Oncology Bcps Review

Front 1

Alkylating agents mechanism

Back 1

Cause covalent bond formation of drugs to NA and proteins: cross linking on DNA strands

-Not phase specific

-Most common: cyclophosphamide, ifosfamide, carmustine, dacarbazine, temozolomide

Front 2

Cyclophosmaide and ifosfamide toxicity and agent

Back 2

Hemorrhagic cystitis and MESNA/hydration

Front 3

Alkylating agents AE

Back 3

BMS, mucosal ulceration, pulmonary fibrosis (carmustine), interstitial PNA, alopecia, NV, amenorrhea, hemorrhagic cystitis (C/I), encephalopathy (I), seizures (carmustine)

Front 4

Antimetabolites MOA

Back 4

Structural analogs of natural metabolites that falsely insert into pyrimidine or purine ring (interfere with NA synthesis)

-Active in S phase

-Folate, purine, pyrimidine

Front 5

Folate agents

Back 5

Pemetrexed, MTX, pralatrexate

Front 6

Pyrimidine agents

Back 6

Azacitidine, 5-FU, cytarabine, capecitabine, gemcitabine, decitabine

Front 7

Purine analogs

Back 7

Pentostatin, cladribine, fludarabine

Front 8

Guanosine analgos

Back 8

Nelarabine

Front 9

Which antimetabolite agents cause Hand, Foot, Mouth

Back 9

5-FU and capecitabine

Front 10

Which antimetabolite agents cause Neurotoxicity

Back 10

nelabarine, cytarabine, fludarabine, MTX

Front 11

Which antimetabolites causes flu-like sx?

Back 11

Gemcitabine

Front 12

Which antimetabolites causes mucositis?

Back 12

5-FU and MTX

Front 13

Which antimetabolites cause conjunctivitis?

Back 13

Cytarabine (high doses)

Front 14

Which antimetabolites cause HUS?

Back 14

Gemcitabine

Front 15

Which antimetabolites cause opportunistic infections?

Back 15

Cladribine and fludrabine

Front 16

Which antimetbolite causes TLS, SIRS, or cap leak?

Back 16

Clofarabine

Front 17

DDI with capecitabine

Back 17

Warfarin

Phenytoin

Front 18

DDI with mercaptopurine

Back 18

Warfarin

Allopurinol

Front 19

DDI with MTX

Back 19

NSAIDS, amoxicillin, sulfasazline, doxycycline, HCTZ, omeprazole, phenytoin, folic acid

Front 20

DDI with 5FU

Back 20

Warfarin

Front 21

Treatment for TLS for patients taking Clofabarine

Back 21

IV fluids, allopurinol

Front 22

Prophylaxis for SIRS and capillary leak for patients taking clofarabine

Back 22

CSteroids

Front 23

Tx of pemetrexed toxicities

Back 23

Lowering homocysteine with folic acid and B12

Front 24

Antitumor antibiotics MOA

Back 24

Block DNA and RNA transcription through intercalation of nucleic acid in DNA: strand breakage

Front 25

Antitumor agents

Back 25

Mitomycin (DNA), Dactinomycin (RNA), Bleomycin (DNA in mitosis and G2)

Daunorubicin, doxorubicin, mitoxantrone, valrubicin

Front 26

Antitumor agents MOA

Back 26

Severe NV

Alopecia, stomatitis

Anthracyclines: cardiac toxicity (doxo = dauno > ida > epi > mitox): lifetime dosing

Vesicants

Bleomycin = pulm fibrosis/interstitial pneumonitis

Mitomycin = HUS

Front 27

What type of dose adjustment is needed for anthracyclines?

Back 27

Hepatic

Front 28

What type of dose adjustment is needed for bleomycin?

Back 28

Renal

Front 29

How are anthracyclines excreted?

Back 29

bile: adjust dose based on total bilirubin

Front 30

What is the lifetime dose of doxorubicin?

Back 30

450-550 mg/m2 (taking into account other anthracyclines given)

Front 31

Hormones and Antagonist agents MOA

Back 31

Act on hormone-dependent tumors by inhbiting or decreasing production of the disease-causing hormone

Front 32

AE of hormones and antags

Back 32

Edema, menstrual disorders, hot flashes, tumor flare, thromboembolic events, gynecomastia, increased LFTs, NVD, endometrial cancer (tamoxifen), bone loss (LHRH and aromatase inhibitors), seizures (enzalutamide)

Front 33

DDI with tamoxifen

Back 33

anticoagulants and cyclophosphamide

Front 34

Plant alkaloid MOA

Back 34

Inhibit replication of cancer cells

Taxanes and vincas interfere with microtubule assembly in M phase

Camptothecins and epipodophyllotoxins inhibit Top 1 and 2 --> DNA strand breaks

Front 35

Plant Alkaloid AE

Back 35

BMS, mucositis, NVD,

Front 36

Which plant alkaloid causes hand foot mouth

Back 36

doxataxel

Front 37

Which plant alkaloid causes hypotension or HSN on admin

Back 37

Paclitaxel

Front 38

Which plant alkaloid causes neurotoxicity?

Back 38

Vincristine

Front 39

Which plant alkaloid causes PN and myalgia/arthralgia?

Back 39

Paclitaxel

Front 40

Which plant alkaloid causes secondary malignancies

Back 40

Top 2 inhibitors

Front 41

Which plant alkaloid cause SIADH?

Back 41

Vincas

Front 42

DDI with docetaxel?

Back 42

CYP3A4, inhibitors and inducers

Front 43

DDI with vincas?

Back 43

Phenytoin, erythromycin, zidovudine

Front 44

Which plant alkaloids are vesicants?

Back 44

Vincas

Front 45

Which plant alkaloids should not be given intrathecally?

Back 45

Vincas

Front 46

Biologic response modifiers and monoclonal antibodies MOA

Back 46

Activate the bodys immune mediated host defense mechanism to malignant cells

--have direct biologic effects on malignancies

-monoclonal AB bind to specific antigens and kill malignant cells through apoptosis

Front 47

Biologic response modifiers and monocloncals AE

Back 47

cardiac, pulm, renal impairment, mental status change, depression, MSK pain

Front 48

Which BRM causes TLS?

Back 48

rituximab

Front 49

Which BRM causes skin rash?

Back 49

bevacizumab

Front 50

Which BRM causes cutaneous and severe infusion reactions and ILD?

Back 50

cetuximab

Front 51

Which BRM causes hypothyroidism

Back 51

Tositumomab

Front 52

Which BRM cause DVT, neutropenia, and PE?

Back 52

thalidomide and lenalidomide

Front 53

Platinum compounds MOA

Back 53

Alkylating-like: inhibit DNA synthesis

Cisplatin, carboplatin, oxalaplatin

Front 54

Which platin requires hydration and premeds?

Back 54

Cisplatin

Front 55

Which platin should have thrombocytopenia monitoring?

Back 55

Carboplatin

Front 56

Which platin has unique neurotoxicities?

Back 56

Oxaliplatin

Front 57

What is sorafenib?

Back 57

Tyrosine kinase inhibitor used for treatment of advanced renal cell carcinoma

Front 58

What are SE of sorafenib?

Back 58

Diarrhea, fatigue, rash, hand-foot, HTN, NV, neutropenia, and alopecia

Front 59

What is sunitinib?

Back 59

Inhibits multiple tyrosine kinases and is used for treatment of advanced renal cell cancer and GI tumor

Front 60

What are side effects of sunitinib?

Back 60

Neutropenia, rash, changes in skin color, fatigue, malgia, HA, HTN, nausea, LFTs increase

Front 61

Which enzyme does sunitinib effect?

Back 61

CYP3A4

Front 62

What is dasatinib?

Back 62

Target BCR-ABL mutations (resistant to imatinib) and inhibits leukemic cell growth

-CLL and ALL treatment

Front 63

What are side effects of dasatinib?

Back 63

Rash, thrombocytopenia, edema, weight changes, electrolyte changes, arrhythmias

CYP3A4 interactions

Front 64

What is lapatinib?

Back 64

Multiple tyrosine kinase inhibitors

Used with capecitabine to treat HER2 positive BCA

Front 65

What are side effects of lapatanib?

Back 65

NVD, BMS, LFT increase, palmar-plantar erythrodysesthesia

CYP3A4

Front 66

What is asparaginase?

Back 66

removes exogenous asapargines from leukemic cells

-need intradermal testing

-hyperuricemia, hyperglycemia, renal problems

Front 67

What is hydroxyurea?

Back 67

Inhibits DNA synthesis without messing up RNA and protein synthesis

AE: BMS, leukopenia, NVD, constipation, mucositis, rare but fatal hepatotoxicity and pancreatitis

Front 68

What is Erlotinib

Back 68

HER1 and EGFR tyrosine kinase inhibitor

Front 69

AE of erlotinib

Back 69

anorexia, stomatitis, ILD, 3A4

Front 70

What are temsirolimus and everolimus?

Back 70

mTOR inhibitors used for treatment of renal cell carcinoma

Front 71

AE of everolimus

Back 71

BMS anorexia, rash, mucositis, edema, high glucose, HPL, 3A4

Front 72

SE of 5FU

Back 72

GI, diarrhea

Front 73

Which med can cause hyperpigmentation of skin?

Back 73

Bleomycin, Bisulfan

Front 74

What is metabolite that causes HCystitis?

Back 74

Acrolein (cyclophosphamide at doses > 1g/m2)

Front 75

Which med causes keratitis, conjunctivitis, and severe CNS when given in doses > 1 g/m2

Back 75

Cytarabine, ara-C

Front 76

Which med causes otoxicity, CNS tox, acute/delayed emesis, nephro

Back 76

Cisplatin

Front 77

Which med has extravasation risk

Back 77

Dactinomycin

Front 78

Which med causes a cute and delayed diarrhea?

Back 78

Irinotecan (Camptosar)

Front 79

What is rescue agent for MTX toxicity?

Back 79

Leucovorin

Front 80

Which med should be avoided cold stimulus

Back 80

oxaliplatin

Front 81

Which taxane causes more edema/fluid retention

Back 81

Docetaxel

Front 82

Which taxane causes more PN

Back 82

paclitaxel

Front 83

Order of vincas causing PN

Back 83

Vincristine > vinblastine

Front 84

Which vinca has less BMS

Back 84

vincristine

Front 85

Treatment for extravasation

Back 85

Dexrazoxane, DMSO

Front 86

Which 2 chemo meds are least likely to cause BMS

Back 86

Vincristine

Asparaginase

Front 87

When should ESAs be used in cancer treatment

Back 87

Metastatic disease when Hb <10 and receiving chemo

NOT in curable disease!

Front 88

Is stage 2 breast cancer curable?

Back 88

Yes

Front 89

Which has a lower rate of VTE: anastrazole or tamoxixfen?

Back 89

anastrazole

Front 90

Risk factor for ovarian cancer

Back 90

Lack of pregnancy

Front 91

Purpose of progesterone in HRT

Back 91

Prevent endometrial hyperplasia

Front 92

Long term HRT increases risk of which cancers

Back 92

breast and ovarian

Front 93

Determine curable vs palliative!

Back 93

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