656 - Intro To Oncology (Set 1)

Front 1

What is the mechanism of action for vincristine?

Back 1

Vincristine inhibits microtubule formulation in mitotic spindle, resulting in an arrest of dividing cells at the metaphase stage

Front 2

What is the indication for vincristine?

Back 2

Acute Leukemia

Front 3

What are the common off label uses of vincristine?

Back 3

Hodgkins Lymphoma, Lymphoma, & Testicular Cancer

Front 4

Is vincristine adjusted for either renal or hepatic impairment?

Back 4

Vincristine is adjusted for hepatic impairment.

Front 5

What is the maximum dosage of vincristine if the intent is not curative?

Back 5

2 mg/dose

Front 6

What is (are) the contraindication(s) for vincristine?

Back 6

Demyelinating form of Charcot-Marie-Tooth syndrome

Front 7

What is the Black Box Warning for vincristine?

Back 7

Intrathecal use is fatal.

Front 8

What are the common adverse effects of vincristine?

Back 8

Alopecia, Neuropathy, Constipation

Front 9

What rare, but serious adverse effects are associated with vincristine?

Back 9

Bronchospasm & Hepatic Failure

Front 10

What notable drug interactions are associated with vincristine?

Back 10

Vincristine is a substrate of CYP3A4 and ABCB1, avoid inducers and inhibitors. BCG (immune stimulant) decreased efficacy, avoid.

Front 11

What "clinical pearl" was we given for vincristine?

Back 11

Myelosuppression is not usually severe.

Front 12

What is the mechanism of action for paclitaxel?

Back 12

It promotes microtubule assembly by enhancing the action of tubulin dimers, stabilizing existing microtubules, and inhibiting their disassembly, interfering with the late G2 mitotic phase, and inhibiting cell replication.

Front 13

What are the indications for paclitaxel?

Back 13

Breast Cancer, Non Small Cell Lung Cancer, Ovarian Cancer

Front 14

What are the common off label uses of paclitaxel?

Back 14

Bladder Cancer, Cervical Cancer, Small Cell Lung Cancer, & Head and Neck Cancers

Front 15

Are there any renal or hepatic adjustments for paclitaxel?

Back 15

The dose is adjusted for hepatic impairment.

Front 16

What is (are) the contraindication(s) for paclitaxel?

Back 16

Hypersensitivity to taxane of creamaphor.

Front 17

What is the Black Box Warning for paclitaxel?

Back 17

Bone marrow suppression. Hypersensitivity.

Front 18

What are the common adverse effects of paclitaxel?

Back 18

Neutropenia, Neuropathy, Rash, Alopecia, Hypotension, Elevated LFTs, NVD

Front 19

What rare but serious adverse effects are associated with paclitaxel?

Back 19

Anaphylaxis & Heart Block

Front 20

What drug interactions are associated with paclitaxel?

Back 20

Clozapine, increased risk agranulocytosis, avoid. CYP3A4 and CYP2C8 substrate, avoid inducers and inhibitors. Immune stimulants, decreased efficacy, avoid.

Front 21

Should taxane derivatives be administered before or after platinum (why)?

Back 21

Taxane derivatives should be administered before platinum derivatives (to limit mylosuppression and to enhance efficacy).

Front 22

What drugs should be used for premedication of a patient who is to receive paclitaxel?

Back 22

Dexamethasone, diphenhydramine, and ranitidine.

Front 23

How should paclitaxel be administered?

Back 23

Infuse through a 0.22 micron in-line filter and nonsorbing administration set.

Front 24

What is the mechanism of action for docetaxel?

Back 24

Promotes the assembly of microtubules from tubulin dimers, and inhibits the depolymerizatin of tubulin, which stabilizes microtubules in the cell. This results in inhibition of DNA, RNA, and protein synthesis.

Front 25

What are the indications for docetaxel?

Back 25

Breast Cancer, Non Small Cell Lung Cancer, Prostate Cancer, Head and Neck Cancer, & Gastric Cancer

Front 26

What are the common off label uses of docetaxel?

Back 26

Bladder Cancer, Cervical Cancer, Small Cell Lung Cancer, & Ovarian Cancer

Front 27

What is (are) the contraindication(s) of docetaxel?

Back 27

Hypersensitivity to taxane or polysorbate 80, ANC < 1500

Front 28

What are the Black Box Warnings of docetaxel?

Back 28

Bone marrow suppression, fluid retention, hepatic impairment, hypersensitivity, treatment related mortality

Front 29

What are the common adverse effects of docetaxel?

Back 29

Fluid retention, neutropenia, neuropathy, rash, alopecia, hypotension, elevated LFTs, NVD

Front 30

What are the rare but serious adverse effects of docetaxel?

Back 30

Secondary Malignancies & Acute Respiratory Distress Syndrome

Front 31

What drug interactions are associated with docetaxel?

Back 31

Clozapine, increased risk agranulocytosis, avoid. CYP3A4 and ABCB substrate, avoid inducers and inhibitors. Immune stimulants, decreased efficacy, avoid.

Front 32

How should docetaxel be infused?

Back 32

Over 1-hr through nonsorbing polyethylene lined (non-DEHP) tubing; in-line filter is not necessary.

Front 33

Describe premedication of a patient who is to receive docetaxel?

Back 33

Dexamethasone for 3 days to avoid fluid retention.

Front 34

What is the mechanism of action of bleomycin?

Back 34

Inhibits synthesis of DNA; binds to DNA leading to single- and double-strand breaks.

Front 35

What are the indications for bleomycin?

Back 35

Testicular Cancer, Head and Neck Cancer, Hodgkins Lymphoma, Lymphomas

Front 36

What are the common off label uses of bleomycin?

Back 36

Ovarian Cancer

Front 37

Is bleomycin adjusted based on either renal or hepatic function?

Back 37

Dosing is adjusted based on renal function.

Front 38

What is (are) the contraindication(s) of bleomycin?

Back 38

Hypersensitivity

Front 39

What are the Black Box Warnings for bleomycin?

Back 39

Idiosyncratic Reaction & Pulmonary Toxicity

Front 40

What are the common adverse effects of bleomycin?

Back 40

Fever, Rash on Hands and Feet, Hyperpigmentation, Alopecia, Chronic Interstitial Pneumonitis, and Pulmonary Fibrosis

Front 41

What rare but serious adverse effects are associated with bleomycin?

Back 41

Angioedema; Steven Johnson Syndrome; and Severe Idiosyncratic Reaction consisting of Hypotension, Mental Confusion, Fever, Chills, and Wheezing

Front 42

What drug interactions are associated with bleomycin?

Back 42

Brentuximab, myloid growth factors, additive pulmonary toxicity, avoid. Immune stimulants, decreased efficacy, avoid. Vaccines, increased toxic effects, avoid.

Front 43

What is the cumulative lifetime dose limit for bleomycin?

Back 43

400 units

Front 44

What is the maximum single dose limit for bleomycin?

Back 44

30 units

Front 45

What is the unit to milligram conversion for bleomycin?

Back 45

1 unit = 1 mg

Front 46

Describe premedication of a patient who is to receive bleomycin.

Back 46

Premedicate with acetominophen to prevent fever.