Pharm 25 Drug List Flashcards Preview

Hematology Oncology > Pharm 25 Drug List > Flashcards

Flashcards in Pharm 25 Drug List Deck (55):
1

List the Alkylating Agents: Nitrogen Mustard drugs

Cyclophosphamide
Ifosfamide

2

Cyclophosphamide and Ifosfamide unique ASEs?

Hemorrhagic cystitis

CNS toxicity - confusion, AMS, encephalopathy

3

Why is Mesna used in conjunction with Ifosfamide?

Binds to acrolein to prevent hemorrhagic cystitis

4

List the Alkylating Agents: Platinum Analogues drugs

1. Carboplatin
2. Cisplatin
3. Oxaliplatin

5

ASEs of Platinum Analogue: Carboplatin?

Myelosuppression - thrombocytopenia

6

ASEs of Platinum Analogue: Cisplatin?

Ototoxicity

Highly emetic: acute (18-24hrs post tx) and delayed (48-72 hrs post tx)

Nephrotoxicity

7

ASEs of Platinum Analogue: Oxaliplatin?

Cold sensitivity - pharygolaryngeal dysethesia

Peripheral neuropathy

8

List the Topoisomerase Enzyme Inhibitor drugs

1. Irinotecan
2. Doxorubicin
3. Etoposide

9

List the Topoisomerase Enzyme Inhibitor: Camptothecins drug

Irinotecan

10

List the Topoisomerase Enzyme Inhibitor: Anthracycline drug

Doxorubicin

11

List the Topoisomerase Enzyme Inhibitor: Epipodophyllotoxin drug

Etoposide

12

ASEs of Camptothecins: Irinotecan?

When taking Irinotecan pts with UGT1A1 allele can experience life threatening diarrhea

Hepatic impairment

Neutropenia (UGT1A1 28)

13

What adjunct therapies do you use to avoid both acute and delayed diarrhea when taking Irinotecan?

Acute: use atropine

Delayed: use loperamide

14

ASEs of Anthracycline: Doxorubicin?

Cardiotoxicity (dilated cardiomyopathy)

Urine discoloration

15

What medication is often given with Doxorubicin to reduce cardiotoxicity?

Dexrazoxane

16

MOA of Dexrazoxane + Doxorubicin?

Inhibits free radical formation ---> limiting cardiotoxicity

17

What potential ASE occurs with using Dexrazoxane + Doxorubicin?

Potential decreases the chemo drug effectiveness.

18

ASEs of Epipodophyllotoxin: Etoposide?

Infection related rxn: HypoTN, fever/chills

Hypersensitivity rx: Anaphylaxis, tachy, bronchospasm, dyspnea

19

List the Antimicrotubule drugs

1. Vincristine
2. Docetaxel
3. Paclitaxel

20

List the Antimicrotubules: Vinca Alkaloid drug

Vincristine

21

List the Antimicrotubules: Taxanes drugs

Docetaxel
Paclitaxel

22

ASEs of Vinca Alkaloid: Vincristine?

Neurotoxicity: sensor, motor, peripheral neuropathy

Fatal if administered intrathecally - irreversible

23

What is best practice to avoid causing fatality when administering Vincristine?

Use IV mini infusion bags not syringes

24

ASES of Taxanes: Docetaxel
and Paclitaxel?

Cardiovascular - peripheral edema, flushing

Neurotoxic- cumulative peripheral neuropathy

25

List the Antimetabolites

1. Capecitabine
2. Fluorouracil (5-FU)
3. Cytarabine
4. Methotrexate (MTX)

26

List the Antimetabolites: Pyrimidine Analogue dugs

1. Capecitabine
2. Fluorouracil (5-FU)
3. Cytarabine

27

ASEs of Pyrimidine Analogues: Capecitabine and Fluorouracil (5-FU)

Continuous infusion:
- Mucosal damage
- Palmar - plantar erythrodysesthia ("hand-foot syndrome")

Genetic polymorphism defect (DPD)

28

List the Antimetabolites: Antifolate drug

Methotrexate (MTX)

29

ASEs of Antifolate: Methotrexate (MTX)

Mucosal damage

Hepatotoxicity and Nephrotoxicity

30

What are 2 drug interactions with Methotrexate (MTX)?

- NSAIDs (decreased clearance of MRX --> increased toxicity)

- PPIs (elevate and prolong serum MTX levels (high dose MTX)

31

What medication is used as a chemotherapy rescue agent and a chemotherapy modulating agent?

Leucovorin (Folinic Acid)

32

How is Leucovorin used as a chemotherapy rescue agent?

Used in MTX toxicity

Actively competes with and displaces MTX from intracellular binding sites

Restores active folate stores required for DNA/RNA synthesis.

33

How is Leucovorin used as a chemotherapy modulating agent?

Fluorouracil efficacy

Enhances FdUMO (metabolite of 5-FU) binding to thymidylate synthesis ---> inhibiting thymidylate enzyme causing DNA damage.

34

List the Antitumor antibiotic drug

Bleomycin

35

ASEs of Antitumor antibiotic: bleomycin?

Pulmonary fibrosis "Bleo Lung"

36

List the Proteosome inhibitor drug

Bortezomib

37

ASEs of Proteosome inhibitor: Bortezomib?

Peripheral neuropathy (less if given SubQ vs IV)

Herpes reactivation

38

List the Immunomodulator

Lenalidomide

39

BB warning of Immunomodulator: Lenalidomide?

Arterial/venous thromboembolic events (w/ dexamethasone)

Severe birth defects, embryo-fetal death (extensive REMS program)

40

List the Monoclonal antibodies drugs

1. Rituximab
2. Trastuzumab
3. Cetuximab
4. Bevacizumab
5. Pembrolizumab

41

General ASEs of Monoclonal antibodies drugs?

Infusion related---> need to titrate d/t how large the molecules are

Immune-mediated ---> toxic epidermal necrolysis, enterocolitis, hepatitis, progressive multifocal leukoencephalopathy, mucocutaneous rxn.

42

List the Monoclonal antibodies: Anti-CD20 drug

Rituximab

43

ASEs of Anti-CD20: Rituximab

Hep B reactivation

High lymphocytes count = high infusion reaction potential

CCL pts- pneumocystis jiroveccii (PCP) and antiherpetic viral prophylaxis

44

List the Monoclonal antibodies: Anti-HER2 drug

Trastuzumab

45

ASEs of Anti-HER2: Trastuzumab

Cardiotoxicity (reversible t1/2=30 days)
- HF
- Arrythmia
- Cardiomyopathy

46

List the Monoclonal antibodies: Anti-PD drug

Pembrolizumab

47

ASEs of Anti-PD: Pembrolizumab

Immune-mediated:
- Colitis
- Dermatitis
- Hyperglycemia
- Hyperthyroidism
- Nephritis
- Pneumonitis

48

List the Monoclonal antibodies: EGFR Inhibitor

Cetuximab

49

ASEs of EGFR Inhibitor: Cetuximab

Dermatological: acneiform rash, other skin rashes

Electrolyte abnormality - hypomagnesemia (may be d/t high expression of EGFR in kidneys)

50

List the Monoclonal antibodies: VEGF Inhibitor

Bevacizumab

51

ASEs of VEGF inhibitor: Bevacizumab

Impaired wound healing
GI perforation
Proteinuria/nephrotic syndrome

52

List the Tyrosine Kinase Inhibitor (TKI) drugs

1. Imatinib
2. Ibrutinib
3. Sorafenib
4. Erlotinib

53

MOA of Tyrosine Kinase Inhibitor (TKI) drugs?

Shuts down TK activity preventing the transfer of a phosphate group from ATP to tyrosine residues in proteins.

Targets extracellular and intracellular TK receptors and ligands and intracellular fusion proteins

54

Advantaged of Tyrosine kinase inhibitor drugs?

Single compound targeting multiple kinases

Efficacy in multiple tumor types

Oral therapy = convenient and less complex

55

Disadvantages of Tyrosine Kinase Inhibitor drugs?

Lots of drug-drug interactions

Toxicities

Pts if monitored less frequently