRIMIDINE ANALOGS ARE USED
F-UMP
S-dUMP
FOLATE ANTIMETABOLITE MOA AND PHASE
INTERFERE WITH ENZYMES INVOLVED IN FOLIC ACID CYCLE, BLOCKING PURINE AND PYRIMIDINE SYNTHESIS DURING S PHASE
HOW IS DOSING DIFFERENT FOR METHOTREXATE IN RA/PSORIASIS VS ONCOLOGY
DOSES IS MUCH HIGHER IN ONCOLOGY
RA/PSORIASIS DOSES ARE WEEKLY DOSES
WHAT IS ADMINISTERED TO ↓ RISK OF NEPHROTOXICITY WITH METHOTREXATE
HYDRATION AND IV NA-BICARB TO ALKALINIZE THE URINE
IF WANT TO USE SUPPLEMENTS TO ↓ RISK OF SIDE EFFECTS WITH FOLATE ANTIMETABOLITES, WHICH ONES ARE USED?
A REDUCED FORM OF FOLIC ACID IS NEEDED (REGULAR FOLATE DOES NOT WORK)
WHICH MEDICATIONS CAN INTERACT WITH METHOTREXATE
NSAIDS
SALICYLATES
WHICH mTOR AGENTS CAN BE USED IN ONCOLOGY
EVEROLIMUS
TEMSIROLIMUS
EVEROLIMUS SIDE EFFECTS
MOUTH ULCERS/STOMATITIS
RASH
INTERSTITIAL LUNG DISEASE
PERIPHERAL EDEMA
DYSLIPIDEMIA
↑BP
BEVACIZUMAB MOA
VEGF INHIBITOR
VEGF INHIBITOR CONCERNS
IMPAIRS WOUND HEALING - DO NOT GIVE 28 DAYS BEFORE OR AFTER SURGERY
SEVERE/FATAL BLEEDING
GI PERFORATION
TRASTUZUMAB MOA
HER2 INHIBITOR
HER2 INHIBITOR CONCERNS
MONITOR LVEF DUE TO RISK OF HF
CETUXIMAB MOA
EGFR INHIBITOR
EGFR INHIBITOR PHARMACOGENOMICS
FOR LUNG CANCER
MUST BE KRAS WILD TYPE TO USE
MUTATION PREDICTS POOR RESPONSE
EGFR INHIBITOR CONCERNS
ACNEIFORM RASH
RASH INDICATES BETTER RESPONSE TO DRUG
AVOID SUNLIGHT
USE EMOLLIENTS, STEROIDS, ABX TO REDUCE SKIN DAMAGE
RITUXIMAB MOA
LEUKOCYTE CLUSTER OF DIFFERENTIATION (CD) ANTIGEN INHIBITOR
CD-INHIBITOR CONCERNS
PREMEDICATE WITH BENADRYLL, APAP, STEROID DUE TO RISK OF INFUSION REACTIONS
PROGRAMMED DEATH RECEPTOR-1 (PD-1) INHIBITOR CONCERNS
IMMUNE-MEDIATED TOXICITIES
CYTOTOXIC T-LYMPHOCYTE ANTIGEN-4 (CTLA-4) INHIBITOR CONCERN
REMS PROGRAM
FATAL IMMUNE MEDIATED REACTION
WHAT TESTING SHOULD BE DONE BEFORE ADMINISTERING TKIs
PHARMACOGENOMIC TESTING TO IDENTIFY PATIENTS WHO WILL BENEFIT
IMATINIB USE AND MOA
CHRONIC MYELOGENOUS LEUKEMIA (CML)
BCR-ABL INHIBITOR
IMATINIB CONCERNS
MUST BE BCR-ABL POSITIVE TO USE
CAN CAUSE FLUID RETENTION AND EDEMA
BRAF INHIBITOR USE
USED IN MELANOMA
BRAF INHIBITOR CONCERNS
MUST BE BRAF V600E OR V600K MUTATION POSITIVE
NEW MALIGNANCIES CAN OCCUR
MITOGEN-ACTIVATED EXTRACELLULAR KINASE (MEK) 1 AND 2 INHIBITOR CONCERNS
USED IN COMBINATION WITH BRAF INHIBITORS IN PATIENTS WITH BRAF V600E AND V600K MUTATIONS
EGFR INHIBITOR USE
NON-SMALL CELL LUNG CANCER (NSCLC)
EGFR INHIBITOR CONCERNS
MUST BE EGFR MUTATION POSITIVE
RASH THAT INDICATES A BETTER RESPONSE
ANAPLASTIC LYMPHOMA KINASE (ALK) INHIBITORS USE
NON-SMALL CELL LUNG CANCER (NSCLC)
ANAPLASTIC LYMPHOMA KINASE (ALK) INHIBITORS CONCERNS
MUST BE ALK MUTATION POSITIVE
COMMON TOXICITIES WITH TKIs
THYROID GLAND (HYPOTHYROIDISM)
HEART (QT PRLONGATION)
SKIN (RASH)
BLOOD VESSELS (HTN, HAND AND FOOT SYNDROME)
LIVER (HEPATOTOXICITY)
INTESTINES (DIARRHEA)
WHICH ORAL CHEMO AGENTS SHOULD BE GIVEN WITH FOOD
IMATINIB
CAPECITABINE
WHICH ORAL CHEMO AGENTS CAN BE TAKEN WITHOUT REGARD TO FOOD
ANASTRAZOLE
TAMOXIFEN