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46 Cards in this Set
- Front
- Back
What is the mechanism of action for vincristine?
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Vincristine inhibits microtubule formulation in mitotic spindle, resulting in an arrest of dividing cells at the metaphase stage
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What is the indication for vincristine?
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Acute Leukemia
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What are the common off label uses of vincristine?
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Hodgkins Lymphoma, Lymphoma, & Testicular Cancer
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Is vincristine adjusted for either renal or hepatic impairment?
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Vincristine is adjusted for hepatic impairment.
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What is the maximum dosage of vincristine if the intent is not curative?
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2 mg/dose
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What is (are) the contraindication(s) for vincristine?
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Demyelinating form of Charcot-Marie-Tooth syndrome
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What is the Black Box Warning for vincristine?
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Intrathecal use is fatal.
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What are the common adverse effects of vincristine?
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Alopecia, Neuropathy, Constipation
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What rare, but serious adverse effects are associated with vincristine?
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Bronchospasm & Hepatic Failure
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What notable drug interactions are associated with vincristine?
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Vincristine is a substrate of CYP3A4 and ABCB1, avoid inducers and inhibitors. BCG (immune stimulant) decreased efficacy, avoid.
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What "clinical pearl" was we given for vincristine?
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Myelosuppression is not usually severe.
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What is the mechanism of action for paclitaxel?
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It promotes microtubule assembly by enhancing the action of tubulin dimers, stabilizing existing microtubules, and inhibiting their disassembly, interfering with the late G2 mitotic phase, and inhibiting cell replication.
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What are the indications for paclitaxel?
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Breast Cancer, Non Small Cell Lung Cancer, Ovarian Cancer
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What are the common off label uses of paclitaxel?
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Bladder Cancer, Cervical Cancer, Small Cell Lung Cancer, & Head and Neck Cancers
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Are there any renal or hepatic adjustments for paclitaxel?
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The dose is adjusted for hepatic impairment.
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What is (are) the contraindication(s) for paclitaxel?
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Hypersensitivity to taxane of creamaphor.
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What is the Black Box Warning for paclitaxel?
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Bone marrow suppression. Hypersensitivity.
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What are the common adverse effects of paclitaxel?
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Neutropenia, Neuropathy, Rash, Alopecia, Hypotension, Elevated LFTs, NVD
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What rare but serious adverse effects are associated with paclitaxel?
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Anaphylaxis & Heart Block
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What drug interactions are associated with paclitaxel?
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Clozapine, increased risk agranulocytosis, avoid. CYP3A4 and CYP2C8 substrate, avoid inducers and inhibitors. Immune stimulants, decreased efficacy, avoid.
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Should taxane derivatives be administered before or after platinum (why)?
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Taxane derivatives should be administered before platinum derivatives (to limit mylosuppression and to enhance efficacy).
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What drugs should be used for premedication of a patient who is to receive paclitaxel?
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Dexamethasone, diphenhydramine, and ranitidine.
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How should paclitaxel be administered?
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Infuse through a 0.22 micron in-line filter and nonsorbing administration set.
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What is the mechanism of action for docetaxel?
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Promotes the assembly of microtubules from tubulin dimers, and inhibits the depolymerizatin of tubulin, which stabilizes microtubules in the cell. This results in inhibition of DNA, RNA, and protein synthesis.
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What are the indications for docetaxel?
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Breast Cancer, Non Small Cell Lung Cancer, Prostate Cancer, Head and Neck Cancer, & Gastric Cancer
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What are the common off label uses of docetaxel?
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Bladder Cancer, Cervical Cancer, Small Cell Lung Cancer, & Ovarian Cancer
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What is (are) the contraindication(s) of docetaxel?
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Hypersensitivity to taxane or polysorbate 80, ANC < 1500
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What are the Black Box Warnings of docetaxel?
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Bone marrow suppression, fluid retention, hepatic impairment, hypersensitivity, treatment related mortality
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What are the common adverse effects of docetaxel?
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Fluid retention, neutropenia, neuropathy, rash, alopecia, hypotension, elevated LFTs, NVD
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What are the rare but serious adverse effects of docetaxel?
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Secondary Malignancies & Acute Respiratory Distress Syndrome
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What drug interactions are associated with docetaxel?
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Clozapine, increased risk agranulocytosis, avoid. CYP3A4 and ABCB substrate, avoid inducers and inhibitors. Immune stimulants, decreased efficacy, avoid.
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How should docetaxel be infused?
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Over 1-hr through nonsorbing polyethylene lined (non-DEHP) tubing; in-line filter is not necessary.
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Describe premedication of a patient who is to receive docetaxel?
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Dexamethasone for 3 days to avoid fluid retention.
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What is the mechanism of action of bleomycin?
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Inhibits synthesis of DNA; binds to DNA leading to single- and double-strand breaks.
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What are the indications for bleomycin?
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Testicular Cancer, Head and Neck Cancer, Hodgkins Lymphoma, Lymphomas
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What are the common off label uses of bleomycin?
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Ovarian Cancer
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Is bleomycin adjusted based on either renal or hepatic function?
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Dosing is adjusted based on renal function.
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What is (are) the contraindication(s) of bleomycin?
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Hypersensitivity
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What are the Black Box Warnings for bleomycin?
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Idiosyncratic Reaction & Pulmonary Toxicity
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What are the common adverse effects of bleomycin?
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Fever, Rash on Hands and Feet, Hyperpigmentation, Alopecia, Chronic Interstitial Pneumonitis, and Pulmonary Fibrosis
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What rare but serious adverse effects are associated with bleomycin?
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Angioedema; Steven Johnson Syndrome; and Severe Idiosyncratic Reaction consisting of Hypotension, Mental Confusion, Fever, Chills, and Wheezing
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What drug interactions are associated with bleomycin?
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Brentuximab, myloid growth factors, additive pulmonary toxicity, avoid. Immune stimulants, decreased efficacy, avoid. Vaccines, increased toxic effects, avoid.
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What is the cumulative lifetime dose limit for bleomycin?
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400 units
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What is the maximum single dose limit for bleomycin?
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30 units
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What is the unit to milligram conversion for bleomycin?
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1 unit = 1 mg
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Describe premedication of a patient who is to receive bleomycin.
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Premedicate with acetominophen to prevent fever.
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