Term
| What are the three approved agents for chemoprevention? |
|
Definition
- Tamoxifen for breast cancer
- Celebrex for FAP variant of colon cancer
- HPV vaccine for cervical cancer
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Term
| What does each Performance Status grade mean? |
|
Definition
0 = normal 1 = no strenuous activity 2 = out of bed more than 50% of the time 3 = out of bed less than 50% of the time 4 = bed ridden
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Term
| What does adjuvant chemotherapy mean? |
|
Definition
| Chemotherapy after radiation or surgery |
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|
Term
| What does neoadjuvant chemotherapy mean? |
|
Definition
| Chemotherapy before surgery |
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|
Term
| What are the grades and measures of toxicity? |
|
Definition
1 = Mild 2 = Moderate 3 = Hospitalized - non-life threatening 4 = Hospitalized - life threatening 5 = Dead
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Term
| What agents act in the M phase of the cell cycle? |
|
Definition
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|
Term
| What drug has a 2 mg dose cap for a single dose? |
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Definition
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|
Term
| What chemo drug has constipation as a major side effect? |
|
Definition
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Term
| What chemo drug has diarrhea as a major side effect? How do you manage it? |
|
Definition
ironotecan manage with scheduled loperamide q2h and q4h at night and watch for dehydration/electrolyte abnormalities |
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Term
| When is ixabepilone indicated? |
|
Definition
- Combo w/ capecitabine for metastatic or locally advanced breast cancer after failure with anthracycline and a taxane
- Monotherapy in metastatic or locally advanced breast cancer after failure with anthracycline and a taxane and capecitabine
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Term
| What are 4 counseling points for ixabepilone? |
|
Definition
- Get liver function tests done
- Avoid if sensitive to Cremophor EL (paclitaxel)
- Contains alcohol
- Avoid grapefruit juice
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|
Term
| What chemo drugs are specific to the G2 phase of the cell cycle? |
|
Definition
Bleomycine Podophylootoxins (etoposide, teniposide)
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Term
| What unique complication may bleomycin cause? |
|
Definition
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|
Term
| What is the single dose cap and lifetime dose cap of bleomycin? |
|
Definition
Single dose cap = 30 unit Lifetime dose cap = 400 units
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Term
| What dose of MTX usually requires leucovorin rescue? |
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Definition
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Term
| When should you measure MTX levels for leucovorin rescue? |
|
Definition
| 48 hours after MTX has ended then 24 hours during leucovorin rescue |
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Term
| If MTX is 10-7 after 48 hours, when dose of leucovorin should you give? |
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Definition
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|
Term
| If MTX is 10-3 after 48 hours, what dose of leucovorin should you give? |
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Definition
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|
Term
| What level of MTX can you stop giving MTX? |
|
Definition
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|
Term
| What is the major toxicity of MTX at high IV doses? How is it prevented? |
|
Definition
Renal toxicity Give hydration with sodium bicarb |
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|
Term
| What is the major side effect of MTX at intermediate IV doses? |
|
Definition
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|
Term
| What class of drugs causes a delayed and prolonged myelosuppression of 6-8 weeks with severe nausea and vomiting? |
|
Definition
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|
Term
| What are the risk factors for breast cancer? |
|
Definition
- Age
- Gender
- Endocrine
- Early menarche
- Nulliparity
- Estrogen replacement
- Genetics
- FH
- BRCA1, BRCA2
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Term
| What are the pros of tamoxifen chemoprevention for breast cancer? |
|
Definition
- Decreased risk of breast cancer
- Decreased osteoporotic fractures
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Term
| What are the cons of tamoxifen for breast cancer chemoprevention? |
|
Definition
- Increased VTE, etc
- Increased cataracts
- Increased endometrial cancer
- Increased hot flashes
- No survival benefit
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|
Term
| What is first line hormonal treatment for metastatic breast cancer in premenopausal women? |
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Definition
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|
Term
| What is first line hormonal treatment for metastatic breast cancer in postmenopausal women? |
|
Definition
| Antiestrogen or Aromatase Inhibitor (anastrazole or letrozole) |
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|
Term
| What are the common sites of metastasis for breast cancer? |
|
Definition
|
|
Term
| What is the DLT for 5FU for a continuous infusion? |
|
Definition
|
|
Term
| What is the DLT for 5FU for a bolus? |
|
Definition
|
|
Term
| What is the DLT of cyclophosphamide? |
|
Definition
|
|
Term
| What medications do you give along with cyclophosphamide? |
|
Definition
Hydration (3L/day) Mesna Both for Hemorrahagic cystitis |
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|
Term
| What medications do you give along with paclitaxel? |
|
Definition
- Dexamethasone 20 mg Q12 and Q6 h B4
- Benadryl 50 mg IV 3-60 min prior
- Ranitidine 50 mg IV 30-60 min prior
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Term
| What medications do you give along iwth docetaxel? |
|
Definition
| Dex 8 mg bid 3 days prior to chemo |
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Term
| What medications do you NOT administer with trastuzumab (Herceptin)? |
|
Definition
| cyclophosphamide or doxorubicin |
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|
Term
| What is the most serious complication with trastuzumab? |
|
Definition
|
|
Term
| What is the pathology behind acute chemotherapy-associated N/V? |
|
Definition
|
|
Term
| What class of drugs are best in acute emesis? |
|
Definition
| 5-HT3 serotonin receptor antagonists |
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|
Term
| What is the dosing for scheduled dolasetron? |
|
Definition
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|
Term
| What is the scheduled dosing of granisetron? |
|
Definition
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|
Term
| What is the scheduled dosing of ondansetron? |
|
Definition
| 8 mg po bid or 16 mg po qd |
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|
Term
| What is the scheduled dosing of dexamethasone for N/V? |
|
Definition
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|
Term
What is the antiemetic regimen for high risk chemo? What moderate drugs also get this regimen? |
|
Definition
- 5-HT3 antagonist day 1
- Dex days 1-4
- Aprepitant days 1-3
Anthracycline, carboplatin, ironotecan, cyclophosphamide, MTX |
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|
Term
| What antiemetic regimen is used for moderate risk of chemotherapy? |
|
Definition
- 5-HT3 antagonist day 1
- Dex day 1
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|
Term
| What antiemetic regimen is used for low risk chemotherapy? |
|
Definition
|
|
Term
| What antiemetic regimen is used for minimal risk chemo? |
|
Definition
|
|
Term
| What medications are used for breakthrough N/V? |
|
Definition
- Proclorperazine
- Metoclopramide
- Lorazepam
- Ondansetron
- Granisetron
- Haloperidol (refractory)
- Dronabinol (refractory)
- Dexamethasone (refractory)
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|
Term
| What are the few SE with 5-HT3 antagonists? |
|
Definition
| Headache and constipation |
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|
Term
| What is the scheduling for palonosetron and why? |
|
Definition
| single dose due to long half-life |
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|
Term
| What 5-HT3 antagonists are available as generic? |
|
Definition
| ondansetron and granisetron |
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|
Term
What 5-HT3 is available as a patch?
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|
Definition
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|
Term
| What dose of dexamethasone should be given if also with aprepitant? |
|
Definition
|
|
Term
| What type of DI is associated with aprepitant? |
|
Definition
| CYP3A4 inducers b/c aprepitant is a substrate |
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|
Term
| What SE are associated with prochlorperazine? |
|
Definition
| sedation, lethargy, hypotension, skin sensitization |
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|
Term
| What SE are associated with dronabinol and what population should avoid this drug? |
|
Definition
euphoria, mood changes, abnormal thinking avoid in elderly |
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|
Term
| In what population is mucositis the most common? |
|
Definition
|
|
Term
| Where does mucositis occur? |
|
Definition
|
|
Term
| Explain the Grades for mucositis--> |
|
Definition
- Grade 1 = soreness +/- erythmia
- Grade 2 = patient can swallow solid food
- Grade 3 = patient cannot swallow food
- Grade 4 = alimentation is not possible
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|
Term
| What treatments work for mucositis? |
|
Definition
- Magic mouthwash
- Salf water gargles
- Topical analgesia (with xylocaid viscous)
- Systemic analgesia
- Nystatin
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|
Term
| What is Kepivance (palifermin) and when is it used? |
|
Definition
| KGF receptor stimulator that is used to stimulated epithelial cells in patients with severe mucositis with hematological malignancies receiving chemo for BMT |
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|
Term
| What is the is the po opiod regimen for a patient with pain score 7-10 and is opiod naive? |
|
Definition
|
|
Term
| What is the is the po opiod regimen for a patient with pain score 7-10 and is not opiod naive? |
|
Definition
| increase 10-20%, assess q1h |
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|
Term
| What is the is the iv opiod regimen for a patient with pain score 7-10 and is opiod naive? |
|
Definition
| 2-5 mg IV MS, assess q15 min |
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|
Term
| What is the is the iv opiod regimen for a patient with pain score 7-10 and is not opiod naive? |
|
Definition
| increase 10-20%, assess q15min |
|
|
Term
| What is the is the po opiod regimen for a patient with pain score 4-6 and is opiod naive? |
|
Definition
| MSSR 15-30 mg bid, assess q4-24 hour, decrease pain by 50% or more |
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|
Term
| What is the starting dose of Percocet for moderate pain? |
|
Definition
|
|
Term
| What is the starting dose of IR morphine for moderate pain? |
|
Definition
|
|
Term
| What is the starting dose of SR morphine for moderate pain? |
|
Definition
|
|
Term
| How do you adjust fentanyl doses for renal function? |
|
Definition
| < 10 ml/min = 50 % reduction |
|
|
Term
| What condition can increase fentanyl absorption? |
|
Definition
|
|
Term
| What antidepressant is used in neuropathic pain for cancer patients? |
|
Definition
|
|
Term
| What anticonvulsants are used for neuropathic pain in cancer patients? |
|
Definition
| gabapentin, carbamazapine |
|
|
Term
| What patients can get fluoroquinolones for infection prophylaxis? |
|
Definition
Leukemia Lymphoma Transplant |
|
|
Term
| What drug prevents HSV in SCT patients? |
|
Definition
|
|
Term
| What drug prevents CMV in SCT patients? |
|
Definition
|
|
Term
| What is the febrile neutropenia regimen for low-risk pts ? |
|
Definition
|
|
Term
| What is the maximum lifetime dose of amphoteracin? |
|
Definition
|
|
Term
| What medications can minimize toxicity of amphoteracin? |
|
Definition
NS dopamine infusion APAP/ CS premeds |
|
|
Term
| What drugs can be used for dyspnea? |
|
Definition
O2 Opiods BZD CS Supportive care |
|
|
Term
| What is the range for mild hypercalcemia of malignancy? |
|
Definition
|
|
Term
| What is the range for severe hypercalcemia fo malignancy? |
|
Definition
|
|
Term
| What is the primary treatment for NSCLC stage I-II? |
|
Definition
|
|
Term
| What is the main chemo treatment for metastatic lung cancer? (PS 0-2) |
|
Definition
cisplatin + paclitaxel carboplatin + paclitaxel |
|
|
Term
| What is the calcert equation for carboplatin dosing? |
|
Definition
|
|
Term
| What premedication regimen is required for pemetrxed? |
|
Definition
|
|
Term
| Vinorelbine is used for what type of tx of NSCLC? |
|
Definition
|
|
Term
| What is the main SE of EGFR inhibitor in NSCLC? |
|
Definition
| rash and interstital lung dz |
|
|
Term
| What is the main SE with cituximab? |
|
Definition
|
|
Term
| What are the ABCDEs of melanoma? |
|
Definition
- asymetry
- border
- color
- diameter
- evolution
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|
|
Term
| What is the standard therapy for metastatic melanoma? |
|
Definition
|
|
Term
| What is the most common histology of renal cell cancer? |
|
Definition
|
|
Term
| What drug has a side effect of hyperglycemia dn hyperlipidema that likely requires treatment? |
|
Definition
|
|
Term
| What premeds are required for temsirolimus? |
|
Definition
|
|
Term
| What is the best treatment for metastatic renal cell cancer? |
|
Definition
|
|
Term
| What is the first line treatment for CLL and age > 70 (if treatment indicated) |
|
Definition
| chlorambucil + prednisone |
|
|
Term
| Whatis the first line therapy for CLL and age < 70 (if treatment is indicated)? |
|
Definition
| fludarabine/pentostatin + cyclophosphamide + rituximab |
|
|
Term
| What is standard therapy for Hodkin's lymphoma? |
|
Definition
|
|
Term
| What therapy is used for relapse or treatment failure of Hodgkin's lymphoma? |
|
Definition
|
|
Term
| What therapy is standard for Non-Hodgkin's lymphoma? |
|
Definition
|
|
Term
| What is standard treatment for ALL? |
|
Definition
|
|
Term
| What drug is used for AML-M3? |
|
Definition
| All-trans retinoic acid, then chemo |
|
|
Term
| What drug is the mainstay for AML treatment? |
|
Definition
|
|
Term
| What drug has to be given with Ara-C? |
|
Definition
| dexamethasone eye drugs x 7 days for high dose |
|
|
Term
|
Definition
| multiple myeloma induction for non-transplant patients |
|
|
Term
| What is maintenace therapy for MM? |
|
Definition
| thalidomide and prednison |
|
|
Term
| What is salvage therapy for MM if progress < 6 months? |
|
Definition
thalidomide lenalidomide bortezomib |
|
|
Term
| What is salvage therapy for MM if progress > 6 months? |
|
Definition
|
|
Term
| What is the main SE of thalidomide? |
|
Definition
|
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