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90 Cards in this Set
- Front
- Back
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Name the 3 Aromatase inhibitors
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1.) Anastrozole (Arimidex)
2.) Lestrozole (Femara) 3.) Exemestane (Aromasin) |
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What are the ADR of the Aromatase inhibitors?
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Mood changes
Weight loss Hot flashes Bone Loss (give a bisphonate!) Myalgias Arthralgias Thrombosis |
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Name the 3 Anti-androgens
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1.) Flutamide (Eulexin)
2.) Bicalutamide (Casodex) 3.) Nilutamide (Nilandron) |
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What are the ADRs of the anti-androgens?
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Hot flashes
Loss of libido Impotence |
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What's Fulvestrant (Faslodex)?
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Antiestrogen downregulator
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Route of Administration of Fulvestrant?
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IM monthly injection
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ADR of Fulvestrant (Faslodex)?
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Thrombosis
Hot flashes |
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What's Faslodex used for?
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Metastatic breast cancer
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Name the antiestrogen receptor modulators (SERMS)?
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1.) Tamoxifen (Nolvadex)
2.) Toremifene (Fareston) 3.) Raloxifene (Evista) |
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ADR of the SERMS
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Mood changes
Hot flashes Thromboembolism Endometrial cancer |
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Benefits of the SERMS
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Cancer prevention
Little to no bone loss Increases HDL |
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What's the route of administration of the gonadotropin-releasing hormone analogs
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IM or SC depot (monthly, 2, 3, or 4 months)
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Toxicities of the gonadotropin-releasing hormone analogs?
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Flare reaction
Hot flashes Mood changes Impotence/loss of libido Bone Loss (use bisphosphonates) gynecomastia |
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Considerations for the gonadotropin-releasing hormone analogs?
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1.) Prevent tumor flare with anti-androgens
2.) Bisphosphonates should be used |
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Name 2 antiangiogenic agents
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Thalidomide
Lenalidomide |
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Indications of Thalidomide and Lenalidomide
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Multiple myeloma
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Route of administration of Thalidomide and Lenalidomide
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PO
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Toxicities of Thalidomide and Lenalidomide
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BMS
Peripheral neuropathy/tremors Diarrhea Drowsiness/Somnolence Thrombosis Teratogenic Stevens-Johnson Rash |
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What's Bevacizumab (Avastin)?
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Monoclonal antibody used for colon, breast, and lung cancers
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What's the route of administration of Bevacizumab?
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IV
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ADR or Bevacizumab (Avastin)?
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HTN
Bleeding: GI Poor wound healing |
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What's the MoA of Erlotinib (Tarceva) and Cetuximab (Erbitux)?
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EGFR inhibitors
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Indications of Erlotinib (Tarceva)?
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NSCLC and pancreatic cancer
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Route of administration of Erlotinib (Tarceva)?
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PO
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ADR of Erlotinib (Tarceva) and Cetuximab (Erbitux)?
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Acneiform Rash
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What's Sunitinib (Sutent) and Sorafenbib (Nexavar) indicated for?
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clear cell renal cell carcinoma
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Imatinib (Gleevec) is the DOC for what?
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CML and GI stromal cell cancer
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What's the dose of Gleevec?
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400-800 mg PO daily
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ADR of rituximab (Rituxan)?
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Infusion reaction
Hypersensitivity Hypotension |
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ADR of trastuzumab (Herceptin) and lapatinib (Tykerb)?
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Infusion reaction
Cardiotoxicity Rash |
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Considerations with Trastuzumab (Herceptin) and Lapatinib (Tykerb)?
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Additional cardiotoxicity to taxane and anthracycline, check baseline EF prior to initiation and periodically
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Interferon alpha-2a is used for __________
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Hepatitis B and C
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ADR of interferon alpha-2a
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Flu-like syndrome
Severe fatigue Neurological (vertigo, confusion, and depression) |
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L-asparaginase (Elspar) ADR?
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hypersensitivity
hepatotoxicity/pancreatitis cerebral dysfunction |
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ADR of hydroxyurea
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Myelosuppression
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Bleomycin ADR?
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Pulmonary fibrosis
Fevers (premedicate with APA) NOT A TRUE HYPERSENSITIVITY REACTION! |
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ADR of doxorubicin
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Myelosuppression
Cardiotoxicity (acute and chronic) Mucositis Severe N/V Total alopecia Sterility/amenorrhea |
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How would you treat extravasation of doxorubicin?
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DMSO and cold compresses
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Cumulative cardiac toxity prevention: limit lifetime doses!
Daunorubicin and Doxorubicin |
550 mg/m2
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Cumulative cardiac toxity prevention: limit lifetime doses!
Idarubicin |
150 mg/m2
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Cumulative cardiac toxity prevention: limit lifetime doses!
Epirubicin |
900 mg/m2
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The Camptothecins (irinotecan and topotecan) are _________
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cell-cycle specific
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Irinotecan causes what type of diarrhea?
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Early diarrhea
Myelosuppression |
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Severe ADR of Topotecan?
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Myelosuppression (profound)
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The taxanes MoA?
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Bind to tubulin; promote microtubule assembly preventing diassembly and mitosis. Cell cycle specific
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ADR of Paclitaxel (Taxol)
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Myelosuppression
Peripheral Neuropathies Hypersensitivity (must premedicate!) Mucositis Myalgias Alopecia |
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ADR of Docetaxel (Taxotere)
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Myelosuppression
Fluid Retention Syndrome Alopecia |
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The Taxanes have to be dose reduced for _______ dysfunction
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hepatic
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Severe ADR of the taxanes?
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Neuropathies
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Infusions of the Taxanes have to be stopped immediately for ____________ reactions
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hypersensitivity
May rechallenge with additional premeds and slower infusions |
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Etoposide MoA?
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Inhibits topoisomerase II enzymes needed for DNA strand repair
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ADR of etoposide?
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Myelosuppression
Mucositis |
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NEVER EVAH do what with the vinca alkaloids?
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FATAL IF GIVEN INTRATHECALLY!
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ADR of Vincristine
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Peripheral neurotoxicity (foot drop)
Constipation CNS neuropathy (jaw pain, ataxia, facial palsies) |
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How would you treat vincristine extravasation?
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Hyaluronidase
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ADR of vinblastine and vinorelbine?
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Myelosuppression
Neurotoxicity (mild) Muscle aches Vesicant |
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Give _________ with the vinca alkaloids
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laxatives
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The Vinca alkaloids have to be dose adjusted for ________ dysfunction
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hepatic
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ADR of carboplatin (Paraplatin)
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Myelosuppression
N/V Neuropathies |
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ADR of oxaliplatin (Eloxatin)
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Thermal dysethesias, peripheral neuropathies, rash
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Indications of Oxaliplatin (Eloxatin?
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Colon cancer
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Dose of Oxaliplatin (Eloxatin)?
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85 mg/m2 IV infusion
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Considerations for Oxaliplatin?
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Avoid exposure to cold
Magnesium and calcium supplementation reduces neuropathies but could compromise efficacy |
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How would you determine the dose for Carboplatin (Paraplatin)?
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Dose = (Desired AUC) X (GFR +25)
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Name the 3 heavy metal compounds?
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Cisplatin
Carboplatin Oxaliplatin |
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Heavy metal compounds are _____________
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cell-cycle non-specific
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ADR of Cisplatin
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Nephrotoxicity
Severe N/V Neuropathies Ototoxicities |
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How should procarbazine be taken?
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Orally on an empty stomach
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ADR of procarbazine?
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Myelosuppression
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What are the drug interactions of procarbazine?
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MAO inhibitors
Interaction with TCAs tyramine-containing foods Disulfram reaction with alcohol |
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What is Temozolomide (Temodar) indicated in?
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Brain tumors (primary and metastatic)
Temozolomide crosses the BBB |
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What's the route of administration of Temozolomide
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Oral 150mg/m2/day for 5 days
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Special notes for Temozolomide (Temodar)?
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Give on an empty stomach
PCP prophylaxis needed |
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ALWAYS give _______ with ifosfamide (Ifex)
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Mesna
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ADR of ifosfamide (Ifex)
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hemorrhagic cystitis
CNS toxicity |
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ADR of cyclophosphamide (Cytoxin)
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Myelosuppression
Delayed N/V Alopecia Hemorrhagic cystitis Infertility Secondary malignancies |
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Considerations for cyclophosphamide?
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Hydration needed (3 L/day for 72 hours PO or IV)
Mesna is only used in high doses |
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When should cyclophosphamide be taken?
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Take in the morning if using oral tablets
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ADR of Pemetrexed (Alimta)
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Diarrhea
Neutropenia Stomatitis Rash |
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Supplement Pemetrexed (Alimta) with ____ and ______
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Folic acid and Vitamin B-12 to reduce toxicities
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How is Pemetrexed eliminated?
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Renally eliminated (Avoid if CrCl is less than 45 ml/min)
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Avoid ________ around dosing of pemetrexed
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NSAIDs
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When would you use leucovorin rescue with methotrexate?
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With high IV dose (100 mg- 10 g/m2)
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ADR of intrathecal methotrexate
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neurotoxicity
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ADR of PO low daily dose methotrexate
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hepatoxicity
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Intermediate IV methotrexate dose has what ADR?
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myelosuppression, mucositis
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High IV dose of methotrexate has what ADR?
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mucositis, nephrotoxicity, hepatotoxicity
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ADR of fludarabine (FAMP)
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Myelosuppression (T-cells)
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6-mercaptopurine has an interaction with what drug?
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Allopurinol
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Gemcitabine (Gemzar) has what ADR?
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Myelosuppression, generalized rashes, and flu-like symptoms
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