Therapeutics - Chemo 4

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kyleannkelsey
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300690
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Therapeutics - Chemo 4
Updated:
2015-04-13 14:54:23
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Therapeutics Chemo
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Therapeutics - Chemo
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Therapeutics - Chemo
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  1. What are the Common uses for Cisplatin?
    NSCLC, SCLC, bladder, head/neck, testicular
  2. What are the SE for Cisplatin?
    • Nausea/vomiting (HT) (100% if not pre-treated)
    • PN
    • Ototoxicity
    • Nephrotoxicity
  3. What special information should you know about Cisplatin?
    • Hydrate with NS
    • Most emetic agent
    • Delayed hypersensitivity
  4. What are the Common uses for Carboplatin?
    NSCLC, SCLC, ovarian, bladder, head/neck
  5. What are the SE for Carboplatin?
    • Thrombocytopenia and leukopenia
    • Anemia
    • Less PN, ototoxicity, n/v and nephrotoxicity than cisplatin
  6. What special information should you know about Carboplatin?
    • Dosed based on AUC
    • Delayed hypersensitivity
  7. What are the Common uses for Oxaliplatin?
    Colorectal, breast, head/neck,, ovarian, pancreatic
  8. What are the SE for Oxaliplatin?
    • PN (DLT, HT):
    • Acute <14 days, Exacerbated by cold, hands, feet, peri-oral
    • Persistent > 14 days, Hands and feet, May be permanent
  9. What special information should you know about Oxaliplatin?
    • DO NOT USE = Mg/Ca bolus before and after for PN prevention
    • DO = prolonging administration may help with PN
  10. What are the Common uses for Cyclophosphamide?
    NHL, breast, CLL, ALL
  11. What are the SE for Cyclophosphamide?
    Hemorrhagic cystitis (HT)
  12. What special information should you know about Cyclophosphamide?
    • Hydrate and frequent urination to prevent HC
    • S/S: pain on urination, hematuria, urgency
    • MAY use mesna to prevent HC
    • Can occur months later
  13. What are the Common uses for Ifosfamide?
    Sarcomas, testicular, NHL
  14. What are the SE for?
    • Hemorrhagic cystitis (HT)
    • CNS toxicity – confusion, ataxia, slurred speech (may be caused by metabolites) – treated with Methylene blue (not prophylactic)
  15. What special information should you know about?
    • Hydrate and frequent urination to prevent
    • S/S: pain on urination, hematuria, urgency
    • ALWAYS use mesna
  16. What dosage forms does Mesna come in?
    IV and Oral
  17. What are the Common uses for Procarbazine?
    Hodgkin’s lymphoma, malignant glioma
  18. What are the SE for Procarbazine?
    Disulfiram-like reaction with alcohol
  19. What special information should you know about Procarbazine?
    • Oral therapy
    • Weak monoamine oxidase inhibitor: tyramine-free diet
    • Drug interactions: SSRIs, tricyclic antidepressants
  20. What are the Common uses for Temozolomide?
    Glioblastoma multiforme, metastatic melanoma (for these b/c cross BBB well)
  21. What are the SE for Temozolomide?
    Constipation, nausea (53%) and vomiting (42%), headache (41%), seizure (23%)
  22. What special information should you know about Temozolomide?
    • Oral therapy
    • Readily crosses BBB
  23. What are the Common uses for Bendamustine?
    CLL, NHL, MM
  24. What are the SE for Bendamustine?
    Skin reactions (Stevens Johnson Syndrome (SJS), Toxic epidermal necrolysis (TEN) syndrome, rash)
  25. What special information should you know about Bendamustine?
    • Tumor lysis can occur – may need allopurinol
    • Infection prophylaxis should be considered with CLL patients because of extensive immunosuppression
  26. What are the SE for Belomycin?
    • Interstitial pneumonitis and pulmonary fibrosis – (HT)
    • Low levels of aminohyrdrolase in lung and skin
    • Agent with the greatest risk
    • Mortality rate of 50%
    • Clinical presentation: Dyspnea, low-grade fever, non-productive cough, X-ray shows diffuse bilateral infiltrates
  27. What are the Common uses for Arsenic Trioxide?
    Acute promyelocytic leukemia (APL)
  28. What are the SE for Arsenic Trioxide?
    • Retinoic acid syndrome (HT) – can be fatal
    • Electrolyte abnormalities - ↓ K+, ↓Mg or ↑ K+
    • QT prolongation
  29. What special information should you know about Arsenic Trioxide?
    • RA Syndrome: fever, dyspnea, weight gain, pulmonary infiltrates, and pleural effusion
    • Must be treated with corticorsteroids immediately (dexamethasone 10 mg IV bid)
  30. What are the Common uses for Thalidomide?
    MM, MDS
  31. What are the SE for Thalidomide?
    • Teratogenicity (HT)
    • PN
    • Drowsiness
    • Constipation
  32. What special information should you know about Thalidomide?
    • REMS: S.T.E.P.S ™ Program
    • Increased risk of DVT/PE with dex
  33. What are the Common uses for Lenalinomide?
    • MM, MDS
  34. What are the SE for Lenalinomide?
    • Teratogenicity
    • Fatigue
  35. What special information should you know about Lenalinomide?
    • REMS: RevAssist
    • Increased risk of DVT/PE with dex
  36. What are the Common uses for Pomalidomide?
    MM
  37. What are the SE for Pomalidomide?
    Teratogenicity
  38. What special information should you know about Pomalidomide?
    • POMALYST REMs
    • Possible x-sensitivity with Thalidomide and Lenalidomide
    • Increased risk of DVT/PE with dex
  39. What are the Common uses for Olaparib?
    BRCA-mutated advanced ovarian cancer in patients who have failed >= 3 prior courses of chemotherapy
  40. What special information should you know about Olaparib?
    Hold for new or worsening pulmonary disease as fatal pneumonitis has occurred
  41. What are the SE for Olaparib?
    • Anemia (up to 90%)
    • Nausea (64-75%)
    • Increased serum creatinine (30%)
    • AML/MDS

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