Naplex Review Chapter 41 Oncology

Front 1

how often should mammograms be performed and starting at what age

Back 1

age 40
annually

Front 2

how often should a clinical breast exam be performed
what ages

Back 2

every 3 years for 20-30
annually > 40

Front 3

how often should a sigmoidoscopy be done

how often for colonoscopy

how often for FOBT

Back 3

every 5 years for sigmoid

every 10 years for colonoscopy

and an annual fecal occult blood test
ALL for women and men >50

Front 4

what is the standard exam for screening prostate cancer

Back 4

PSA blood test with or without digital rectal exam

Front 5

phases of cell cycle

Back 5

M-mitosis, division into 2 daughter cells

g0- resting phase
g1- cell growth + prep for DNA replication
s1- DNA synthesis
g2- premiotic phase- growth+ Polymeases made

Front 6

BSA equation

Back 6

.007184x kg ^ 0.425 x cm ^0.725

Front 7

how do alkylators work

generic meds

Back 7

cross-link DNA, preventing cell replication
altretamine
bendamustine
busulfan
carmustine
chlorambucil
cyclophosphamide
ifosfamide
lots more....

Front 8

cyclophosphamide
brand?

ifosfamide- brand?

Back 8

c- Cytoxan

I- ifex

Front 9

carmustin preparation directions

Back 9

must be in glass or non-PVC container

Front 10

bladder toxicity common with which alkylators

give what to protect against hemorrhagic cystitis

Back 10

high dose cyclophosphamide and ALL ifosfamide

give MESNA to protect

Front 11

which alkylate requires refrigeration

Back 11

chlorambucil (Leukeran)

Front 12

which med is an antiadrogen - androgen production inhibitor?

dosing recc for this med

Back 12

abiraterone (zytiga)

take on an empty stomach

Front 13

which 3 meds are androgren receptor blockers

Back 13

bicalutamide (casodex)

flutamide (Eulexin)

nilutamide
used for prostate CA

Front 14

Enzalutamide
MOA

Back 14

antiandrogen- receptor signaling pathway inhibitor

for castration resistant prostate cancer

Front 15

Degarelix
MOA

Back 15

goserelin (Zoladex
Leuprolide (Lupron)

Front 16

LHRH agonist (antiandrogren and anti-estrogen)
4 meds

Back 16

goserelin (Zoladex
Leuprolide (Lupron)
Histrelin
Triptorelin

Front 17

LHRH agonists
SE

Back 17

hot flashes, bone pain, impotence

gynecomastia
consider Ca and vit D suppl- osteoporosis
tumor flare initially

Front 18

aromatase inhibitors
4 meds- brand and generic

Back 18

ALL PO
anastrozle - arimidex
exemestane - aromasin
letrozole- femara
used for breast CA

Front 19

aromatase inhibitors
SE

Back 19

fatigue, rash, osteoporosis,

increased CV RISK over SERMs

Front 20

which 2 aromatase meds require glucocorticoid and mineralcorticoid supplementation

Back 20

fluvestrant (faslodex)
raloxifene (Evista)
tamoxifen (nolvadex)
all are PO, except fluvetrant (IM)

Front 21

what are the 4 antiandrogen/SERMs

Back 21

fluvestrant (faslodex)
raloxifene (Evista)
tamoxifen (nolvadex)
toremifene
all are PO, except fluvetrant (IM)

Front 22

SERM BBW

SE

Back 22

increased risk of DVT, MI, PE
they block estrogen in beast CA, but increase estrogen in other tissues

SE- hot flashes, weight gain, flushing, edema

Front 23

anthracyclines class
meds

Back 23

the RUBICINs
doxorubicin (Adriamycin)
epirubicin (ellence)
mitoxantrone

Front 24

anthracycline class
SE

Back 24

radiation recall rxn's occur
lipososmal forms- higher hand/foot syndrome + allergic rxn
red urine
cardiotoxic- do not exceed max lifetime dose

Front 25

dexrazoxane
what is it used for

Back 25

cardioprotective, use when doxorubicin dose exceeds 300mg/m2

Front 26

folate antimetabolites class
MOA
3 meds

Back 26

prevent DNA synthesis
Methotrexate(Trexall, mexate, folex)
pemetrexed
pralatrexate

Front 27

methotrexate
SE
Dosed how?

Back 27

myelosuppresion, mucositis, hepatic and renal toxicity, pulmonary toxicity

dosed weekly

Front 28

high doses of MTX, require what med to rescue

Back 28

leucovorin will decrease MTX toxicity

its and active form of folic acid that bypasses the actions of MTX blockade of DHF reductase

Front 29

avoid what meds with MTX

MTX counseling points

Back 29

probenacid, aspirin, PCN, NSAIDS= decreased elimination of med= toxicity

MTX- maintain hydration, drink fluids

Front 30

pemetrexed
required what supplements

Back 30

folic acid and B12

also, dexamethasone before to reduce toxicities

Front 31

immune modulators class
2 meds
MOA

Back 31

dec angiogenesis, and kill abnormal cells
+ help bone marrow create new healthy cells

lenalidomide (Revlimid)
thalidomide (thalomid)

Front 32

lenadlidomide
SE

Back 32

PREG CAT X
severe birth defects- available only thru revAssist program, where pt, doc, and pharmacist are registered

Front 33

thalidomide
SE

Back 33

Preg Cat X
STEPS program- like RevAssist

Front 34

interferons
moa
meds

Back 34

inhibit tumor growth, down reg oncogenes
interferon alfa (roferon)

peginterferon (pegasys)

Front 35

interferon class
SE

Back 35

suicide ideation, depression, flu like syndrome

Front 36

interluekins
MOA
meds

Back 36

stim immune system to target cancer cells

aldesleukin (IL2)

Denileukin diftitox (Ontak)-IL2+ diphtheria toxin

Front 37

monoclonial antibody- angiogenesis inhibitor class
med
MOA

Back 37

bevacizumab (avastin)

limits tumors blood supply, binds to VEGF-A

Front 38

bevacizumab
SE

Back 38

pain from GI perforation
impairs wound healing, stop 28 days before surgery
DVT, PE, MI

Front 39

MABs-Cell surface marker targeted therapies
most known med in this class?
usually target?
exceptions?

Back 39

rituximab (rituxan)
most target CD20
alemtuzumab- targets CD-52
Brentuximab targets cd-30

Front 40

alemtuzumab- SE

Back 40

prolonged myelosuppresion (max 12 months), rquires bactrim

Front 41

rituximab
SE + dosing directions

Back 41

infusions must be done in hospital or clinic- cause it can be fatal

admin with Benadryl and APAP before infusion
risk of reactivation of Hep-B + tumor lysis syndrome

Front 42

cell surface marker targeted med
tositumab
MOA
SE

Back 42

iodine 131, causes cell damage by forming free radicals

both gamma and beta emitter

need-thyroid protective iodine regimen

Front 43

immunotherapy class
med
MOA

Back 43

ipilimumab
takes the chains off T cell activation-autoimmune system unleashed!!

Front 44

MAB- overexpression targeted meds

Back 44

cetuximab (Erbitux)

trastuzumab (Herceptin)
trastuzumab-DM1

Front 45

cetuximab
what indicated poor response?
SE

Back 45

K-ras mutation, if colorectal cancer has this mutation, med wont work- so test before txing
SE-acne like rash, and ca and mg wasting

Front 46

trastuzumab
required for use
SE

Back 46

HER2/neu over expression required for use

must be >2+ IHC t respond
SE- cardiomyopathy (CHF)

Front 47

mTor inhibitor class
meds

Back 47

everolimus

"limos" have motors

Front 48

carboplatin
class of med?
brand
MOA

Back 48

Platinum-based
Paraplatin-AQ
cross links DNA- leading to apoptosis

Front 49

cisplatin
brand
MOA
SE, whats used to decrease this

Back 49

platinol
cross links DNA
SE- nephrotoxicity***, hydrate and sometime manitol used to avoid renal failure
ototoxicity

Front 50

oxaliplatin
brand
SE

Back 50

platin-cross links DNA
eloxatin
SE- neuropathy exacerbated by exposure to cold

Front 51

mercaptopurine
class of med?
MOA

interaction with what med

Back 51

purine antimetabolite-inhibit purine synthesis
6-MP
azathipurine (Imuran) is prodrug of 6-MP

allopurinol inhibits metabolism-increasing 6-MP 400%

Front 52

Pyrimidine antimetabolite meds

Back 52

capecitabine (Xeloda)

Fluorouracil 5-FU

Gemcitabine (gemzar)

Front 53

what med is prodrug of 5fu

Back 53

capecitabine- PO tk with meal

Front 54

5FU is given with __________ to increase 5fu efficacy

Back 54

leucovorin

Front 55

taxane class
meds?
MOA

Back 55

MOA- inhibit microtubule function
docetaxel (taxotere)
paclitaxel (taxol)

give taxanes 1st before platins- otherwise elim is reduced

Front 56

taxanes
how to dispense

Back 56

need to b in non-PVC container and use non-PVC tubing due to leaching of DEHP

Front 57

pretreat taxanes with

Back 57

Benadryl, dexamethasone and h2 blocker

Front 58

irinotecan
brand
class
MOA

Back 58

camptosar
topoisomerase 1 inhibitor
blocks coiling and uncoiling of DNA
SE- acute diarrhea tx with atropine

Front 59

etoposide
brand
class and MOA

Back 59

VePesid VP-16-requires refrigeration
topoisomerase II inhibitor
blocks coiling and uncoiling of DNA

Front 60

ALL TYROSINE KINASE INHIBITORS INTERACTI WITH

Back 60

3A4 , avoid grapefruit juice

Front 61

imatinib
brand
MOA

Back 61

gleevac
TKI targets BCR-ABL

Front 62

eritinib
brand
MOA
directions

Back 62

Tarceva
TKI targets EGFR
po daily 1 h before and 2 h after meal

Front 63

ruxolitnib
brand
MOA

Back 63

jakafi
TKI targets JAK1 and JAK2 kinases

Front 64

vinca alkaloids
meds

Back 64

vinblastine (velban)
vincristine (vincasar, oncovin)
vinorelbine

Front 65

vincristine dosing

Back 65

max single dose capped at 2mg

Front 66

vinca alkaloids should be given...
and NEVER,"",

Back 66

give IV, NEVER intrathecally

Front 67

bleomycin
moa
se
max dose

Back 67

blocks topoisomerase II
pulmonary rxns, pneumonitis
mx life time dose=400 units

Front 68

to use ESAs in cancer, must fill out

Back 68

ESA APPRISE-cuz can cause tumor growth and shorten survival

Front 69

ESAs should only be used if Hgb levels are

Back 69

<10 prior to tx

Front 70

gen and brand names of ESA`

Back 70

epoetin alfa (epogen, Procrit)

darbapoetin (aranesp)

Front 71

neutropenia is...

ANC equation

Back 71

ANC <500 mm3

ANC=( (%Band + %Segs)x WBC )/ 100

Front 72

CSF meds
brand and generic

Back 72

sargramostim (leukine)

filgrastim (neupogen)

pegfilgrastim (neulasta)

Front 73

med tat can be used for thrombocytopenia prevention

Back 73

oprelvekin

Front 74

5-HT3 Receptor antagonit

Back 74

ondanestron (Zofran)
granisetron
dolasetron
palonosetron

Front 75

granisetron
brand name
do not use how?

Back 75

sancuso patch
granisol solution- do not use IV for CINV

Front 76

phenothiazine meds
MOA

Back 76

block dopamine in CNS- chemo trigger zone
prochlorperazine (compro)

promethazine (Phenergan)

Front 77

corticosteroid used in CINV

Back 77

dexamethasone (decadron)

Front 78

cannaboids used in CINV

Back 78

dronabinol CIII

Front 79

aprepitant
brand/
moa

Back 79

emend
substance p/ neurokinin receptor antagonist

fosaprepitant-prodrug (emend for injection)

Front 80

tx for hypercalcemia

Back 80

bisphosphonates - zoledronic acid
zometa- zoledronc acid 4mg monthly
reclast- zoldronic acid 5mg yearly

Front 81

aromatase inhibitors only work in...

Back 81

POST menopausal women

Front 82

to prevent NV commonly used meds in combo

Back 82

dexamethasone
ondanestron or other 5HT3 blocker
aprepitant

Front 83

what class of meds is contraindicate with apomorphine

Back 83

5ht3 antag-ondanestron, granisteon