For breast cancer in HR+ tumors (estrogen/progesterone)

Tamoxifen increases risk of endometrial cancers - others decrease risk

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Fulvestrant increases osteoporosis, increases hyperlipidemia - others improve these

Increase risk of thromboembolic events (DVT, PE, MI, stroke) with all antiestrogens/SERMs. SERMs (these are Selective Estrogen Receptor Modulators, or "Designer Estrogens" - they block estrogen in breast tumors, but act as estrogen agonists in other tissues)

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A lot but most importantly decreased bone density and increased risk for osteoporosis: consider calcium and vitamin D supplementation, weight bearing exercise, DEXA screening

Used for prostate CA in males and endometriosis, fibroids and breast cancer in females: initally increase the production of androgens and estrogens; followed by down regulation through a negative feedback loop resulting in suppressed gonadotropin release, LH, and FSH, resulting in a chemical castration/ocphorectomy

hot flashes, bone pain, impotence, injection side pain/swelling, gynecomastia, peripheral edema

&

decrease bone density and increase risk for osteoporosis: consider calcium and vitamin D supplementation, weight bearing exercise and DEXA screening

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Alkylators cross link DNA thus preventing cell replication

What a serious side effect of cyclophosphamide and how to protect against it?

Bladder toxicity with high-dose cyclophosphamide and ALL doses of ifosfamide give MENSA (Mesnex) to protect against hemorrhagive cystits and also ensure adequate hydration

bindto VEGF - vascular endothelial growth factor, high cost for modest benefit

intercalation into DNA, inhibiting topoisomerase II, and creating oxygen - free radicals that damage cells

not exceed max lifeteime dose

when doxorubicin doses are anticipated to continue beyond 300 mg/m²

400 - 500 mg/m²

myelosuppression, mucositis, hepatic and renal toxicity (renal is dose - related). Pulmonary toxicity - monitor

Leucovorin is the active form of folic acid (basically, it undose the effects cause by methotrexate)

Retinoids are vitamin A analogues and they decrease cell proliferation and promotes apoptosis

Pregnancy category X!

Know that there are a tun of side effects that patients indeed get!

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Management: dexamethasone 10 mg IV q12 hrs

Generic: Aldesleukin

Brand: Proleukin

Initerleukins may only be used in patients with normal ____ and ____ functions?

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Initerleukins may only be used in patients with normal cardiac and pulmonary functions as defined by thallium stress testing and polmonary function testing?

capillary leak syndrome (hypotension, decreased organ perfusion, possible death)

Interleukins correlate with high incidence of bacterial endocarditis, if indwelling catheter then provide ____ antibiotic prophylaxis prior to therapy

What class of drugs decrease the effectiveness of interleukins and thus shouldn't be used?

Inhibit growth factors required for cell growth and decrease cell survival

Diphenhydramine prior to infusion due to severe infusion reactions (3%)

With monoclonal antibodies, acne-like rash onset in 1st 2 weeks of treatment, severe rash possible. Presence of rash correlates with _____.

decrease angiogenesis

Pregnancy category X: severe birth defects (limb defects, cardiac, GI, ear, eye, GU)

System for Thalidomide Education and Prescribing Safety (STEPS) program to dispense

NO. Only available under restricted distribution program RevAssist - patient prescriber and pharmacist must be registered with RevAssist

see medical attention if develop shortness of breath, chest pain, or arm or leg swelling