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70 Cards in this Set
- Front
- Back
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MOA of INH
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FAS 2 inhibition
bacteriostatic structural analog of pyridoxine |
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INH DDI
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2C9, 2C19, 2E1
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ADRs of INH
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hypersensitivity rxns
hematologic peripheral neuritis (convulsion---death) decrease in hepatic mixed fxn oxidases age-dep. jaundice |
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PK of INH
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prodrug- must be activated by catalase peroxidase (KatG)
penetrates cells easily (including CSF) structural analog of pyridoxine |
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MOA of rifampin
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inhibits DNA dependent polymerase
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DDI rifampin
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induces 3A4, 2C9, 2C19
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ADRs rifampin
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jaundice
flu-like syndrome sweat, saliva turns reddish-orange |
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MOA of ethambutol
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blocks arabinosyl transferase enzyme (essential for cell wall synthesis)
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ADRs of ethambutol
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optic neuritis (need routine eye checks)
GI upset |
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MOA of pyrazinamide
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FAS1 inhibition
affects activity of mycobacterial fatty acid synthestase I gene (FAS1)- interferes w/mycolic acid biosynthetic pathway |
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ADRs of pyrazinamide:
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liver injury
hyperuricemia (acute episodes of gout) |
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ADRs of ofloxacin
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phototoxicity
inhibits cyp1A2 metal chelation CNS toxicity GI toxicity musculoskeletal toxicity QT prolongation |
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Atripla
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efavirenz (NNRTI)
emtricitabine (NRTI) tenofovir (NRTI) |
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SE of efavirenz (NNRTI)
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HA
dizziness abnormal dreams impaired concentration metabolized by CYP3A4, 2B6 |
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SE of NRTI (emtricitabine + tenofovir)
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lactic acidosis (damage to mitochondria)
hepatomegaly w/steatosis lipodystrophy pancreatitis peripheral neuropathy |
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when on INH should supplment w/??
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pyrixodine
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DNA alkylating agents ADRs:
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mucosal toxicity
CNS toxicity-N,V reproductive disorders immunosuppression alopecia |
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ADR mechlorethamine
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sterility
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ADR cyclophosphamide
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hemmorhagic cystitis--MESNA + fluids
N, V |
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ADR ifosfamide
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N, V
neurotoxicity (DLF)--give methylene blue |
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ADR carmustine, lomustine
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myelosupression--DELAYED AND PROLONGED
pulmonary damage |
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ADR procarbazine
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inactivates MAO--hypertensive crisis w/tyramine containing foods
disulfiram like rxn w/EtOH N, V myelosuppression following po neurotoxicity |
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adr mitomycin
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hemolytic-uremic syndrome
pulmonary fibrosis cardiotoxicity (CHF) |
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adr cispatin
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nephrotoxicity (prevent w/pretx chloride diuresis)
oto, neuro tox (give Zofran) |
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adr carboplatin
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less nephro, oto, neurotoxicity, less N, V than cisplatin
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oxaliplatin adr
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neurotoxicity (peripheral neuropathies--DLT)
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anthracycline adrs
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cardiotoxicity (pretx w/dexrazoxane)
myelosupression alopecia vesicant "radiation recall rxn" doxorubicin flare |
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bleomycin adr
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skin toxicity
pulmonary toxicity |
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adr dactinomycin
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severe myelosuppression
vesicant D glossitis cheilitis oral muscosal ulcerations much less potent when given orally compared to IV |
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adr MTX
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ulceration
myelosuppression hepatotoxicity CNS toxicity at high doses high doses: nephrotoxicity (need to hydrate and alkalinize urine) leucovorin TO THE RESCUE |
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mercaptopurine adr
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mild myelosuppression
hyperuricemia, gout (give allopurinol) hepatotoxicity w/l-t use TPMT deficiency: prone to myelosuppression |
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adr thiguanine
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myelosuppresssion: DLT
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5-FU adrs
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N,V
myelosupr (esp dopo bolus dose) mucosal damage (DLT w/continuous infusion) hand-foot syndrome DPD deficiency (increased sensitivity) |
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capecitabine adrs
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toxicity profile is more favorable than IV 5-FU
hand-foot syndrome GI myelosuppression is UNCOMMON |
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gemcitabine adrs
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myelosuppresion: major
elevations of serum transaminases, proteinuria, hematuria |
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adrs of vinca alkaloids
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vincristine: neurotoxicity (peripheral neuropathies---DLT)
vinblastine: myelosuppression (DLT) |
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taxanes adrs
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DLT: myelosupree
alopecia neurotox myalgias hypersensitivity rxns caused by vehicle (pretx w/H1 antag + glucocorticoid) |
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topotecan adrs
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myelosup DLT
reversible mod to severe anemia fatigue, anorexia, skin rash |
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etoposide adrs
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myelo DLT
hypersensitivity rxns |
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trastuzumab adrs
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cardiotox--CHF
N, V HA, dizziness pain in abdomen or back |
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cetuximab adrs
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infusion rxns--can be severe- dyspnea, rash, itching, decreased BP, loss of consciousness, heart attack
acne-form rash is worsened by sun asthenia, malaise |
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adr imatinib
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mild myelo
D fluid retention (mild to severe) |
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little myelosuppression
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bleomycin
mercaptopurine capecitabine imatinib (mild) vincristine MTX w/leucovorin |
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DLT of neurotoxicity:
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vincristine
oxaliplatin |
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DLT of hemorrhagic cystitis
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cyclophosphamide
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DLF at high doses of mucosal damage
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5-FU
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vesicants
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mechlorethamine
anthracyclines dactinomycin |
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pulmonary toxicities
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carmustine
lomustine mitomycin (fibrosis) bleomycin (fibrosis) |
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neurotoxicity
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ifosfamide
procarbazine cisplatin carboplatin taxanes |
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cardiotoxicity
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mitomycin
anthracylcine trastuzumab |
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skin toxicity
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bleomycin
cetuximab (acne-form rash) 5-FU + capectabine (hand-foot syndrome) |
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nephrotoxicity
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cisplatin
carboplatin (less) MTX |
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hepatotoxicity
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MTX
mercaptopurine |
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hand-foot syndrome
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5-FU
capectabine |
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myaglias
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taxanes
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adr thiguanine
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myelosuppresssion: DLT
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5-FU adrs
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N,V
myelosupr (esp dopo bolus dose) mucosal damage (DLT w/continuous infusion) hand-foot syndrome DPD deficiency (increased sensitivity) |
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capecitabine adrs
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toxicity profile is more favorable than IV 5-FU
hand-foot syndrome GI myelosuppression is UNCOMMON |
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gemcitabine adrs
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myelosuppresion: major
elevations of serum transaminases, proteinuria, hematuria |
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adrs of vinca alkaloids
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vincristine: neurotoxicity (peripheral neuropathies---DLT)
vinblastine: myelosuppression (DLT) |
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taxanes adrs
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DLT: myelosupree
alopecia neurotox myalgias hypersensitivity rxns caused by vehicle (pretx w/H1 antag + glucocorticoid) |
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topotecan adrs
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myelosup DLT
reversible mod to severe anemia fatigue, anorexia, skin rash |
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etoposide adrs
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myelo DLT
hypersensitivity rxns |
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trastuzumab adrs
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cardiotox--CHF
N, V HA, dizziness pain in abdomen or back |
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cetuximab adrs
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infusion rxns--can be severe- dyspnea, rash, itching, decreased BP, loss of consciousness, heart attack
acne-form rash is worsened by sun asthenia, malaise |
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adr imatinib
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mild myelo
D fluid retention (mild to severe) |
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little myelosuppression
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bleomycin
mercaptopurine capecitabine imatinib (mild) vincristine MTX w/leucovorin |
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DLT of neurotoxicity:
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vincristine
oxaliplatin |
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DLT of hemorrhagic cystitis
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cyclophosphamide
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DLF at high doses of mucosal damage
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5-FU
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