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93 Cards in this Set
- Front
- Back
Alkylating agents mechanism
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-Not phase specific -Most common: cyclophosphamide, ifosfamide, carmustine, dacarbazine, temozolomide |
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Cyclophosmaide and ifosfamide toxicity and agent
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Hemorrhagic cystitis and MESNA/hydration |
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Alkylating agents AE
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BMS, mucosal ulceration, pulmonary fibrosis (carmustine), interstitial PNA, alopecia, NV, amenorrhea, hemorrhagic cystitis (C/I), encephalopathy (I), seizures (carmustine) |
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Antimetabolites MOA
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-Active in S phase -Folate, purine, pyrimidine |
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Folate agents
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Pemetrexed, MTX, pralatrexate
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Pyrimidine agents |
Azacitidine, 5-FU, cytarabine, capecitabine, gemcitabine, decitabine |
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Purine analogs
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Pentostatin, cladribine, fludarabine
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Guanosine analgos
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Nelarabine
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Which antimetabolite agents cause Hand, Foot, Mouth
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5-FU and capecitabine |
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Which antimetabolite agents cause Neurotoxicity
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nelabarine, cytarabine, fludarabine, MTX |
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Which antimetabolites causes flu-like sx?
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Gemcitabine
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Which antimetabolites causes mucositis? |
5-FU and MTX |
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Which antimetabolites cause conjunctivitis?
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Cytarabine (high doses) |
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Which antimetabolites cause HUS? |
Gemcitabine |
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Which antimetabolites cause opportunistic infections? |
Cladribine and fludrabine |
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Which antimetbolite causes TLS, SIRS, or cap leak? |
Clofarabine
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DDI with capecitabine
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Phenytoin |
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DDI with mercaptopurine
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Allopurinol |
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DDI with MTX
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NSAIDS, amoxicillin, sulfasazline, doxycycline, HCTZ, omeprazole, phenytoin, folic acid |
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DDI with 5FU |
Warfarin |
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Treatment for TLS for patients taking Clofabarine
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IV fluids, allopurinol |
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Prophylaxis for SIRS and capillary leak for patients taking clofarabine
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CSteroids |
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Tx of pemetrexed toxicities
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Lowering homocysteine with folic acid and B12 |
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Antitumor antibiotics MOA
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Block DNA and RNA transcription through intercalation of nucleic acid in DNA: strand breakage |
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Antitumor agents |
Daunorubicin, doxorubicin, mitoxantrone, valrubicin |
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Antitumor agents MOA
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Alopecia, stomatitis Anthracyclines: cardiac toxicity (doxo = dauno > ida > epi > mitox): lifetime dosing Vesicants Bleomycin = pulm fibrosis/interstitial pneumonitis Mitomycin = HUS |
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What type of dose adjustment is needed for anthracyclines?
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Hepatic |
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What type of dose adjustment is needed for bleomycin?
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Renal |
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How are anthracyclines excreted?
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bile: adjust dose based on total bilirubin |
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What is the lifetime dose of doxorubicin?
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450-550 mg/m2 (taking into account other anthracyclines given) |
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Hormones and Antagonist agents MOA
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Act on hormone-dependent tumors by inhbiting or decreasing production of the disease-causing hormone |
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AE of hormones and antags
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Edema, menstrual disorders, hot flashes, tumor flare, thromboembolic events, gynecomastia, increased LFTs, NVD, endometrial cancer (tamoxifen), bone loss (LHRH and aromatase inhibitors), seizures (enzalutamide) |
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DDI with tamoxifen
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anticoagulants and cyclophosphamide |
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Plant alkaloid MOA
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Taxanes and vincas interfere with microtubule assembly in M phase Camptothecins and epipodophyllotoxins inhibit Top 1 and 2 --> DNA strand breaks |
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Plant Alkaloid AE
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|
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Which plant alkaloid causes hand foot mouth
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doxataxel
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Which plant alkaloid causes hypotension or HSN on admin |
Paclitaxel |
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Which plant alkaloid causes neurotoxicity? |
Vincristine |
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Which plant alkaloid causes PN and myalgia/arthralgia? |
Paclitaxel |
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Which plant alkaloid causes secondary malignancies |
Top 2 inhibitors |
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Which plant alkaloid cause SIADH? |
Vincas |
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DDI with docetaxel?
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CYP3A4, inhibitors and inducers |
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DDI with vincas? |
Phenytoin, erythromycin, zidovudine
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Which plant alkaloids are vesicants?
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Vincas |
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Which plant alkaloids should not be given intrathecally? |
Vincas |
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Biologic response modifiers and monoclonal antibodies MOA
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--have direct biologic effects on malignancies -monoclonal AB bind to specific antigens and kill malignant cells through apoptosis |
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Biologic response modifiers and monocloncals AE
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cardiac, pulm, renal impairment, mental status change, depression, MSK pain |
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Which BRM causes TLS?
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rituximab |
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Which BRM causes skin rash? |
bevacizumab |
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Which BRM causes cutaneous and severe infusion reactions and ILD? |
cetuximab |
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Which BRM causes hypothyroidism |
Tositumomab |
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Which BRM cause DVT, neutropenia, and PE?
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thalidomide and lenalidomide |
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Platinum compounds MOA
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Cisplatin, carboplatin, oxalaplatin |
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Which platin requires hydration and premeds?
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Cisplatin |
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Which platin should have thrombocytopenia monitoring? |
Carboplatin |
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Which platin has unique neurotoxicities? |
Oxaliplatin |
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What is sorafenib?
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Tyrosine kinase inhibitor used for treatment of advanced renal cell carcinoma |
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What are SE of sorafenib? |
Diarrhea, fatigue, rash, hand-foot, HTN, NV, neutropenia, and alopecia |
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What is sunitinib? |
Inhibits multiple tyrosine kinases and is used for treatment of advanced renal cell cancer and GI tumor |
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What are side effects of sunitinib? |
Neutropenia, rash, changes in skin color, fatigue, malgia, HA, HTN, nausea, LFTs increase |
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Which enzyme does sunitinib effect?
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CYP3A4 |
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What is dasatinib? |
-CLL and ALL treatment |
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What are side effects of dasatinib?
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CYP3A4 interactions |
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What is lapatinib?
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Used with capecitabine to treat HER2 positive BCA |
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What are side effects of lapatanib?
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CYP3A4 |
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What is asparaginase?
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removes exogenous asapargines from leukemic cells -need intradermal testing -hyperuricemia, hyperglycemia, renal problems |
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What is hydroxyurea?
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AE: BMS, leukopenia, NVD, constipation, mucositis, rare but fatal hepatotoxicity and pancreatitis |
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What is Erlotinib
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HER1 and EGFR tyrosine kinase inhibitor |
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AE of erlotinib
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anorexia, stomatitis, ILD, 3A4 |
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What are temsirolimus and everolimus?
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mTOR inhibitors used for treatment of renal cell carcinoma |
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AE of everolimus
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BMS anorexia, rash, mucositis, edema, high glucose, HPL, 3A4 |
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SE of 5FU
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GI, diarrhea |
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Which med can cause hyperpigmentation of skin?
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Bleomycin, Bisulfan |
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What is metabolite that causes HCystitis? |
Acrolein (cyclophosphamide at doses > 1g/m2) |
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Which med causes keratitis, conjunctivitis, and severe CNS when given in doses > 1 g/m2
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Cytarabine, ara-C
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Which med causes otoxicity, CNS tox, acute/delayed emesis, nephro |
Cisplatin |
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Which med has extravasation risk |
Dactinomycin |
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Which med causes a cute and delayed diarrhea?
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Irinotecan (Camptosar) |
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What is rescue agent for MTX toxicity?
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Leucovorin |
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Which med should be avoided cold stimulus |
oxaliplatin |
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Which taxane causes more edema/fluid retention |
Docetaxel |
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Which taxane causes more PN |
paclitaxel |
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Order of vincas causing PN
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Vincristine > vinblastine |
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Which vinca has less BMS |
vincristine |
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Treatment for extravasation
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Dexrazoxane, DMSO |
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Which 2 chemo meds are least likely to cause BMS |
Asparaginase |
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When should ESAs be used in cancer treatment |
Metastatic disease when Hb <10 and receiving chemo NOT in curable disease! |
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Is stage 2 breast cancer curable? |
Yes |
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Which has a lower rate of VTE: anastrazole or tamoxixfen? |
anastrazole |
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Risk factor for ovarian cancer |
Lack of pregnancy |
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Purpose of progesterone in HRT |
Prevent endometrial hyperplasia |
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Long term HRT increases risk of which cancers |
breast and ovarian |
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Determine curable vs palliative! |
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