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60 Cards in this Set
- Front
- Back
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Name the alkylating agents for chemo.
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cyclophosphamide
cisplatin |
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Name the antimetabolites used for chemotherapy.
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MTX
5-FU cytarabine (Ara-C) |
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Which ABX are used for chemotherapy?
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doxorubicin
bleomycin |
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Which vinca alkaloids are used for chemotherapy?
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vinblastine/vincristine
paclitaxel |
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What type of drug is cyclophosphamide?
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alkylating agent
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What is the most common SE of cyclophosphamide?
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hemorrhagic cystitis
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Why is cyclophosphamide bladder toxic?
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acrolein
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How do the alkylating agents work?
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they prevent cell division by cross-linking DNA strands and decreasing DNA synthesis
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What is a major nononcologic indication for use of cyclophosphamide?
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wegener's granulomatosis
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What needs to be monitored in pts taking cyclophosphamide?
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CBC q2wks
BMP " " LFTs qmonth UA " " |
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What are the cytochrome interactions of cyclophosphamide?
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3A4 substrate
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What drugs (beside 3A4 drugs) interfere with cyclophosphamide?
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succinyl choline - may lead to prolonged neuromuscular blockade because cyclo reduces pseudocholinesterace activity
Anticholinergics b/c they delay bladder emptying |
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What re the ADRs of cyclophosphamide?
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alopecia
N/V infertility leukopenia hemorrhagic cystitis (bladder CA possible) |
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What are the 3 main cancers we use cisplatinum to treat?
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bladder, testicular, and ovarian
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What should be monitored in cisplatinum therapy but not cyclophosphamide?
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audiography
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What drugs cause SNHL?
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furosemide
cisplatin aspirin gent tobra vanco |
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What electrolytes must be watched closely with cisplatinum therapy?
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Mg
Ca K |
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How does ototoxicity from cisplatin manifest?
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high frequency loss
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How does MTX work?
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folate antimetabolite --> inhibiting DNA synthesis
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MTX should not be given with which antibiotic?
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bactram (TMP-SMX)
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What drugs may interact with MTX? (most are theoretical)
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cyclosporin (may inc toxicity of each)
hepatotoxic agents like AZA or sulfasalazine |
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Which chemo drug is an abortifacient?
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MTX
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What are common unique toxicities of MTX
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stomatitis
macular punctate extremity rash fever macrocytosis/heme abnormalities |
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What factors can give you macrocytosis?
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liver disease
hypothyroid drugs (MTX, AZT) alcohol folate or B12 deficiency |
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When do ADRs typically occur from MTX?
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w/in 24-48 hrs of dose
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Is pulmonary toxicity seen with high dose or low dose MTX?
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both
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5-fluorouracil is a _____
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antimetabolite
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How does 5-FU work?
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pyrimidine antimetabolite that interferes with DNA synthesis by blocking methylation of deoxyuridylic acid
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What is 5 FU often used for?
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topically for AK or superficial BCCs
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What are the drug interactions of 5-FU?
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may potentiate warfarin
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How does cytarabine work?
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gets incorporated into DNA -> inhibiting synthesis
at high doses it inhibits DNA polymerase |
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What is cytarabine used for?
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AML
ALL CML lymphomas |
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What unique lab parameter needs to be monitored in cytarabine therapy?
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serum uric acid
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What are the ADRs associated with cytarabine?
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drug fever
alopecia N/V/D mucositis myelosuppression cytarabine syndrome cerebellar toxicity |
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Name 2 toxic effects that occur with cytarabine only.
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cytarabine syndrome - Characterized by fever, myalgia, bone pain, chest pain, maculopapular rash, conjunctivitis, & malaise
cerebellar toxicity |
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How does doxorubicin work?
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inhibits DNA and RNA synthesis by intercalation between base pairs - inhibits topo II
and is an iron chelator |
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What is one of the main indications for use of doxorubicin?
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sarcomas
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What needs to be monitored in doxorubicin therapy but no other chemo?
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ECG, +/- ECHO
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What are the cytochrome interactions of doxorubicin?
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2D6 and 3A4 substrate
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What drug should not be given with doxorubicin? Why?
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cyclophosphamide - enhances cardiac toxicity and may decrease clearance leading to coma/seizures/enhanced myelosuppression
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What are the main ADRs of doxorubicin?
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Cardiotoxicity
potent vesicant radiation recall mucosiis myelosuppression |
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Which drug can cause radiation recall 5-7d post administration?
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doxorubicin
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What is the main treatment indication for bleomycin?
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testicular CA
and hodkins/NHL |
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Why do you need to do pfts for pts on bleomycin
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can cause acute or chronic interstitial pneumonitis -> pulmonary fibrosis
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With which chemo drug is a scleroderma like rash possible? (erythema, rash, striae, induration, hyperkeratosis, vesiculation, and peeling of the skin, particularly palmar / plantar surfaces
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bleomycin
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what drugs work by stopping cell division to block growth?
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vinca (plant) alkaloids
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Aka antimicrotubule agent or antimitotic agent
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vinca alkaloid = taxane = mitotic inhibitor etc
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Name the vinca alkaloids
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vinblastine
vincristine vindesine vinorelbine ( and the taxanes) |
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Name the 2 taxanes
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docetaxel
paclitaxel |
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what is paclitaxel used for?
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metastatic br CA and stent coating
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how does vinblastin work?
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Binds tubulin and inhibits microtubule formation, therefore, arresting the cell at metaphase by disrupting the formation of the mitotic spindle
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What is the main indication for vinblastine?
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hodgkins/NHL
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What 2 drugs do you need to monitor serum uric acid?
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vinblastine
cytarabine (but cyclophosphamide can exacerbate gout) |
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What are the cytochrome interactions of vinblastine?
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3A4 substrate
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What is the dose limiting toxicity of vinblastine?
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myelosuppression
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What is the MOA of paclitaxel?
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Promotes microtubule assembly by enhancing the action of tubulin dimers, stabilizing existing microtubules, and inhibiting their disassembly interferes with late G2 mitotic phase cell replication inhibited
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what are the indications for paclitaxel?
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breast cancer
SCLC and NSCLC ovarian CA |
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What are the cytochrome interactions of paclitaxel?
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2C9 and 3A4 substrate (just like (doxorubicin was 2D6 and 3A4)
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What is a common reason to have to stop paclitaxel and give steroids? when is it most common?
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hypersensitivity rxn; first hour of infusion
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What side effect is unique to paclitaxel?
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***peripheral neuropathy
hypersensitivity rxn arthralgia/myalgia rhythm abnormalities |
