Pharm Immune

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Androgen antag, used in prostate Ca

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Flutamide is a androgen antag, used in Prostate Ca, post-orchiectomy (S/E gynecomastia & Decr libido)

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Anti-Ca Rx a/w sensitized skin recall rxn to radiation

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Dactinomycin (inhibits DNA-dependent RNAP) used in Wilms Tumor is a/w sensitized skin recall rxn to radiation

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AntiNeoplastic most a/w disulfiram-like reaction

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Procarbazine is the anti-neoplastic most a/w disulfiram-like reaction

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AntiNeoplastic most a/w hemorrhagic cystitis

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Cyclophasphamide (nitrogen mustard alkylator) may cause Hemorrhagic Cystitis (mesna & hydration helps)

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Antimetabolite with Decr cytotoxicity w/ leucovorin

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Methrotrextate (DHFR inhibitor)

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Antimetabolite with Incr cytotoxicity with leucovorin

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5-FU (thymidylate synthetase inhibitor)

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Antineoplastic drugs that cause cardiomyopathies

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Anthracyclines (doxorubicin & daunorubicin) bind DNA, Trastuzumab (anti-HER2) cause cardiomyopathy

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Antineoplastic most a/w acoustic nerve damage

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Cisplatin: nephro & neurotoxic, antineoplastic most a/w acoustic nerve damage

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Antineoplastic with Incr cytotoxicity w/ hypouricemics

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6MP. Allopurinol (hypouricemic) ->Decr xanthine oxidase ->Decr 6-Mercaptopurine metabolism ->Incr toxicity

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Antineoplastics that cause Pulmonary Fibrosis

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Blemycin & Busulfan (Antineoplastics) ->Pulmonary Fibrosis [so does Amiodarone, 1a Antiarrhythmic]

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Aprepitant MOA & Indication

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Substance P NK1-R blocker, used for emesis in cehmo

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Colchine MOA

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Inhibits microtubule formation & Decr LTB4 -> Decr chemotaxis

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Cyclophosphamide S/E

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Cyclophasphamide (nitrogen mustard alkylator) may cause Hemorrhagic Cystitis (mesna & hydration helps)

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Cyclosporin MOA

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Binds to Cyclophilins -> Decr Calcineurin -> Decr transcription of cytokine genes (esp IL-2)

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Describe the activation and metabolism of 6-MP

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6-MP is activated by HGPRT (deficient in metabolized by Xanthine Oxidase. Allopurinol ->Decr XO->Incr 6-MP ->Incr Toxicity

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Filgrastim MOA & Indication

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Filgrastim is G-CSF, Incr granulocytes, used post-BMT and during Chmo

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Finasteride MOA & Indication

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Finasteride inhibits 5a reductase (Blocks T -> DHT), used in BPH & Androgen Alopecia

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Flutamide S/E & Indications

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Flutamide is a androgen antag, S/E gynecomastia & Decr libido (used in Prostate Ca & post-orchiectomy)

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Fulvestrant MOA & Indication

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Degrades E2 receptors, used in E sensitive breast and endometrial Ca

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Inhibits Thymidylate Synthase as primary MOA

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5-FU Inhibits Thymidylate Synthase (S-phase specific)

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Kawasaki Dz Tx

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IvIg & Aspirin (even in children)

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Leucovorin Indications

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Leucovroin (folinic acid) rescues BM from MTX & works synergystically with 5-FU

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Leuprolide MOA

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GnRH analog, used for precocious puberty

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List Vinca Alkaloids and their MOA

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Vinca alkaloids (Vincristine & Vinblastine) bind tubulin, blocking microtubule formation in M phase

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List drugs that inhibit 5a-reductase

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Finasteride, Dutasteride [Tx BPH & Androgen Alopecia)

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List immunosuppressants that cause PML

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PML: Natalizumab (anti a4-integrin), Rituximab (CD-20), Infliximab (anti-TNFa)

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List the Colony Stimulating Factors

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Sargramostim is GM-CSF, Incr Myeloid cells, & Filgrastim is G-CSFF, Incr granulocytes

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List the Nitrosureas used for CNS cancers

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CNS Nitrosureas: Carmustine, Lomustine (alkylators)

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MOA of Glucocorticoid anti-inflammatory properties

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Incr Lipcortin (Annexin) -> Decr PLA2 -> Decr PAF & AA -> Decr PGs & LTs

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MTX MOA

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MTX inhibits DHFR -> Decr Folate

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Mechanism by which Aspirin produces asthma

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Decr prostaglandins (bronchodilators) relative to leukotrienes (bronchoconstrictors)

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Multiple Myeloma Tx

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MPT or MPV: Melphalan, prednisone, thalidomide/bortezomib (Velcade)

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PPD Components

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PPD composed of Tuberculin (an outer surface protein) and Mycolic Acids

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Pemetrexed MOA and Indication

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PemeTREXED Inhibits Thymidylate Synthetase->Decr Folate. Used in Lung Ca (NSCLC & Mesothelioma).

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Piroxicam MOA

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Reversible COX1/2 inhibitor

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Relief in Carcinoid Syndrome

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Octreotide (somatostatin) [Inhibits 5HT & VIP secretion from tumor cells]

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S/E of platinum anti-neoplastics

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Cisplatin: nephro & neurotoxic (esp acoustic nerve); Carboplatin more Decr BM, less nephro & neurotoxic

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Sargramostim MOA & Indication

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Sargramostim is GM-CSF, Incr Myeloid cells, used post-BMT and during Chemo

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Sirolimus BBW

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[only used for Renal Transplant] Not for Liver Transplant (hepatic artery thrombosis), Not for Lung Transplant (fatal bronchial anastomotic dehiscence)

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Sirolimus MOA & Indication

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Binds FKPB -> Decr mTOR -> Decr response to IL-2; used for Kidney Transplant only

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Streptozocoin MOA

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Nitrosurea that is toxic to Beta cells, used for insulinoma [Carmustine and Lomustine are used for CNS tumors only]

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TNFa Inhibitors

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Etanercept, adalimumab, and inflixamab [BBW may reactivate latent infections]

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Tacrolimus MOA

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Binds immunophilin FK-binding protein (FKBP) -> decr calcineurin -> decr cytokine production (esp IL-2)

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Topical capsaicin MOA

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Capsaicin is used topically in RA, it depletes Substance P

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Topoisomerase II antineoplastic drug

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Etoposide inhibits Topoisomerase II, G2-phase specific, results in DNA breaks & degradation

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Two drugs used for emesis in chemotherapy

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Ondansetron (5HT-3 blocker) & Aprepitant (Substance P NK1-r blocler)

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Tx of Anaphylaxis with pt on Beta-blocker

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Glucagon

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Used topically for RA because it depletes substance P

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Capsaicin is used topically in RA, it depletes Substance P

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What drug is Cyclophosphamide administered with?

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Cyclophosphamide (N mustard alkylator) is administered with mesna to decrease risk of Hemorrhagic Cystitis

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Which anti-neoplastic is metabolized by xanthine oxidase?

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6-MP is metabolized by Xanthine Oxidase. Allopurinol ->Decr XO->Incr 6-MP ->Incr Toxicity

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Zileuton MOA & Indication

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Inhibits 5-Lipoxygenase in Asthma [blocks conversion of AA to LTs]

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In antineoplastic regimens, what does PP stand for?

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Procarbazine & Prednisone (such as in MOPP & BEACOPP)

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ALL Induction Tx

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Vincristine, Prednisone, & a anthracycline [ending in -rubicin]

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Anthracycline stem

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-rubicin [doxorubicin]

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In which leukemia is CNS Prophylaxis employed?

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ALL, Intrathecal MTX [prevents meningeal invasion]

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Imatinib indication & MOA

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Tyrosine Kinase inhibitor used in CML

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Hydroxyurea indications

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Sickle cell dz maintenance, polycythemia vera, essential thrombocytosis

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Snake bite Tx

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Crofab 4-6 vials for everyone