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23 Cards in this Set
- Front
- Back
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what is targeted cancer therapy? how is this different than traditional chemo? |
drugs that stop cancer by interfering with specific molecules involved in tumor growth/spread attacks all rapidly dividing cells, leading to side effects that effect, hair, gi, skin, bone marrow |
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what cancer is brutons tyrosine kinase important in? what drug do you use to treat it? |
malignant b cell profliferation ibrutinib |
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what are some side effects of ibrutinib? why is there an increase in wbc? is this good? |
edema, increase uric acid, fatigue, arthralgia wbcs are pulled out of lymph nodes in blood shows that the drug is working |
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do the VEGF inhibitors work for breast cancer? side effects of vevacizumab/ramucirumab? |
no benefit in breast cancer, get them off it hypertension, proteinuria, impaired wound healing |
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describe diarrhea grade 1? Grade 2? Grade 3? Grade 4? Grade 5? |
1- less than 4 poops a day 2- 4-6 poops a day, not interffering with ADL 3- 7 or more poops a day, interferes with ADL 4-life threatening 5-death |
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treatment at grade 2 diarrhea? grade 3? |
2- iv fluids 3- iv fluids, hospitalization |
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what diet changes can you make to manage diarrhea? |
BRAT diet, avoid dairy products, fluids, small frequent meals |
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what medication are used for diarrhea? how is this given? what if it very severe? what is the alternative drug? |
loperamide 2 tabs after first loose stool, then 1 tab after other poops 1 tab every 2 hours while awake then every 4 hours while asleep lomotil |
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how are the two chemo therapy drugs divided? what causes the shorter one? how do you treat it? what causes the longer one? how is it treated? |
those before 6 months and those after 6 months treatment induced, loperamide immune mediated, stop the drugs and use steriods |
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why is it difficult to determine tki induced hypothyroidsim? what are the two types of tki induced hypothyroidisms? |
cancer symptoms are equivalent, best to get a tsh level recurrance of hypothyroidism (already being treated) and hypothyroidism in patients with previously normal thyroid |
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how do you treat recurrance hypothyroid from tki induced hypothyroid? how do you treat new onset hypothyroid ""? |
double dose of levo 1.6 ug/kg/day or 50 ug |
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what protein is geneotyped before drug therapy is initated? typical side effects of erlotinib or cetuximab? |
KRAS acne like rash, diarrhea, paronychia (nail infection) |
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what are the important questions to ask if patient gets rash from erlotinib/cetucimab? how do you treat mild rash? moderate rash? severe rash? |
taking on empty stomach?...patient compliant with skin hygiene? topical hydrocortisone, 1% clinda hydrocortisone 2.5% clinda and doxy 100 mg bid 2.5% clinda, doxy 100 mg bid, medrol dose pak use sunscreen for all |
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side effects of mutated braf inhibitors like vemurafenib, dabrafenib? side effects from combo therapy? what drug needs an acidic enviornment to be absorbed? how can this be done? |
rash, hand foot syndrome fever, chills, n/v dabrafenib, avoid ppis or use coke |
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how long does it take of ipilimumab/pd1 inhibitors to work? why is the time to effect important? common side effects? |
ctla 4 inhibitor, 4-6 weeks to see drug effect and may have pseudoprogression may see side effects long after d/c rash,diarrhea |
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at what point do you treat ipilimumab diarrhea? how do you treat it? what happens if you do not treat this diarrhea? |
grade 3 or 4
use high dose steroid for 1 week, if that doesnt work use inflixamab leads to colitis or toxic megacolon |
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what are the side efects of pd 1 ihibitors? how long until lung/liver thing occurs? how do you treat it? |
pneumonitis and hepatitis and colitis 2-3 months 3-4 months hold meds, monitor, add prednisone 1-2 mg/kg/day |
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how do you treat pd1 inhibitor induced colitis renal dysfuction? grade 1-4? |
1 continue 2 hold, 0.5-1 mg /kg/day prednisone 3 hold,, 1-2 mg/kg/day 4 d/c add prednisone renal is only grade 1-3 |
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could pd1 inhibtors affect anytihng in the endocrine system? what issue should you look out for? |
can cause both hyper and hypothyroidism adrenal crisis, use fluids and steriods |
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what lab tests will determine adrenal inssufficiency? |
low am cortisol and low acth (if secondary cause) |
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how does talimogene laherparepvec work? how is the drug dosed? will the patient develope the virus after therapy? |
herpes simplex virus 1 is given intralesionally and produces gm csf leading to tumor lysis depends on size of lesion yes patient will develpe viral syndrome |
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where should you give talimogene and why? any special cleaning? |
seperate room, because of other immunosuprressed patients bleach everything, place materials into a bag with more bleach |
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how is talimogene stored? who give it to the patient? how is it disposed? |
-90- -70 degrees Celsius provider that ordered it or their PA biohazard for incineration DO NOT GIVE SYSTEMIC ANTIVIRALS, TOPICAL IS FINE |
