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70 Cards in this Set
- Front
- Back
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5 groups included in alkylating agents
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Nitrogen Mustards
Nitrosurueas Akylsulfantes Ethylamines Triazenes |
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MOA of an alklyating agents
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Affect interactions involving guanine in DNA. The drugs either add methyl or alkyl groups into positions where they don't belong 'causing miscoding of DNA.
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1st line treatment for CLL (Give brand and generic)
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Chlorambucil (Leukeran)
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ADR of Busulfan
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Pulonary toxicity and hyperurecemia (take with allopurinol to help avoid)
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Which nitrogen mustards are administered orally?
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Cyclophosphamide (Cytoxan)
Busulfan (Myserlan) Chlorambucil (Leukeran) Melphalan (Alkeran) L-PAM |
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What is the major side effect of Cyclophosphamide? What is given to help prevent it? What are 2 other major side effects?
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hemorraghic cystitis.
MESNA is given with it to help protect the bladder. Other side effects are alopecia and SIADH |
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What are the Nitrosureas mainly used for and why?
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They are mainly used for CNS cancers because they are lipid soluble and are the only ones that can cross the BBB.
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Common toxicity of Carmustine and Lomustine?
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Leukopenia.
Also Pulmonary toxicity with chronic carmustine use |
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Which nitrosurea is given orally?
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Lomustine (CEENU)
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Indication for Mechlorethamine? GIve the brand name as well.
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Indicated for Hodgkin's disease.
Brand: Mustargen |
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Name all the Platinum Analogues (Give brand and Generic is possible)
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Altretamine (Hexalen)
Carboplatin (Paraplatin) Cisplatin (Platinol) Dacarbazine (DTIC -DOME) Procarbazine (Matulene) |
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What must cisplatin be mixed with in order to precent forming inactive metabolites?
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Must be mixed a chloride-containing solution
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What medication must be administered with Cisplatin in order to avoid Induced nephrotoxicity?
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Amifostine
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Main side effects of Cisplatin and Carboplatin?
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Neurotoxicity and Ototoxicity
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ADR of Procarbazine (Matulane)
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CNS effects - Ataxia, depression, and insomnia
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Which platinum analogues has a major drug interaction with alcohol causing the disulfiram rxn?
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Procarbazine (Matulane)
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What do they liposomal forms fo Danurobusicin and Doxarubicin treat?
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AIDS-related Karposi's sarcoma.
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Name the Anthracyclines (Brand and generic)
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Doxorubicin (Andriamycin)
Danurubicin (Cerubidine) Idarubicin (Idamycin) Mitoxantrone (Novantrone) |
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What are the general side effects of Anthracyclines?
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CARDIOTOXICITY, alopecia, stomatits.
Some have possible urine discoloration (Mitoxantrone - blue -green & Doxorubicin - red) |
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What can be given with Anthracycline to help reduce r/o cardiotoxicity?
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Dexrazoxane (Zinecard)
It's an iron chelator that removes the iron from the doxorubicin drug complex. |
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ADR of Bleomycin
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Pulmonary fibrosis, mucositis, and BM suppression
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Indication for Dactinomycin
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Used for women that have MTX-resistant carcinoma and for pediatric tumors
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ADR of Mitomycin
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stomatitis
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MOA of Methotrexate
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prevents the reduction of folic acid to tetrahydrofolic acid by inhibiting the enzyme dihydrofolic acid reductase
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What is given for MTX toxicity?
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Leucovorin
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MOA of Cytarabine?
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Inhibits DNA polymerase
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ADR of Cytarabine?
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Conjunctivitis
High doses may cause slurred speech and forgetfulness |
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ADR of Fludarabine
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Neurotoxicity and pulmonary toxicity
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Indication and ADR for Mercaptopurine
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Treatment of ALL
ADR - cholestatic liver dysfunction |
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Which Purine Antagonist treat Hairy cell Leukemia?
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Cladribine (Leustatin)
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Name the Pyrimidine Antagonist (Brand and Generic)
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Gemcitabine (Gemzar)
Capecitabine (Xeloda) Flouroouracil (Adrucil) 5-FU Floxuridine (FUDR) |
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ADR of Gemcitabine
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Grade 3-4 neutropenia
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Indication of Gemcitabine
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For Pancreatic Cancers
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MOA of Pyrimidine Antagonists
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Interferes with the biosynthesis of uridine and thymine
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ADR of Floxuridine (FUDR)
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Darkening of the nails and hair
Dry brittle hair, N/V/D |
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What are the 3 Vinca Alkaloids? (Brand and generic)
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Vincristine (Oncovorin)
Vinblastine (Valban) Vinorelbine (Navelbine) |
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ADR of Vinca Alkaloids?
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Neurotoxicity (Peripheral neuropathy)
Myelosuppression |
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What drugs are cell specific? (Name the drug and cell cycle phase)
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L-Aspariginase (G1 phase)
Antimetabolites (S phase) Bleomycin and Etoposide (G2 phase) Vinca Alkaloids (M phase) Nitrosureas (G0 phase) Bleomycin |
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ADR of Pacitaxel (Taxol)
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Neutropenia
Bradycardia Neurotoxicity |
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ADR of Docitaxel (Taxotere)
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Fluid retention
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What is the one thing to remember to do when administering taxanes?
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Pre-medicate with diphenhydramine, H2 blockers, or with dexamethasone.
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When do you use Topotecan (Hycamtin)?
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When a patient has failed cisplatin-therapy
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ADR of Irinotecan
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Severe diarrhea (control with anti-cholinergic), dehydration
Always pre-treat with anti-emetics |
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Black box warning of Alentuzumab (Give Brand name as well)
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BB Warning: Can causes severe infections, infusion reactions, and cytopenias.
Correct with premedication (PCP and Herpes virus) Brand Name = Campath |
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Brand name of Gemtuzumab
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Mylotarg
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Which biologics need to have the patients pre-medicated in order to help prevent infusion related reactions? (Include brand and generic)
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Alentuzumab (Campath)
Gemtuzumab (Mylotarg) |
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Indication and ADR of Tamoxifen
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Indication: An Anti-estrogen that is used to for the treatment of breast cancer
ADR: flushing and weight gain |
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MOA of Hydroxyurea
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Impairs DNA synthesis through inhibition of ribonucleotide reductase
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Indication of Asparaginase
Brand Name |
Treatment of ALL
Elspar |
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ADR of Aspariginase
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hyperglycemia
CNS disturbances pancreatits GI complaints |
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Which taxane do you have to only pre-medicate with Dexamethasone ONLY?
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Docetaxal (Taxotere)
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Brand name for Ganisetron
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Kytril
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Brand name for Palonestron HCL
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Aloxi
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Brand name for Dolasetron
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Anzemet
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ADR of Dolasetron
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Can cause EKG interval changes which are related to frequency and magnitude to blood levels of the metabolite
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What is Aprepitant?
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An new class of anti-emetic for highly emetogenic chemotherapy drugs.
Taken once daily for 3 days. Used only for prevention of Nausea and vomiting, not for treatment of active N/V |
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Cetixumab indication
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1st medication used for the treatment of advanced colorectal cancer that has spread to other parts of the body
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Brand name of Cetuximab
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Erbitux
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Brand name of Abarelix
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Plenaxis
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Abarelix Indication
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The 1st gonadotropin releasing hormone antagonist for the treatment of pallative prostate cancer
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Tosistumomab Indication
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Indicated for the treatment of Non-Hodgkin's Lymphoma
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Generic of Bexxar
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Tosistumomab
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ADR of Plenaxis
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hot flashes, breast tenderness, constipation, sleep disturbance, and back pain
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Indication of Bevicizumab
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1st line treatment for patients with metastatic colorectal cancer
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Explain the drug interaction between Bactrim and MTX
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Increase bone marrow toxicity (prolonged neutropenia and thrombocytopenia)
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What happens when you take 6-MP and Allopurinol together?
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Allopurinol will catalyze the metabolism of 6-MP, therefore increasing the conc. of 6-MP
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Why should you not take MTX and NSAIDS together?
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Because they both compete for renal elimination and the NSAIDS are the ones that get eliminated increasing the conc. levels of MTX causing toxicity.
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Bortezomib is used for the treatment of what?
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Mult. Myeloma
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What drug is used for 1st line treatment for non-small cell lung cancer?
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Gefitinib (Iressa)
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What oral Epidermal growth factor receptor medication is used to treat patients with locally advanced metastatic non-small cell lung cancer one patient has failed original chemotherapy?
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Erlotinib (Tarceva)
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