Chemotherapy by FLEX – Flashcards
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Imantinib
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Gleevac Tyrosine Kinase Inhibitor CML, GIST 400-800 mg daily with food Fluid retention, edema, dermatological effects
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Erlotinib
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Tarceva Tyrosine Kinase Inhibitor Lung, pancreatic cancer 100-150 mg daily on empty stomach Interstitial lung disease, dermatological effects, diarrhea
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Gefitinib
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Iressa Lung cancer 250 mg daily
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Lapatinib
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Tykerb Tyrosine Kinase Inhibitor Breast Cancer 1250 mg daily on empty stomach QTc prolongation, diarrhea, pulmonary toxicity, hand-foot syndrome
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Sorafinib
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Nexevar Tyrosine Kinase Inhibitor RCC, unresectable hepatocellular cancer 400 mg BID on empty stomach hand-foot syndrome
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Sutinib
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Sutent Tyrosine Kinase Inhibitor GIST, RCC 50 mg daily Cardiotoxicity, hand-foot syndrome
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Intrathecal chemotherapy
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The following drugs can be given through this route: cytarabine (ara-C) cytarabine liposomal thiotepa methotrexate
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Red colored chemotherapy
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The following drugs are this color: anthracyclines (eg. daunorubicin, doxorubicin, epirubicin, idarubicin)
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Yellow colored chemotherapy
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Methotrexate is this color.
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Blue colored chemotherapy
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Mitoxantrone is this color.
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Purple colored chemotherapy
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Mutamycin is this color
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Tyrosine kinase inhibitors
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-nib suffix common indxn RCC, GIST common ade hand-foot syndrome
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Aromotase Inhibitors
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Examples of this class of drugs: aminoglutethemide anastrozole exemestane letrozole common indxn breast cancer common ade arthralgias, HLP, osteoporosis, hot flashes dosed usually once daily
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Aminoglutethemide
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Cytadren aromatase inhibitor, blocks steroidogenesis breast, prostate cancer 250 mg PO Q6H adrenocortical insufficiency, hypoaldosteronisms, lethargy, rash
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Anastrozole
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Arimidex non-steroidal aromatase inhibitor breast cancer 1mg PO daily arthralgias, HLP, osteoporosis, hot flashes
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Letrozole
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Femara non-steroidal aromatase inhibitor breast cancer 2.5 mg PO daily arthralgias, HLP, osteoporosis, hot flashes, fatigue
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Exemestane
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Aromasin irreversible steroidal aromatase inhibitor 25 mg PO daily arthralgias, HLP, osteoporosis, hot flashes, fatigue
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Antiandrogens
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-amide suffix common indxn prostate cancer common ade hot flushes, gynecomastia
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Bicalutamide
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Casodex non-steroidal antiandrogen prostate cancer 50 mg daily hot flushes, gyneocmastia
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Flutamide
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Eulexin nonsteroidal antiandrogen prostate cancer hot flushes, gynecomastia, diarrhea, elevated LFT
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Nilutamide
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Nilandron nonsteroidal antiandrogen prostate cancer 150 mg PO daily (50 mg tabs) hot flushes, gynecomastia, visual disturbances
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Antiestrogens
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Examples include: fluvestrant, tamoxifen, and toremifene common indxn breast cancer common ade hot flushes
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Fluvestrant
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Faslodex antiestrogen breast cancer 250 mg IM monthly
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Tamoxifen
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Nolvadex SERM - nonsteroid antiestrogen with some agonist activity breast cancer 20 mg PO daily hot flushes, edema, endometrial cancer, blood clots
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Toremifene
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Fareston SERM - nonsteroid antiestrogen with some agonist activity breast cancer 60 mg PO daily tumor flare, hot flashes, nausea, caution in thromboembolic disease
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LHRH analogs
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-relin common suffix common indxn breast cancer common ade initial transient disease flare, hot flash, impotence, decrease BM density common route IM
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Goserelin
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Zoladex LHRH analog prostate, breast cancer 3.6 mg SQ monthly 10.8 mg SQ Q 3 months initial transient disease flare, hot flash, impotence, decrease BM density
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Leuprolide
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Lupron depot LHRH analog prostate, breast cancer 7.5 mg IM monthly 22.5 mg IM q 3 month initial transient disease flare, hot flash, impotence, decrease BM density
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Triptorelin
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Trelstar Depot LHRH analog prostate, breast cancer
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Monoclonal antibodies
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-mab suffix -mo, mouse -xi, chimeric -zu, humanized -tu, tumor -ci, cardiovascular -li, immune system -vi, viral
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Alemtuzumab
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Campath anti-CD52 B-cell CLL pancytopenia, infection, infusion reaction
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Bevacizumab
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Avastin anti-VEGF NSCLC, colon, breast impaired wound healing, proteinuria, bleeding, HTN, thromboembolism
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Cetuximab
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Erbitux EGFR inhibitor colon cancer, head/neck cancer acne form rash, elyte changes, infusion reaction
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Gemtuzumab
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Mylotarg CD33+ relapse AML hypersensitivity, pancytopenia
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Ibritumomab
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Zevelin Anti-CD20 linked with radioactive Yttrium-90 Refractory B-cell lymphoma Infusion reaction, BMS, cutaneous reaction
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Panitumumab
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Vectibix EGFR+ metastatic colorectal cancer acneform rash, elyte changes, infusion related reactions
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Rituximab
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Rituxan CD20+ B-cell lymphoma infusion reaction
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Tositumomab
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Bexxar Anti-CD20 linked with radioactive iodine Refractory B-cell lymphoma infusion reaction, hypothyroidism, BMS
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Vesicants
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The following drugs share this infusion related reaction: anthracyclines (daunorubicin, doxorubicin, epirubicin, diarubicin), dactinomycin mechlorethamine melphalan mitomycin C vinca alkaloids (vinblastine, vincristine, vinorelbine)
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Hyaluronidase
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Hydrase vinca alkaloid extravasation
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Dexrazoxane
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Totect, Zinegard cardioprotectant for anthracyclines infuse 15-30 minutes before anthracycline in a 10:1 ratio
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Sodium thiosulfate
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Used for dactinomycin and mechlorethamine extravasation.
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Cardiotoxic chemotherapy
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These drugs include anthracyclines, mitoxantrone, cyclophosphamide
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Amifostine
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Ethyol used to minimize cisplatin-induced renal toxicity
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Leucovorin
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Wellcovorin antidote for folic acid antagonist start 24-48 hours after high dose MTX and continue until level <0.05 uM/L
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MeSNA
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2 mercaptoethanesulfate used for high dose cyclophosphamide and ifosfamide induced hemorrhagic cystitis
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Filgrastim (G-CSF)
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Neupogen stimulate neutrophil production 5 mcg/kg SQ weekly bone pain, fever
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PEG-filgrastim
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Neulasta stimulate neutrophil production 6 mg SQ x1dose bone pain, fever
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Sargramostim (GM-CSF)
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Leukine stimulates neutrophil production 250 mg/m^2 SQ daily bone pain, fever, hypotension
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Epoeitin-alpha
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Procrit, Epogen stimulate RBC production 150 u/kg SQ TIW 40,000 u SQ weekly HTN, HA, fever, monitor H/H, ferritin, transferritin supplement Fe as needed DO NOT USE IF Hgb>12
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Darbepoeitin
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Aranesp stimulate RBC production 2.25 mcg/kg weekly monitor H/H, ferritin, transferritin supplement Fe as needed DO NOT USE IF Hgb>12
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Oprelvekin
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Neumega stimulate megakaryocytopoeisis, thrombopoeisis 50 mcg/kg SQ daily days 10-21 arrhythmias, palpitations, peripheral edema, dizziness, fluid retention
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Asparginase
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Elspar enzyme, hydrolyzes asparagine AA ALL lymphoma HSR, hypofibrinogenemia, use test dose
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Bleomycin
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Blenoxane intercalation, free radicals testicular cancer, lymphoma pulmonary fibrosis, use test dose, avoid O2 therapy
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Bortezomib
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Velcade Proteosome inhibitor Multiple Myeloma May cause neuropathy
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Capecitabine
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Xeloda PO prodrug of 5-FU, pyrimidine analog breast, colorectal cancer hand-foot syndrome, diarrhea
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Cisplatin
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Platinol DNA cross-linker highly emtogenic, nephrotoxic, ototoxic, peripheral neuropathy, hypokalemia, hypomagnesemia requires vigorous hydration
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Cyclophosphamide
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Cytoxan alkylating agent hemorrhagic cystitis, neutropenia, delayed nausea, mucositis, alopecia, SIADH
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Docetaxel
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Taxotere microtubule stabilizer breast, lung, ovarian cancer peripheral edema, peripheral neuropathy, HSR premed with dexamethasone
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Doxorubicin
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Adriamycin topoisomerase I/II inhibitor breast, solid tumor, sarcoma, leukemia, lymphoma cardiotoxicity, vesicant
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Fluorouracil
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Adrucil pyrimidine analog neutropenia, hand-foot syndrome
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Ifosfamide
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Ifex alkylating agent hemorrhagic cystitis, requires hydration and MeSNA
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Irinotecan
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Camptosar Topoisomerase I inhibitor colorectal cancer Early cholinergic effects, late diarrhea effects, acute diarrhea treatable with atropine.
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Methotrexate
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Trexall antifolate myelosuppression, mucositis, diarrhea, stomatitis, renal failure leucovorin rescue
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Oxaliplatin
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Eloxatin DNA corsslinker Colorectal, esophageal, gastric fatigue, anemia, N/V, pain, neuropathy
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Vincristine
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Oncovin blocks microtubule assembly neurotoxic, peripheral neuropathy, constipation, vesicant, low emtogenicity, low myelosuppression
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Zolendronic acid
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Zometa osteolytic boney metastasis inhibits osteoclast bone resorption, osteoclast apoptosis renal toxicity
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Pamidronate
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Aredia bisphosphonate osteolytic boney metastasis inhibits osteoclast bone resorption, osteoclast apoptosis renal toxicity
