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47 Cards in this Set
- Front
- Back
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Cytoxan
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Cyclophosphamide
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Trad. Alkylating agent
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Cyclophosphamide
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Lymphoma, Multiple Myeloma,
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Cyclophosphamide
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1-5mg/kg/d Q day PO
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Cyclophosphamide
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Hemorrhagic cystitis is a concern but Neutropenia is dose limiting SE
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Cyclophosphamide
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Rate limiting SE of Cyclophosphamide
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neutorpenia
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How to prevent hemorrhagic cystitis
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Hydration +/- Mesna (high dose-transplant
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Cyclophosphamide patient counseling
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maintain good fluid intake and empty bladder often
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Platinol, CDDP, DDP, Cisdiamminedichloroplatinum (II), Cis-Platinum are names for
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Cisplatin
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class of cisplatin
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non-trad alkylating
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dose limiting SE of cisplatin
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Renal Failure- dose limiting
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what 2 chemos have little myelosuppression
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cisplatin and bleomycin
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how do you prevent renal failure in cisplatin use
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Pre and Post hydration with NaCl
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When do you hold the dose of cisplain srcr, crcl, plt, wbc, anc
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Scr >1.5mg/dl, CRCl<60ml/min, Plt<100,000, WBC<4000cells/mm3, ANC<1000cells/mm3
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Topoisomerase 2 inhibitor with little myelosuppression
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Bleomycin
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which drug requires chest x-ray and pulmonary function test
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bleomycin
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major SE of pulmonary toxicity
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bleomycin
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true SE of anaphylaxis
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Bleomycin
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dose limit DO NOT EXCEED cumulative dose 230 units/m2 or total dose of 400 units
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Bleomycin
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which chemo requires test dose when using for lymphoma but isn't that beneficial in prediction anaphylaxis
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Bleomycin
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which drug has the SE of myelosuppression, cardiotoxicity, and radiation recall
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Doxyrubicin
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DO NOT EXCEED cumulative LIFETIME dose 550 mg/m2
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Doxorubicin
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At what EF do you discontinue Doxorubicin
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<40
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what is the prev/trt of cardiac tox of Doxorubicin
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Dexrazoxane- works by chelating Fe
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how is Doxorubicin excreted
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hepatobiliary- adjust dose if bilirubin is high (like natural products)
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which topo 2 drug is known to be photosensitizing
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Doxorubicin
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Bleoxane, Bleo are names of what chemo
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Bleomycin
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Causes of resistance
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Tumor sanctuaries (CNS and testes)
Altered pharmacokinetics Decreased absorption Increased metabolism Cellular alterations Enzyme production or binding affinity Decreased accumulation of drug in cell Increased production of cytoplasmic glutathione Potential method of choosing best drug(s) |
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what are the resistance mechanims for alkylating agents
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Decreased cellular uptake
Increased glutathione Increased DNA repair enzymes guanin-06-alkyl transferase ERCC1 DNA ligase |
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name 3 ways to individualize therapy
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BRCA-1 (dna repair- you want less)
RRM1 Beta-tubulin III |
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methods of resistance to Antimetabolite (4)
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Decreased cellular uptake
Increased nucleotide synthesis by salvage pathways Altered enzyme binding affinity Increased metabolism |
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methods of resistance to natural products (mitotic spindle poisons – topoisomerase inhibitors) (6)
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Drug efflux by P170-glycoprotein
Altered enzyme binding affinity Altered enzyme production Altered binding site Increased cellular metabolism |
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Name 3 alkylating agent
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Cyclophosphamide- Cytotoxan
Cisplatin- Cis-Platinum, Platinol, CDDP, DDP, Cisdiamminedichloro -platinum (II) Carboplatin-Paraplatin, CBDDP |
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Name 2 S phase agents
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Gemcitabine-Gemcitabine, Gemzar
5-Fluorouracil/Capecitabine- 5-FU, Xeloda |
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S phase agents also called
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Antimetabolites or Topoisomerase ihibitors
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Name 4 M phase agents
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Vincristine-Oncovin, VCR
Vinorelbine-Navelbine Paclitaxel- Taxol Docetaxel- Taxotere |
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M phase agents are also known as
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Microtubule Targeting Agent
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Which agent eats PVC bags
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Paclitaxel
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Which drug has fake anaphylaxis? For it you give dexamethasone when?
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Paclitaxel
12, 6, 1 hour before administration |
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what is the dose limiting SE of Paclitaxel
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Myelosuppression
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What does 5-FU block
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Thymidine synthase
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Big dose of 5-FU SE
daily or continuous of 5-FU SE |
Big-myelosuppression
daily- mucositis, dose-limiting |
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Topical 5-FU
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Effudex
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Which do you never ever give intrathecally
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Vincristine, Vinorelbuine
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what is the dexamthasone dose for Docetaxel
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Dexamethasone 8 mg PO BID x 3 days, starting 1 day prior to taxotere
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At what bilirubin level do you go to 50%, 25%, contrindicated
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1-3, 3-5, >5
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emploi (m.) du temps
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schedule
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