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50 Cards in this Set
- Front
- Back
Anti-metabolites |
Common: myelosuppression, mucositis, alopecia, N/V, tumor lysis syndrome (TLS) |
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Leucovorin is rescue for prevention of BMS and musositis, caused by which drug? |
MTX |
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MTX ADRs |
Stomatitis, mucositis, myelosuppression, chemical arachnoiditis, renally adjusted |
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mercaptopurine, thioguanine |
Myelosuppression, mild N/V/D, stomatitis, cholestatic liver dysfunction (increased bili, +/- transaminases), jaundice |
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DDI: reduce dose of azathiopurine/6MP by 75% with concomitant use of what? |
Allopurinol |
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Pyrimidine analogues: 5FU, Capecitabine (Xeloda) |
Toxicities depend on route, dose, and schedule. Bolus causes myelosuppression. Continuous infusion causes mucositis, diarrhea, HF syndrome |
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Cytarabine |
Toxicities with high dose: conjunctivities, cerebellar dysfunction. Cytarabine syndrome: fever, myalgia, bone and chest pain |
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Gemcitabine (Gemzar) |
Myelosuppression, mild N/V, stomatitis, increased LFTs |
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Topical 5FU |
HF syndrome |
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Alkylators |
Common: myelosuppression, alopecia, mucositis, sterility/infertility/teratogenicity, second malignancies (leukemias, bladder cancer from CTX) |
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Cyclophosphamide (CTX), Ifosfamide |
Hemorrhagic cystitis (caused by metabolite acrolein), highly emetogenic, delayed N/V |
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Ifosfamide, platinums, busulfan, MTX, cytarabine |
Neurotoxicity |
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Cisplatin |
Nephrotoxicity |
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Cisplatin, HD CTX, carmustine, melphan |
N/V (severe and delayed) |
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Busulfan |
Sinusoidal obstruction syndrome of liver, seizures (pretreatment with Keppra). Busulfan tan (hyper-pigmentation of skin), busulfan lung (pulm fibrosis |
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Platinum alkylators ie Cisplatin (Platinol), Carboplatin (paraplatin), Oxplatin (eloxatin), is FOLFOX regimen |
Myelosuppression, thrombocytopenia (carboplatin's dose limiting toxicity), severe N/V (acute and delayed) with cisplatin) Hypersensitivity, ototoxicity, nephrotoxicity, neurotoxicity (peripheral neuropathy, loss of taste), DLT of olaliplatin is sensory neuropathy that is aggravated by cold |
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Procarbazine (matulane) |
weak MAOI |
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Radiation |
Xerostomia, dry mouth |
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High dose MTX, 5-FU |
stomatitis, mucositis, esophagitis |
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Tx for xerostomia |
Amifostine (ethyol) prior to RT |
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Tx for mucositi, stomatitis |
rinse with mouthwash |
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General dosing schedule for MTX |
weekly dose, never qd! |
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Prevention of arachnoiditis from IT MTX or cytarabine |
Hydrocortisone 25 mg |
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risk factors for ifosfamide induced encephalopathy |
high dose, bolus dose, low albumin Tx: methylene blue |
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Nephrotoxicity |
High dose MTX, cisplatin, ifosfamide, Bevacizumab (proteinuria) |
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Tx for MTX nephrotoxicity |
Alkalinization of urine with Na bicarb |
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DDI with MTX |
NSAIDs, probenacid, PPIs, bactrim, sulfonamides, salicylates, phenytoin, vit C, nephrotoxins |
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Hemorrhagic cystitis prevention and tx |
prevention: suprahydration and frequent voiding. Mesna Tx: bladder irrigation with saline and instillation |
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Renal dose adjustment |
Cisplatin, MTX<carboplatin, cyclophosphamide, bleomycin, etoposide |
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Hepatic dose adjustment |
Vinca alkaloids, anthracyclines, taxanes, gemcitabine, irinotecan, etoposide |
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Antitumor inhibiitors |
Myelosuppression (DLT), N/V (except bleomycin), mucositis, alopecia |
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Daunorubicin, Doxorubicin, Idarubicin |
Cardiac |
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Bleomycin, mitomycin |
Pulmonary |
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Daunorubicin, dactinomucin, bleomucin |
Radiation recall dermatitis |
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Doxorubicin |
Vesicant (extravasation and tissue necrosis), cardiomyopathy. CHF (late onset, chronic) |
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Cardioprotectant for doxorubicin |
Fe chelator dexrazoxane |
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Cardiotoxicity with biological agents |
Bevacizumab, Sunitinib, Trastuzumab, high dose IL-2 |
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No O2 after surgery with what agent? |
Bleomycin |
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Pulm toxicity (lung fibrosis) |
Bleomycin (>400 unit or >200 unit/m^2), carmustine, cyclophosphamide, busulfan (busulfan lung), chlorambucil |
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Peripheral neuropathy |
Platinums, taxanes, vincas, anti-myeloma agents (thalidomide, lenalidomide, bortezomib) |
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Vinca alkaloids |
Neurotoxicity (DLT), peripheral neuropathy, exacerbated by cold exposure, neutropenia, constipation (use laxatives) |
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Taxanes |
Neutropenia, neurotoxicity (DLT), hypersensitivity reaction (need premeds), fluid retention |
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Premeds for Paclitaxel HSR (hypersensitivity reaction) |
H1, H2, and corticosteroids (ABCD). A= antiemetic. B= benadryl. C= cimetidine (any H2 blocker). D=Dexamethasone. DON'T use PVC bags! |
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Docetaxel (Taxotere) |
Pleural effusion, fluid retention |
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Pre-med for fluid retention for Docetaxel |
Dexamethasone |
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Rituximab infusion-related rxn (BBW) |
hypotension (cytokine release), bronchospasm, MI, arrhythmias. Premeds: benadryl, famotidine, dexamethasone |
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Asparaginase (Elspar) |
Pancreatitis, hepatotoxicity, decrease clotting factors |
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Irinotecan |
Diarrhea (DLT), treat with loperamide, myelosuppression |
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Acne, rash |
Geftinib, imatinib, erlotinib, cetuximab |
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Antidote to doxorubicin extravasation (skin) |
Dexrazoxane + cold compress |