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90 Cards in this Set

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Name the 3 Aromatase inhibitors
1.) Anastrozole (Arimidex)
2.) Lestrozole (Femara)
3.) Exemestane (Aromasin)
What are the ADR of the Aromatase inhibitors?
Mood changes
Weight loss
Hot flashes
Bone Loss (give a bisphonate!)
Myalgias
Arthralgias
Thrombosis
Name the 3 Anti-androgens
1.) Flutamide (Eulexin)
2.) Bicalutamide (Casodex)
3.) Nilutamide (Nilandron)
What are the ADRs of the anti-androgens?
Hot flashes
Loss of libido
Impotence
What's Fulvestrant (Faslodex)?
Antiestrogen downregulator
Route of Administration of Fulvestrant?
IM monthly injection
ADR of Fulvestrant (Faslodex)?
Thrombosis
Hot flashes
What's Faslodex used for?
Metastatic breast cancer
Name the antiestrogen receptor modulators (SERMS)?
1.) Tamoxifen (Nolvadex)
2.) Toremifene (Fareston)
3.) Raloxifene (Evista)
ADR of the SERMS
Mood changes
Hot flashes
Thromboembolism
Endometrial cancer
Benefits of the SERMS
Cancer prevention
Little to no bone loss
Increases HDL
What's the route of administration of the gonadotropin-releasing hormone analogs
IM or SC depot (monthly, 2, 3, or 4 months)
Toxicities of the gonadotropin-releasing hormone analogs?
Flare reaction
Hot flashes
Mood changes
Impotence/loss of libido
Bone Loss (use bisphosphonates)
gynecomastia
Considerations for the gonadotropin-releasing hormone analogs?
1.) Prevent tumor flare with anti-androgens

2.) Bisphosphonates should be used
Name 2 antiangiogenic agents
Thalidomide
Lenalidomide
Indications of Thalidomide and Lenalidomide
Multiple myeloma
Route of administration of Thalidomide and Lenalidomide
PO
Toxicities of Thalidomide and Lenalidomide
BMS
Peripheral neuropathy/tremors
Diarrhea
Drowsiness/Somnolence
Thrombosis
Teratogenic
Stevens-Johnson Rash
What's Bevacizumab (Avastin)?
Monoclonal antibody used for colon, breast, and lung cancers
What's the route of administration of Bevacizumab?
IV
ADR or Bevacizumab (Avastin)?
HTN
Bleeding: GI
Poor wound healing
What's the MoA of Erlotinib (Tarceva) and Cetuximab (Erbitux)?
EGFR inhibitors
Indications of Erlotinib (Tarceva)?
NSCLC and pancreatic cancer
Route of administration of Erlotinib (Tarceva)?
PO
ADR of Erlotinib (Tarceva) and Cetuximab (Erbitux)?
Acneiform Rash
What's Sunitinib (Sutent) and Sorafenbib (Nexavar) indicated for?
clear cell renal cell carcinoma
Imatinib (Gleevec) is the DOC for what?
CML and GI stromal cell cancer
What's the dose of Gleevec?
400-800 mg PO daily
ADR of rituximab (Rituxan)?
Infusion reaction
Hypersensitivity
Hypotension
ADR of trastuzumab (Herceptin) and lapatinib (Tykerb)?
Infusion reaction
Cardiotoxicity
Rash
Considerations with Trastuzumab (Herceptin) and Lapatinib (Tykerb)?
Additional cardiotoxicity to taxane and anthracycline, check baseline EF prior to initiation and periodically
Interferon alpha-2a is used for __________
Hepatitis B and C
ADR of interferon alpha-2a
Flu-like syndrome
Severe fatigue
Neurological (vertigo, confusion, and depression)
L-asparaginase (Elspar) ADR?
hypersensitivity
hepatotoxicity/pancreatitis
cerebral dysfunction
ADR of hydroxyurea
Myelosuppression
Bleomycin ADR?
Pulmonary fibrosis
Fevers (premedicate with APA) NOT A TRUE HYPERSENSITIVITY REACTION!
ADR of doxorubicin
Myelosuppression
Cardiotoxicity (acute and chronic)
Mucositis
Severe N/V
Total alopecia
Sterility/amenorrhea
How would you treat extravasation of doxorubicin?
DMSO and cold compresses
Cumulative cardiac toxity prevention: limit lifetime doses!

Daunorubicin and Doxorubicin
550 mg/m2
Cumulative cardiac toxity prevention: limit lifetime doses!

Idarubicin
150 mg/m2
Cumulative cardiac toxity prevention: limit lifetime doses!

Epirubicin
900 mg/m2
The Camptothecins (irinotecan and topotecan) are _________
cell-cycle specific
Irinotecan causes what type of diarrhea?
Early diarrhea
Myelosuppression
Severe ADR of Topotecan?
Myelosuppression (profound)
The taxanes MoA?
Bind to tubulin; promote microtubule assembly preventing diassembly and mitosis. Cell cycle specific
ADR of Paclitaxel (Taxol)
Myelosuppression
Peripheral Neuropathies
Hypersensitivity (must premedicate!)
Mucositis
Myalgias
Alopecia
ADR of Docetaxel (Taxotere)
Myelosuppression
Fluid Retention Syndrome
Alopecia
The Taxanes have to be dose reduced for _______ dysfunction
hepatic
Severe ADR of the taxanes?
Neuropathies
Infusions of the Taxanes have to be stopped immediately for ____________ reactions
hypersensitivity

May rechallenge with additional premeds and slower infusions
Etoposide MoA?
Inhibits topoisomerase II enzymes needed for DNA strand repair
ADR of etoposide?
Myelosuppression
Mucositis
NEVER EVAH do what with the vinca alkaloids?
FATAL IF GIVEN INTRATHECALLY!
ADR of Vincristine
Peripheral neurotoxicity (foot drop)
Constipation
CNS neuropathy (jaw pain, ataxia, facial palsies)
How would you treat vincristine extravasation?
Hyaluronidase
ADR of vinblastine and vinorelbine?
Myelosuppression
Neurotoxicity (mild)
Muscle aches
Vesicant
Give _________ with the vinca alkaloids
laxatives
The Vinca alkaloids have to be dose adjusted for ________ dysfunction
hepatic
ADR of carboplatin (Paraplatin)
Myelosuppression
N/V
Neuropathies
ADR of oxaliplatin (Eloxatin)
Thermal dysethesias, peripheral neuropathies, rash
Indications of Oxaliplatin (Eloxatin?
Colon cancer
Dose of Oxaliplatin (Eloxatin)?
85 mg/m2 IV infusion
Considerations for Oxaliplatin?
Avoid exposure to cold

Magnesium and calcium supplementation reduces neuropathies but could compromise efficacy
How would you determine the dose for Carboplatin (Paraplatin)?
Dose = (Desired AUC) X (GFR +25)
Name the 3 heavy metal compounds?
Cisplatin
Carboplatin
Oxaliplatin
Heavy metal compounds are _____________
cell-cycle non-specific
ADR of Cisplatin
Nephrotoxicity
Severe N/V
Neuropathies
Ototoxicities
How should procarbazine be taken?
Orally on an empty stomach
ADR of procarbazine?
Myelosuppression
What are the drug interactions of procarbazine?
MAO inhibitors
Interaction with TCAs
tyramine-containing foods
Disulfram reaction with alcohol
What is Temozolomide (Temodar) indicated in?
Brain tumors (primary and metastatic)

Temozolomide crosses the BBB
What's the route of administration of Temozolomide
Oral 150mg/m2/day for 5 days
Special notes for Temozolomide (Temodar)?
Give on an empty stomach

PCP prophylaxis needed
ALWAYS give _______ with ifosfamide (Ifex)
Mesna
ADR of ifosfamide (Ifex)
hemorrhagic cystitis

CNS toxicity
ADR of cyclophosphamide (Cytoxin)
Myelosuppression
Delayed N/V
Alopecia
Hemorrhagic cystitis
Infertility
Secondary malignancies
Considerations for cyclophosphamide?
Hydration needed (3 L/day for 72 hours PO or IV)

Mesna is only used in high doses
When should cyclophosphamide be taken?
Take in the morning if using oral tablets
ADR of Pemetrexed (Alimta)
Diarrhea
Neutropenia
Stomatitis
Rash
Supplement Pemetrexed (Alimta) with ____ and ______
Folic acid and Vitamin B-12 to reduce toxicities
How is Pemetrexed eliminated?
Renally eliminated (Avoid if CrCl is less than 45 ml/min)
Avoid ________ around dosing of pemetrexed
NSAIDs
When would you use leucovorin rescue with methotrexate?
With high IV dose (100 mg- 10 g/m2)
ADR of intrathecal methotrexate
neurotoxicity
ADR of PO low daily dose methotrexate
hepatoxicity
Intermediate IV methotrexate dose has what ADR?
myelosuppression, mucositis
High IV dose of methotrexate has what ADR?
mucositis, nephrotoxicity, hepatotoxicity
ADR of fludarabine (FAMP)
Myelosuppression (T-cells)
6-mercaptopurine has an interaction with what drug?
Allopurinol
Gemcitabine (Gemzar) has what ADR?
Myelosuppression, generalized rashes, and flu-like symptoms