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Pharmacy Practice 8 > Week 5 > Flashcards

Week 5 Flashcards

1
Q

what are signs/symptoms of acute leukemia?

A

bleeding, bruising, fever, fatigue, weakness, and frequent infections

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2
Q

acute lymphoblastic leukemia derives from malignancy of B or T lymphoblasts?

A

B

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3
Q

acute lymphoblastic leukemia is a cancer of the ___________ and _______

A

bone marrow, blood

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4
Q

Neutropenia is defined as an ANC _______

A

<500

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5
Q

profound neutropenia is defined as an ANC _________

A

<100

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6
Q

define prolonged neutropenia

A

low number of neutrophils for longer than 7 days

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7
Q

how do we calculate ANC?

A

WBC * total neutrophils (segmented neutrophils% + segmented bands%) * 10=ANC

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8
Q

how do we classify febrile neutropenia?

A

fever over 100 F (38C) with sickness symptoms

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9
Q

what is the first step to treating febrile neutropenia?

A

blood/urine cultures and start empiric antibiotics

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10
Q

what is appropriate empiric tx for febrile neutropenia?

A

zosyn

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11
Q

what are signs/symptoms of tumor lysis syndrome?

A

blood in urine, seizures, muscle cramps, AKI, heart failure, renal failure

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12
Q

what are lab values indicating tumor lysis syndrome?
(calcium, uric acid, phosphate, potassium, SCr)

A

calcium less than 7
uric acid over 8
phosphate over 4
potassium over 6
Scr elevated

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13
Q

what are risk factors for tumor lysis syndrome?

A

leukemia, high-grade lymphomas, hepatoblastoma, and neuroblastoma

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14
Q

what does elevated lactate dehydrogenase indicate?

A

cells breaking down

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15
Q

what is tumor lysis syndrome?

A

when tumor cells release their contents into the bloodstream

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16
Q

what are the treatment measures to prevent TLS?

A

excessive hydration, allopurinol, rasburicase, and close monitoring of electrolytes

17
Q

allopurinol given to patients with the HLA-B*5801 allele significantly increases the risk of?

A

allopurinol-induced severe cutaneous adverse reactions (SCAR)

18
Q

how do we treat patients with G6PD deficiency in regards to rasburicase?

A

monitor closely, still give rasburicase

19
Q

what medications are in the Hyper-CVAD regimen used to treat B-ALL?

A

cyclophosphamide, vincristine, mesna, doxorubicin, and dexamethasone

20
Q

which chemo drug has a lifetime maximum cumulative dose?

A

doxorubicin

21
Q

what is the maximum lifetime dose of doxorubicin?

A

450-550

22
Q

why does doxorubicin have a maximum lifetime dose?

A

high risk of cardiotoxicity

23
Q

which organisms are we concerned about with febrile neutropenia?

A

e. coli, klebsiella, and pseudomonas

24
Q

which antibiotic do we use for antimicrobial prophylaxis for febrile neutropenia?

A

fluoroquinolone

25
Q

what drug class is cyclophosphamide?
MoA?

A

alkylating agent
prevents cell division by cross-linking DNA strands and decreasing DNA synthesis

26
Q

what drug class is vincristine?
MoA?

A

antimicrotubular
inhibits microtubular formation preventing mitotic spindle formation in M and S phase

27
Q

what drug class is doxorubicin?
MoA?

A

anthracycline
inhibits DNA and RNA synthesis via inhibition of topoisomerase II

28
Q

what drug class is methotrexate?
MoA?

A

antimetabolite
inhibits DNA specific to S phase. also inhibits dihydrofolate reductase to prevent formation of thymidylate synthetase

29
Q

what drug class is cytarabine?
MoA?

A

antimetabolite
inhibits DNA polymerase specific to S phase

30
Q

why do we give drugs intrathecally for leukemia?

A

cancer can spread into CSF, so distributing drug into CSF will help kill cancer cells within

31
Q

which drugs in the hyper-CVAD regimen are given intrathecally?

A

methotrexate and cytarabine

32
Q

when would we add dosatinib?

A

pts with the Philadelphia chromosome mutation

33
Q

how do we treat PJP prophlyaxis?

A

Bactrim

Pharmacy Practice 8 (4 decks)

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