Quiz 3 (Ch. 4)

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leo25
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134077
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Quiz 3 (Ch. 4)
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2012-02-09 23:39:51
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Pharm Practice
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Antineoplastics (anticancer)
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  1. Name an alkylating agent.
    Cyclophosphamide (Cytoxan)
  2. What is the alkylating agent MOA?
    forms strong covalent bonds with DNA inhibiting replication and causing bond breaks and cell death
  3. Cyclophosphamide
    Cytoxan
  4. Common SE for Cyclophosphamide?
    • leucopenia
    • N/V
    • alopecia
    • diarrhea
    • mucositis
    • amenorrhea
  5. Adverse/Rare SE Cyclophosphamide?
    • hemorrhagic cystitis
    • sterility
    • secondary malignancies
    • SIADH
    • cardiac necrosis
    • renal tubular necrosis
    • skin rash
  6. Which antineoplastic should be taken early in the day if taken orally?
    cyclophosphamide
  7. Which antineoplastic requires patient to drink 3-4 Liters of water after an IV injection?
    cyclophosphamide
  8. Which antineoplastic needs mesna uroprotection to prevent hemorrhagic cystitis?
    cyclophosphamide
  9. What other drugs does cyclophosphamide have an effect on?
    • warfarin
    • succinylcholine
    • vaccines
  10. Name an anthracycline.
    Doxorubicin (Adriamycin)
  11. Which antineoplastic is known for the risk of cardiotoxicity?
    Doxorubicin
  12. Which antineoplastic is a vesicant and can cause severe skin necrosis if extravasation occurs?
    Doxorubicin
  13. Which antineoplastic is only an IV?
    Doxorubicin
  14. What is the anthracycline MOA?
    inhibits DNA and RNA synthesis by intercalation of DNA base pairs and inhibition of DNA repair by topoisomerase
  15. Doxorubicin
    Adriamycin
  16. T/F: anthracyclines can be used to treat non-malignant diseases.
    false
  17. What are the most notable side effects for alkylating agents?
    • bone marrow suppression
    • nausea
    • hemorrhagic cystitis
  18. T/F: alkylating agents can be used to treat both malignant and non-malignant diseases.
    true
  19. What are the adverse/rare SE of Doxorubicin?
    • acute and delayed cardiotoxicity
    • sterility
    • secondary malignancy
  20. What other drugs can Doxorubicin affect?
    • digoxin
    • phenytoin
    • radiation
  21. What drugs could have an affect on Doxorubicin?
    • cyclosporine
    • paclitaxel
    • trastuzumab (could increase cardiotox)
  22. No live virus vaccines should be given during therapy with which drugs?
    • Doxorubicin
    • Capecitabine
    • Cytarabine
    • 5-fluorouracil
    • Gemcitabine
    • Mercaptopurine
    • Methotrexate
  23. Which drug could darken the urine for 24-48 hours?
    doxorubicin
  24. You should watch for fever, malaise, sore mouth or throat, pain or swelling near injection site when taking this drug?
    doxorubicin
  25. Patients should have ejection fraction measured before starting therapy with this drug?
    doxorubicin
  26. Which antineoplastics are similar in structure to naturally occurring compounds?
    antimetabolites
  27. What is the MOA of antimetabolites?
    kill tumor cells by inhibiting DNA synthesis by a specific mechanism or they incorporate themselves into DNA, causing apoptosis
  28. Capecitabine
    Xeloda
  29. Rare/Adverse SE of Capecitabine?
    • chest pain
    • venous thrombosis
  30. What drug can enhance the toxic effect of Capecitabine?
    leucovorin
  31. What drug can Capecitabine have an adverse effect on ?
    phenytoin
  32. Which drug should the sunlight be avoided and wear sunscreen with?
    Capecitabine
  33. T/F: Capecitabine needs to be taken with food.
    true
  34. T/F: Capecitabine can be taken within two hours of an antacid.
    false
  35. Which drug can cause a painful rash on the hands and feet?
    capecitabine
  36. Cytarabine
    ARA-C
  37. Rare/adverse SE of cytarabine?
    • chest pain
    • tumor lysis syndrome
    • neurotoxicity
    • coma
    • rash
    • skin desquamation
    • ocular toxicity (eye)
  38. T/F: cytarabine does not have any major drug interactions.
    true
  39. Changes in mental status may occur during therapy with which drug?
    cytarabine
  40. What drug requires aggressive water intake and antiemetic therapy?
    cytarabine
  41. Which drug requires steroid eye drops to prevent ocular toxicity?
    cytarabine
  42. 5-fluorouracil
    • 5-FU
    • Efudex
  43. Which drug comes in a topical cream or solution dosage form?
    5-fluorouracil
  44. Most common rare/adverse SE of 5-fluorouracil?
    chest pain
  45. What other drugs can 5-fluorouracil have an affect on?
    • carvedilol
    • natalizumab
    • phenytoin
    • warfarin
  46. Which drug should you not take alcohol with?
    5-fluorouracil
  47. Should you avoid sunlight if you are taking 5-fluorouracil?
    yes
  48. Which drug can cause severe diarrhea and mucositis?
    5-fluorouracil
  49. If you have a genetic deficiency of dihydropyrimidine dehydrogenase, which drug might cause you to have increased systemic toxicities?
    5-fluorouracil
  50. Gemcitabine
    Gemzar
  51. What drug class is capecitabine?
    antimetabolite
  52. What drug class is cytarabine?
    antimetabolite
  53. What drug class is 5-fluorouracil?
    antimetabolite
  54. What drug class is gemcitabine?
    antimetabolite
  55. What drug class is mercaptopurine?
    antimetabolite
  56. What drug class is methotrexate?
    antimetabolite
  57. What drug class is doxorubicin?
    anthracycline
  58. What drug class is cyclophosphamide?
    alkylating agent
  59. What drug class is carboplatin?
    platinum compound
  60. What drug class is cisplatin?
    platinum compound
  61. What drug class is Imatinib?
    targeted therapy
  62. What drug class is Rituximab?
    targeted therapy
  63. What drug class is Trastuzumab?
    targeted therapy
  64. What drug class is Docetaxel?
    taxane
  65. What drug class is paclitaxel?
    taxane
  66. What are rare/adverse SE of gemcitabine?
    • hematuria
    • hepatotoxicity
  67. What other drugs can gemcitabine effect?
    • bleomycin
    • fluorouracil
    • warfarin
  68. Which drug can cause severe flu-like symptoms to occur?
    gemcitabine
  69. Need to watch for fever, bleeding and bruising if you are taking ___?
    • gemcitabine
    • mercaptopurine
  70. Which drug can increase the toxicity of radiation if given concurrently with radiation?
    gemcitabine
  71. Thrombocytopenia is common with use of this antimetabolite?
    gemcitabine
  72. Mercaptopurine
    purinethol
  73. Rare/adverse SE of mercaptopurine?
    • encephalopathy
    • ascites
  74. Which drug can increase mercaptopurine levels?
    allopurinol
  75. What other drug can mercaptopurine have an effect on?
    warfarin
  76. Which antimetabolite should be taken on an empty stomach and is used to treat Crohn's?
    mercaptopurine
  77. Which drug has been associated with writing prescriptions with sixfold overdosage?
    • mercaptopurine
    • (do not write 6-MP!!)
  78. Which antimetabolite should be taken in the evening to lower the risk of relapse?
    mercaptopurine
  79. Which drug can be tested for risk of toxicity using TPMT genotyping?
    mercaptopurine
  80. Methotrexate
    rheumatrex
  81. Which drug can be used for an ectopic pregnancy?
    methotrexate
  82. What are the rare/adverse SE for methotrexate?
    • renal failure
    • arachnoiditis
    • encephalopathy (with IT administration)
    • sterility
    • hepatotoxicity
    • demylenating encephalopathy
  83. What other drug can methotrexate have an adverse effect on?
    cyclosporine
  84. What other drugs could affect methotrexate (a lot)?
    • cipro
    • cyclosporine
    • NSAIDs
    • penicillin
    • PPIs
    • salicylates
    • sulfonamides
  85. T/F: prolonged exposure to sunlight should be avoided when taking methotrexate.
    true
  86. Which antimetabolite should not be administered with radiation therapy?
    methotrexate
  87. When giving an IT injection of this drug, a preservative-free solution needs to be used?
    methotrexate
  88. Leukovorin must be given when using high doses of this drug to prevent severe life-threatening myelosuppressionand mucositis?
    methotrexate
  89. Avoid this drug in patients with third spacing like ascites or effusions?
    methotrexate
  90. Which agents are cell cycle nonspecific agents that are directly toxic to DNA by causing strand breaks to form?
    platinum compounds
  91. What is the MOA of the platinum compounds?
    form strong covalent bonds with DNA inhibiting replication and causing cell death
  92. Carboplatin
    Paraplatin-AQ
  93. Cisplatin/CDDP
    • Platinol
    • Platinol-AQ
  94. Imatinib
    Gleevec
  95. Rituximab
    Rituxan
  96. Trastuzumab
    Herceptin
  97. Docetaxel
    Taxotere
  98. Paclitaxel
    Taxol
  99. What are adverse/rare SE of carboplatin?
    • ototoxic
    • hypersensitivity
  100. Which drug class should you avoid taking with carboplatin (or cisplatin too)?
    aminoglycosides because will increase risk of ototoxicity (gentamicin)
  101. Which drug should you absolutely not take if you are pregnant or breastfeeding?
    • carboplatin
    • cisplatin
  102. This platinum compound can cause severe N/V?
    • carboplatin
    • cisplatin
  103. This platinum compound should be taken with plenty of fluids after chemo therapy?
    • carboplatin
    • cisplatin
  104. Hypersensitivity risk increases after 6+ treatments with this drug?
    carboplatin
  105. What is the most common adverse SE of cisplatin?
    ototoxic
  106. For which drug should you verify any dose written for over 100 mg/m2?
    cisplatin
  107. Ototoxicity is more common in children than adults with this drug?
    cisplatin
  108. This platinum compound is highly emetogenic?
    cisplatin
  109. IV hydration should be given before and after _____ therapy?
    cisplatin
  110. While on this drug, potassium and magnesium levels especially should be monitored?
    cisplatin
  111. Renal function should be assessed before giving this drug?
    cisplatin
  112. What other drugs can affect cisplatin?
    • aminoglycosides
    • amifostine
    • taxanes
  113. What other drugs can cisplatin have effects on?
    • topotecan
    • vinorelbine
  114. Mannitol or furosemide can be given with this drug to reduce nephrotoxicity?
    cisplatin
  115. This class kills tumors by targeting abnormal genetic signaling proteins specific to the cancer and many are used in combo with other cytotoxic drugs?
    targeted therapy
  116. What is the MOA of Imatinib?
    inhibits tyrosine kinase needed for cell proliferation and targets the Philadelphia fusion gene
  117. What is the MOA of Rituximab and Trastuzumab?
    they are monoclonal antibodies that target CD-20 antigen on B-cells and the HER2/neu oncogene, respectively
  118. What are the adverse SE of Imatinib?
    • hepatotoxicity
    • heart failure
    • severe bullous dermatologic reactions
    • hemorrhage
  119. What drugs can affect Imatinib?
    • azole antifungals
    • lansoprazole
  120. What other drugs can Imatinib effect?
    • carbamazepine
    • digoxin
    • codeine
    • colchicine
    • fentanyl
    • cyclosporine
    • fludarabine
    • simvastatin
    • tamoxifen
    • tramadol
    • warfarin
  121. Which drug has the common side effect of fluid retention or edema?
    Imatinib
  122. What drug has a common side effect of infusion reaction?
    Rituximab
  123. Which drug is recommended to be pretreated with benadryl and APAP?
    Rituximab
  124. Which drug can reactivate serious infections like Hepatitis B?
    Rituximab
  125. Patient should report shortness of breath, chest tightness, fever or chills during treatment with this drug?
    Rituximab
  126. What other drug can Rituximab have an effect on?
    antihypertensives
  127. What are the rare/adverse SE of Rituximab?
    • severe or fatal mucocutaneous reactions
    • lichenoid dermatitis
    • paraneoplastic pemphigus
    • Stevens-Johnson syndrome
    • toxic epidermal necrolysis
    • anaphylaxis
    • bowel obstruction and perforation
    • progressive multifocal leukoencephalophathy
  128. Which drug is used to treat early stage and metastatic breast cancer?
    trastuzumab
  129. What are rare/adverse SE of trastuzumab?
    • cardiotoxicity
    • pulmonary toxicity
  130. Which two drugs are known well for their cardiotoxic effects?
    • trastuzumab
    • doxorubicin
  131. T/F: patient should have ejection fraction measured before starting therapy with trastuzumab.
    true
  132. Patients treated with trastuzumab should report immediately what symptoms?
    • shortness of breath
    • chest pain
    • fever
    • chills
  133. What other drugs can trastuzumab effect?
    • anthracyclines
    • myelosuppressive chemo
  134. Which drug class is known for its bone marrow suppression and peripheral neuropathies?
    taxanes
  135. What is the MOA of taxanes?
    stabilize the microtubule bundles by promoting assembly and preventing depolymerization, thereby inhibiting cell replication
  136. What are the rare SE for Docetaxel?
    • skin desquamation
    • hypersensitivity
    • oncolysis
  137. You should report any fever or infection to Dr. with what drug?
    docetaxel
  138. Which drug must you premedicate with a corticosteroid to reduce fluid retention?
    docetaxel
  139. T/F: taxanes should be given before platinums when given together to limit toxicity.
    true
  140. What are the rare SE for paclitaxel?
    • hypersensitivity
    • skin rashes
  141. You can experience bradycardia if you are taking which drug?
    paclitaxel
  142. Infection and peripheral neuropathies can be seen with prolonged use of this drug?
    paclitaxel
  143. ____ is a radiosensitizer and will increase effect and toxicity of radiation therapy?
    paclitaxel
  144. Monitor blood pressure regularly while infusing this drug?
    paclitaxel
  145. Severe bone marrow suppression is possible when taking this drug?
    paclitaxel
  146. Premedicate with corticosteroid, benadryl, H2 blocker (histamine) to prevent hypersensitivity with which drug?
    paclitaxel
  147. Which drug class will cause tissue necrosis if extavasation occurs?
    taxanes

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