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171 Cards in this Set
- Front
- Back
Major severe side effect of this drug is ARDS (acute respiratory distress syndrome). which is increased increased with concurrent radiation
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Gemcitabine (Gemzar)
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the common side effects of what drug are the following:
flu like symptoms Myelosuppression Thrombocytopenia |
Gemcitabine (Gemzar)
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Antimetabolites are most effective in the _____-phase?
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S-phase
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This drug's metabolite inhibits thymidylate synthase preventing the synthesis of thymidine needed for DNA synthesis. it also acts as a "false" base and incorportates itself into RNA
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5-FU
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Leucovorin increases what drugs cytotoxicity by prolonging the inhibition of thymidylate synthase?
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5-FU
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this drug increases the cytotoxicity of 5-FU by prolonging the inhibition of thymidylate synthase?
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Leucovorin
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Severe side effects associated with 5-FU?
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Mucositis
Diarrhea |
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this drug causes severe side effects such as: Mucosistis
Diarrhea |
5-FU
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this drug is a PO formulation of 5-FU
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Xeloda (capecitabine)
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must take Xeloda (capecitabine) with food. true or false?
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true
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what oral drug will metabolize into 5-FU inside Tumor/normal tissue? some human carcinomas express thymidine phosphorylase in higher concentrations than surrounding normal tissues, so the 5-FU is preferentially generated in tumor tissue.
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Xeloda (capecitabine)
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frequency and duration of Xeloda (capecitabine) Tx.
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q12h for 2 weeks (14 day supply only)
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which drug's severe side effects include Hand-foot syndrome (palmar plantar erythrodysethesia)? a painful rash on hands and feet
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Xeloda (capecitabine)
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Xeloda (capecitabine) is associated with what severe side effect?
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hand-foot syndrome
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which drugs MOA: in tumor cells competitively inhibits the enzyme needed for DNA strand elongation- DNA polymerase. It also incorporates itself into DNA. Acts only on proliferating cells.
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Cytarabine (ARA-C)
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Cytarabine (ARA-C) acts only on proliferating cells. true or false?
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true
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Cytarabine (ARA-C) MOA?
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in tumor cells competitively inhibits the enzyme needed for DNA strand elongation- DNA polymerase. It also incorporates itself into DNA. Acts only on proliferating cells.
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severe side effect associated with Gemcitabine (Gemzar)?
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ARDS (acute respiratory distress syndrome)
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name 2 antineoplastics given intrathecally
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Cytarabine (ARA-C)
Methotrexate (MTX) |
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Arabinose analog of cytosine
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Cytarabine (ARA-C)
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which aggressive chemo drug is associated with the following side effects:
neutropenia nadir 5-7 days severe emeisis, stomatitis, diarrhea conjunctivitis alopecia tumor lysis syndrom |
Cytarabine (ARA-C)
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side effects associated with Cytarabine IV?
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tumor lysis syndrome
alopecia cerebellar dysfunction conjunctivitis severe emesis, stomatitis, diarrhea neutropenia nadir 5-7 days |
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only certain preservatives are allowed to be used intrathecally. true or false?
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false
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what drug/dose is given 24-48h prior to cytaribine in order to prevent UA levels from climbing?
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Allopurinol 300 mg/day
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which drug's MOA is similar to Cytaribine's by incorporating into DNA, inhibiting polymerase activity?
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Gemcitabine (Gemzar)
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Gemcitabine (Gemzar) MOA?
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incorporating into DNA, inhibiting polymerase activity
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higher tissue concentration? Cytaribine or Gemcitabine?
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Gemcitabine (Gemzar)
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longer half life? Cytaribine (ARA-C) or Gemcitabine (Gemzar)?
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Gemcitabine (Gemzar)
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has activity in solid tumors?
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Gemcitabine (Gemzar)
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Cytaribine (ARA-C) has activity in solid tumors. true or false?
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false
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Gemcitabine (Gemzar) has activity in solid tumors. true or false?
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true
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common side effects associated with Gemcitabine (Gemzar)
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flu like symptoms
Myelosuppression Thrombocytopenia |
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common side effects associated with Fludarabine?
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neutropenia
low CD4 counts |
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which drug is associated with the following common side effects?:
neutropenia low CD4 counts |
Fludarabine
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which drug is associated with a high risk of opportunistic infections, PPx treated for PCP, and should not be combined with steroids?
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Fludarabine
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Methotrexate's class of antineoplastic drugs?
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Folate Antagonist
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which drug reversibly inhibits Dihydrofolate reductase?
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Methotrexate
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Methotrexate's MOA?
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Binds reversibly to dihydrofolate reductase inhibiting the cell’s ability to activate folate.
Thymidine concentration falls impairing the cell’s ability to synthesize DNA |
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intrathecal dose of Methotrexate?
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15 mg
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High dose for IV Methotrexate?
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7-12 g/m2
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what meds are given along with pemetrexed (Alimta) to reduce the severity of specific side effects?
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folate 400mcg daily
B12 1mg injection q 3 cycles steroids |
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folate 400mcg daily
B12 1mg injection q 3 cycles steroids.....given with which drug to reduce side effects? |
Pemetrexed (Alimta)
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ibuprofen interacts with which folate antagonist by increasing AUC by 50%?
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Pemetrexed (Alimta)
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the MOA for 5-FU includes the following?
a. inhibits dihydrofolate reductase b. inhibits thymidylate synthase c. inhibits DNA polymerase d. inhibits ribonucleotide reductase |
inhibits thymidylate synthase
|
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the MOA for Cytarabine includes the following?
a. inhibits dihydrofolate reductase b. inhibits thymidylate synthase c. inhibits DNA polymerase d. inhibits ribonucleotide reductase |
DNA polymerase
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cytrabine (ARA-C) acts only on proliferating cells. true or false?
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true
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this antineoplastic is rapidly deactivated by cytidine deaminases?
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Cytarabine (ARA-C)
|
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painful rash on hands and feet caused by Xeloda (capecitabine)?
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hand-foot syndrome
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the MOA for Pemetrexed (Alimta) includes the following?
a. inhibits dihydrofolate reductase b. inhibits thymidylate synthase c. inhibits DNA polymerase d. inhibits ribonucleotide reductase |
inhibits dihydrofolate reductase
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the MOA for Hydroxyurea includes the following?
a. inhibits dihydrofolate reductase b. inhibits thymidylate synthase c. inhibits DNA polymerase d. inhibits ribonucleotide reductase |
inhibits ribonucleotide reductase
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which of the following are alkylating agents?
a. Methotrexate b. Capecitabine c. 5-FU d. Melphalan e. Xeloda |
Melphalan
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which of the following are alkylating agents?
I. Methotrexate II. Cyclophosphamide III. Ifosfamide IV. 5-FU V. cisplatin a. II b. I & II c. II & III d. I, II, III e. I, II, III, V |
Cyclophosphamide
Ifosfamide |
|
the MOA for carboplatin includes the following?
a. inhibits dihydrofolate reductase b. inhibits thymidylate synthase c. inhibits DNA polymerase d. form covalent bonds to guanine and adenine |
covalent bonds to guanine and adenine
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|
the MOA for cisplatin includes the following?
a. inhibits dihydrofolate reductase b. form covalent bonds to guanine and adenine c. inhibits thymidylate synthase d. inhibits DNA polymerase |
form covalent bonds to guanine and adenine
|
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which platinum compound's severe side effect is nephrotoxicity?
a. carboplatin b. cisplatin c. oxaliplatin d. cytotoxin |
cisplatin
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all platinum compounds cause neurotoxicity. true or false?
|
true
|
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which platinum compound's severe side effects include hypersensitivity and thrombocytopenia?
a. oxaliplatin b. cisplatin c. carboplatin d. 5-FU |
carboplatin
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which platinum compound is associated with the most severe neuropathies?
a. oxaliplatin b. cisplatin c. carboplatin d. 5-FU |
oxaliplatin (Eloxatin)
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which of the following can be given intrathecally?
a. Vincristine b. Cytarabine (ARA-C) c. 5-FU d. Vinblastine |
Cytarabine (ARA-C)
|
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which of the following can be given intrathecally?
a. Vincristine b. Taxol c. 5-FU d. Methotrexate |
Methotrexate
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always adminster vincristine intrathecally. true or false?
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false
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max IV dose of vincristine?
a. 1 mg b. 2 mg c. 3 mg d. 4 mg |
2 mg
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all of the following are true regarding vincristine except?
a. it is a vesicant b. it can cause constipation c. it can be given intrathecally d. max dose is 2 mg IV |
it can be given intrathecally
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topoisomerase inhibitors work in what phase of the cell cycle?
a. S phase b. M phase c. G1 phase d. G2 phase |
G2-phase
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Irinotecan works in what phase of the cell cycle?
a. S-phase b. M-phase c. G2-phase d. T-phase |
G2-phase
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5-FU works in what phase of the cell cycle?
a. M-phase b. S-phase c. G2-phase d. T-phase |
S-phase
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Capecitabine works in what phase of the cell cycle?
a. M-phase b. S-phase c. G2-phase d. T-phase |
S-phase
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Cytarabine works in what phase of the cell cycle?
a. M-phase b. S-phase c. G2-phase d. T-phase |
S-phase
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side effects associated with 5-FU
a. mucositis b. diarrhea/ nausea c. myelosupression d. hand-foot syndrome e. all of the above |
mucositis
diarrhea/ nausea myelosupression hand-foot syndrome |
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what would be appropriate counseling for a patient taking capecitabine?
a. if you miss a dose, double your next dose b. take on empty stomach c. take it twice a day for 30 days d. it can cause diarrhea and a painful rash on your hands and feet |
it can cause diarrhea and a painful rash on your hands and feet
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|
what would be appropriate counseling for a patient taking Xeloda?
a. if you miss a dose, double your next dose b. take on empty stomach c. take it twice a day for 30 days d. it can cause diarrhea and a painful rash on your hands and feet |
it can cause diarrhea and a painful rash on your hands and feet
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all of the following are considered cell-cycle specific except?
a. cytarabine b. methotrexate c. doxorubicin d. irnotecan |
doxorubicin
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all of the following are alkylating agents except?
a. irinotecan b. melphalan c. cyclophosphamide d. temozolomide |
irinotecan
|
|
chemotherapy toxicities associated with capecitabine?
a. diarrhea, hand-foot syndrome b. fever, rash, flu-like symptoms, BMS c. diarrhea, neutropenia d. fluid retention syndrome, peripheral neuropathies |
diarrhea, hand-foot syndrome
|
|
chemotherapy toxicities associated with irinotecan?
a. diarrhea, hand-foot syndrome b. fever, rash, flu-like symptoms, BMS c. diarrhea, neutropenia d. fluid retention syndrome, peripheral neuropathies |
diarrhea, neutropenia
|
|
chemotherapy toxicities associated with gemcitabine?
a. diarrhea, hand-foot syndrome b. fever, rash, flu-like symptoms, BMS c. diarrhea, neutropenia d. fluid retention syndrome, peripheral neuropathies |
fever, rash, flu-like symptoms, BMS
|
|
chemotherapy toxicities associated with docetaxel?
a. diarrhea, hand-foot syndrome b. fever, rash, flu-like symptoms, BMS c. diarrhea, neutropenia d. fluid retention syndrome, peripheral neuropathies |
fluid retention syndrome, peripheral neuropathies
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which of the following is true?
a. Mesna can only be given intravenously b. Mesna should always be used with ifosfamide c. Mesna should always be given with cyclophosphamide d. hemorrhagic cystitisis more common with cyclophosphamide than ifosfamide |
mesna should always be used with ifosfamide
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hemorrhagic cystitisis is more common with cyclophosphamide than ifosfamide. true or false?
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false
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KP will begin doxorubicin treatment today. What baseleine data needs to be obtained before initiating therapy?
a. height and weight b. height, weight, LFTs c. height, weight, LFTs, CBC d. height, weight, LFTs, CBC, ejection fraction |
height, weight, LFTs, CBC, ejection fraction
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KP will begin cisplatin treatment today. What baseleine data needs to be obtained before initiating therapy?
a. weight b. weight, SCr c. weight, SCr, Chem7 d. weight, SCR, Chem7, CBC, H+H e. weight, SCR, Chem7, CBC, LFTs |
weight, SCR, Chem7, CBC, H+H
|
|
Which of the folllwing is true regarding 5-FU?
a. it is considered a vesicant b. it is severely emetogenic c. it can cause mucositis and diarrhea d. leucovorin is admin with 5-FU to reduce toxicities |
it can cause mucositis and diarrhea
|
|
Which of the following is true regarding vinca alkaloids?
a. the max daily dose of vincristine is 20 mg b. diarrhea is a common side effect c. they are fatal when admin intrathecally d. the are considered highly emetogenic |
they are fatal when admin intrathecally
|
|
All of the following are given orally EXCEPT?
a. imatinib b. capecitabine c. exemestane d. bevacizumab |
bevacizumab
|
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which agent targets HER 2/ neu oncogene?
a. imatinib b. bevacizumab c. trastuzumab d. cetuximab |
trastuzumab
|
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which agent targets BCR-ABL translocation gene?
a. imatinib b. bevacizumab c. trastuzumab d. cetuximab |
imatinib
|
|
which agent targets vascular endothelial growth factor?
a. imatinib b. bevacizumab c. trastuzumab d. cetuximab |
bevacizumab
|
|
which agent targets epidermal growth factor receptor?
a. imatinib b. bevacizumab c. trastuzumab d. cetuximab |
cetuximab
|
|
All of the following are side effects of cisplatin EXCEPT:
a. emesis b. hyperkalemia c. renal impairment d. ototoxicity |
hyperkalemia
|
|
all of the following are side effects of cisplatin except:
a. hypokalemia b. severe neutropenia c. nephrotoxicity d. severe nausea |
severe neutropenia
|
|
which agent targets the Her-2neu oncogene?
a. sorafenib b. dasatinib c. cetuximab d. trastuzumab |
trastuzumab
|
|
which agent targets the Her-2neu/EGFR oncogene?
a. sorafenib b. dasatinib c. lapatinib d. cetuximab |
lapatinib
|
|
intermediate methotrexate IV dose? (CMF regimen)
|
40 mg/m2
|
|
which drug is orally administered for blast crisis in chronic myelongenous leukemia?
|
hydroxyurea
|
|
which drug is highly associated with delayed emesis-onset > 48h?
|
cyclophosphamide
|
|
toxicities associated with cyclophosphamide?
|
delayed emesis
hemorrhagic cystitis total alopecia myelosuppression |
|
name of the active metabolite of cyclophosphamide which causes hemorrhagic cystitis?
|
acrolein
|
|
acrolein is an active metabolite associated with which toxicity?
|
hemorrhagic cystitis
|
|
dose considered "higher dose" of cyclophosphamide associated with toxicities such as: pulmonary fibrosis, SIADH
|
1g/m2
|
|
what dose of cyclophosphamide requires Mesna?
|
1g/m2
|
|
what dosage forms is/are Mesna available in?
|
PO
IV |
|
what dosage forms is/are cyclophosphamide available in?
|
PO
IV |
|
which antineoplastic has the following toxicities: hemorrhagic cystitis, cerebellar toxicity, renal tubular toxicity, myelosuppression, alopecia, severe N/V
|
Ifoxfamide (Ifex)
|
|
toxicities associated with Ifoxfamide (Ifex)?
|
hemorrhagic cystitis
cerebellar toxicity renal tubular toxicity myelosuppression alopecia severe N/V |
|
mesna dosing: ________% total ifosfamide dose given in 3 divided bolus doses or _________% given as 24h continuous infusion
|
60%
100% |
|
mesna dosing: ________% total ifosfamide dose given in 3 divided bolus doses
|
60%
|
|
mesna dosing: _________% ifosfamide dose given as 24h continuous infusion
|
100%
|
|
carmustine (BCNU) class of antineoplastics?
|
alkylating agent
nitrosureas |
|
severe toxicities associated with carmustine (BCNU)?
|
pulmonary fibrosis
secondary leukemias myelosuppression total alopecia delayed and severe N/V |
|
antineoplastic associated with tyramine reactions?
|
procarbazine
|
|
class of drugs which interact with procarbazine?
|
TCA
MOAI SSRI |
|
which of the following is/are non-specific?
a. 5-FU b. cisplatin c. cyclophosphamide d. carmustine |
cisplatin
cyclophosphamide carmustine |
|
common and severe side effects associated with cisplatin?
|
severe N/V
ototoxicity BMS neurotoxicity nephrotoxicity electrolyte losses (K, Mg) direct tubular toxicity |
|
this antineoplastic is a direct tubular toxin.
|
cisplatin
|
|
which antineoplastic is associated with the following toxicities: severe N/V, BMS, ototoxicity, neurotoxicity, nephrotoxicity,electrolyte losses (K, Mg), direct tubular toxicity
|
cisplatin
|
|
premeds for cisplatin use?
|
antiemetics 30-60 min prior
IV fluids: 1L NSS before, 1L NSS after KCl (10meq/hr) max MgSO4 (1g over an hour) |
|
what antineoplastic requires the following premeds: antiemetics 30-60 min prior
IV fluids: 1L NSS before, 1L NSS after KCl (10meq/hr) max MgSO4 (1g over an hour) |
cisplatin
|
|
calvert equation?
|
dose (total mg) = AUCdes x (CrCl + 25)
|
|
dosage form oxaliplatin (eloxatin) is/are available in?
|
IV
|
|
drug associated with the following toxicities:
rash, thermal dysethesia, severe neuropathies, alopecia |
oxaliplatin (Eloxatin)
|
|
toxicities associated with oxaliplatin (Eloxatin)?
|
rash, thermal dysethesia, severe neuropathies, alopecia
|
|
antineoplastic associated with thermal dysethesia and severe/permanent neuropathies?
|
oxaliplatin (Eloxatin)
|
|
class known as "spindle poisons", because they primarily inhibit mitosis?
|
vinca alkaloids
taxanes |
|
general MOA for vinca alkaloids, taxanes?
|
"spindle poisons", because they primarily inhibit mitosis
|
|
major toxicities associated with vincristine?
|
neurotoxicity
constipation vesicant |
|
new formulation of paclitaxel which is albumin bound, decreasing the incidence of hypersensitivity?
|
Abraxane
|
|
drug associated with hypersensitivity which requires premeds such as H1 or H2 blocker and steroids?
|
paclitaxel (Taxol)
|
|
drug associated with hypersensitivity, severe neuropathies, total alopecia, myalgias, myelosuppression
|
paclitaxel (Taxol)
|
|
paclitaxel (Taxol) toxicities?
|
hypersensitivity requires H1, H2 blocker and steroids, severe neuropathies, total alopecia, myalgias, myelosuppression
|
|
drug associated with skin and nail changes, fluid retention syndrome, severe neuropathies, myelosuppression, total alopecia, etc
|
docetaxel (Taxotere)
|
|
toxicities associated with docetaxel (Taxotere)?
|
skin and nail changes, fluid retention syndrome, severe neuropathies, myelosuppression, total alopecia, etc
|
|
severe toxicities associated with topotecan?
|
diarrhea
neutropenia |
|
drug class which "directly damages DNA"?
|
anthacyclines
|
|
all anthacyclines are vesicants. true or false?
|
true
|
|
total cumulative life-time dose for doxorubicin and daunorubicin?
|
550 mg/m2
|
|
total cumulative life-time dose for idarubicin?
|
150 mg/m2
|
|
liposomal doxorubicin and daunorubicin are much more cardiotoxic. true or false?
|
false
|
|
liposomal doxorubicin and daunorubicin are much less cardiotoxic. true or false?
|
true
|
|
______________ is a chemoprotectant used to reduce the cardiotoxicity associated with doxorubicin?
|
Dexrazoxane
|
|
what is Dexrazoxane used for?
|
chemoprotectant used to reduce the cardiotoxicity associated with doxorubicin
|
|
antitumor antibiotics used as antineoplastics?
|
mitomycin
bleomycin |
|
_____________ is associated with hypersensitivity reactions, and permanent pulmonary fibrosis - cumulative toxicity.
|
bleomycin
|
|
______________ is associated with the following toxicities: pancreatitis, clotting abnormalities, mild N/V, fever, depression
|
L-asparaginase
|
|
abnormally increased lipase levels are associated with pancreatitis, which along with hypersensitivity rxns are severe side effects associated with _______________
|
L-asparaginase
|
|
pre meds will not be helpful when treating the hypersensitivity rxn associated with L-asparaginase. true or false
|
true
|
|
tyrosine kinase inhibitors are available as IV only. true or false?
|
false
|
|
tyrosine kinase inhibitors are available as PO. true or false?
|
true
|
|
tyrosine kinase inhibitors interact with inhibitors of CYP ________ enzyme
|
3A4
|
|
what monoclonal antibody target is most likely to cause hypersensitivity rxns (ie. epidermal rash).
|
EGFR
|
|
which agent targets VEGF?
a. sorafenib b. dasatinib c. lapatinib d. cetuximab |
sorafenib
|
|
which agent targets EGFR?
a. sorafenib b. dasatinib c. lapatinib d. cetuximab |
cetuximab
|
|
MoAb that targets CD-20 antigen on B-cells
|
retuximab
|
|
brand name of trastuzumab?
|
Herceptin
|
|
generic name for Herceptin?
|
trastuzumab
|
|
drugs which target Her/2neu?
|
trastuzumab
lapatinib |
|
side effects associated with lapatinib?
|
diarrhea
QTc prolongation 3A4 DDI |
|
_________ side effects include:
diarrhea QTc prolongation 3A4 DDI |
lapatinib
|
|
severe infusion reactions are associated with lapatinib. true or false
|
false
|
|
cefuximab and pantiumumab inhibit ___________
|
EGFR
|
|
monoclonal antibody drugs which inhibit EGFR?
|
cefuximab
panitumumab |
|
___________ should not be given for at least 8 weeks before/after surgery, due to it's poor wound healing side effect.
|
bevacizumab
|
|
which of the follow is/are SERMS?
a. bicalutamide b. tamoxifen c. anastrozole d. panitumumab |
tamoxifen
|
|
which of the follow is/are antiandrogens?
a. bicalutamide b. tamoxifen c. anastrozole d. panitumumab |
bicalutamide
|
|
which of the follow is/are aromatase inhibitors?
a. bicalutamide b. tamoxifen c. anastrozole d. panitumumab |
anastrozole
|
|
anastrozole is only effective in post-menopausal women. true or false?
|
true
|
|
name an aromatase inhibitor?
|
anastrozole
lestrozole exemestane |
|
name a SERMs?
|
tamoxifen
toremifene fulvestrant |
|
megestrol is a hormonal antagonist. true or false?
|
false
|
|
megestrol is a hormonal agonist. true or false?
|
true
|
|
which of the following is/are vesicants?
a. anthracyclines b. nitrogen mustards c. vinca alkaloids d. paclitaxel e. 5-FU |
a. anthracyclines
b. nitrogen mustards c. vinca alkaloids d. paclitaxel |
|
which of the following is/are vesicants?
a. anthracyclines b. cytarabine c. vinca alkaloids d. paclitaxel e. 5-FU |
anthracyclines
vinca alkaloids paclitaxel |