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Oncology
Oncology
93
Pharmacology
Pre-School
01/12/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
Prostate cancer treatment for locally advances
Definition
radiation + hormone (goselin)
Term
what regimen for locally advanced prostate
Definition
radiation + triptorelin
Term
Prostate positive DRE, how to responde
Definition
always TRUS and biopsy. also, always perform TRUS and biopsy w/PSA > 10
Term
gleason score ranges
Definition
2-4, well differentiated, 5-6, moderate margins, 7-10 poorly differentiated
Term
prostate cancer treatment for metastatic disease
Definition
palliative care: hormone deprivation w/antiandrogens or LHRH agonists/antagonists
Term
palliative care with antiandrogens (overview)
Definition
most effective in combination therapy, reduces flare risk,
Term
leuprolide
Definition
LHRH agonist,
Term
triptorelan
Definition
LHRH agonist
Term
histrelan
Definition
LHRH agonist
Term
goserelin
Definition
LHRH agonist
Term
flutamide
Definition
non steroidal antiandrogen
Term
bucalutamide
Definition
non steroidal antiandrogen
Term
nilutamide
Definition
non steroidal antiandrogen; many SE, not used often
Term
Degarelex
Definition
LHRH antagonist; reduces testosterone to castration levels, can cause QT prolongation; no risk of tumor flare
Term
definition of hormone refractory prostate cancer
Definition
increasing PSA or symptomatic progression
Term
supportive care in hormone refractory prostate cancer
Definition
prednisone and/or dexamethasone
Term
hormone refractory prostate cancer regimens w/prednisone
Definition
mitoxantrone, docetaxel, cazitaxel
Term
hormone refractory prostate cancer regimens w/estramustine
Definition
vinblastine, etoposide, docetaxel,
Term
hormone refractory prostate cancer regimens w/o prednisone or estramustine
Definition
ketoconazole and doxorubicin; sipuleucel-T (Immunotherapy)
Term
mitoxantrone
Definition
anthracenedione; dose adjust on hepatic function; can cause cardiac events
Term
estramustine
Definition
nitrogen-mustard-estradiol; inhibits microtubules; can cause fluid retention, gynecomastia
Term
preferred regimen in hormone resistant prostate cancer
Definition
docetaxel,prednisone, bevacizumab
Term
sipuleucel-T
Definition
immunotherapy; autologous CD 54+; for minimally symptomatic refractory prostate cancer
Term
cabazitaxel
Definition
microtubule inhibitor; premedicate w/diphenhydramine, dexamethasone, ranitidine; approved for docetaxel failed patients
Term
satraplatin
Definition
platinum-based chemo; no renal impairment or neuropathy; limited myelosuppression; for refractory prostate cancer, no survival benefit but superior time to progression
Term
tx for bone metastasis in prostate cancer
Definition
zolendronic acid or denosumab
Term
NSCLC stage I tx
Definition
surgery or radiation, survival 67%
Term
NSCLC stage II tx
Definition
surgery w/chemo; survival ~ 40%
Term
NSCLC stage III resectable tx
Definition
surgery w/chemo; survival ~ 20%
Term
NSCLC stage III non-resectable or stage IV tx
Definition
chemradiotherapy or chemotherapy; survival ~ 3%
Term
indication for radiotherapy in NSCLC
Definition
postoperative w/positive margins; chemoradiotherapy in unresectable stage III
Term
chemotherapy indications in NSCLC
Definition
stage II and IIIa w/cisplatin-based regimen
Term
preferred chemo regimen in NSCLC
Definition
cisplatin/vinorelbine
Term
NSCLC stage IIIb non-resectable preferred regimen
Definition
cisplatin/etoposide w/radiotherapy
Term
how to treat NSCLC stage IIIb nonresectable w/pleural effusion
Definition
follow stage IV guidelines
Term
NSCLC stage IV first line tx
Definition
cisplatin/pemetrexed in PS 0,1
Term
indication for bevacizumab in stage IV NSCLC
Definition
adjunct to carboplatin/paclitaxel
Term
indication for cetuximab in NSCLC stage IV
Definition
adjunct to cisplatin/vinorelbine in EGFR-positive tumor
Term
when is erlotinib/gefitinib 1st line in NSCLC stage IV
Definition
in patients w/EGFR mutations regardless of PS
Term
NSCLC tx in PS 2,3,4 stage IV
Definition
single regimen tx in PS 2, no chemo in >2
Term
second line tx for NSCLC stage IV
Definition
docetaxel or pemetrexed or erlotinib, may want to reserve erlotinib for 3rd line
Term
which genetic marker is routinely checked in NSCLC
Definition
EGFR which is overexpressed in 80%
Term
best time to progression among NSCLC IIIb or IV tx
Definition
cisplatin and gemcitabine; also highest rate of thrombocytopenia
Term
1st line for NSCLC squamous cell
Definition
cisplatin/gemcitabine
Term
pemetrexed
Definition
for locally advanced or metastatic non-squamous NSCLC; contraindicated CrCl<45; coadminister folic acid + B12
Term
cisplatin
Definition
dose limiting nephrotoxicity, administer w/significant fluids, contraindicated Cr > 1.5; N/V;
Term
carboplatin
Definition
dose-limiting myelosuppression
Term
etoposide
Definition
-25% dose if CrCl<50; -50% if CrCl<10
Term
paclitaxel
Definition
dose adjust by bilirubin
Term
docetaxel
Definition
fluid retention; avoid if bilirubin >1.5
Term
gemcitabine
Definition
elevates liver enzymes; relative contraindication in severe hepatic/renal
Term
vinorelbine
Definition
reduce dose by 1/2 if bilirubin >2, by 75% if bilirubin >3
Term
bevacizumab
Definition
contraindicated w/bleed risk (hemoptysis); add to carboplatin/paclitaxel for OS and RR (bleed risk); contraindicated w/squamous cell; CNS metastasis
Term
indication for cetuximab in NSCLC
Definition
IIIb and IV w/cisplatin and vinorelbine; rash predicted of better outcome
Term
erlotinib
Definition
indicated for all EGFR mutation(?); may cause hepatic failure; gefitinib has similar efficacy
Term
NSCLC rash tx
Definition
grade 1: hydrocortisone; grade 2: fluticasone or oral steroid for multiple rashes; grade 3: oral methylprednisolone
Term
maintenance therapy for non-squamous NSCLC
Definition
pemetrexed
Term
maintenance therapy for squamous NSCLC
Definition
docetaxel
Term
chemotherapies for SCLC
Definition
etoposide/cisplatin; etoposide/carboplatin; cyclophosphamide/doxyrubicin/vincristine;
Term
toptotecan
Definition
topo I inhibitor; myelosuppression dose limiting; reduce dose by 50% if CrCl 20-40; approved for relapsed SCLC w/response to primary therapy 45 days out
Term
mechlorethamine
Definition
cell cycle non-specific nitrogen mustard;cytotoxic, disrupts DNA; extravasation risk; sodium thiosulfate used for antidote
Term
melphalan
Definition
alylating agent; used for multiple myeloma
Term
chlorambucil
Definition
alkylating agent; used for chronic lymphocytic leukemia
Term
cyclophosphamide
Definition
alkylating agent
Term
acrolein
Definition
formed by ifosfamide, causes hemorrhagic cystitis
Term
ifosfamide
Definition
alkylating agent used in testicular cancer
Term
1st line therapy for stage III colorectal cancer
Definition
FOLFOX; oxaliplatin, 5-FU/leucovorin
Term
5-FU regimen for stage III colon cancer
Definition
LV/5-FU bolus days 1-5, repeat @ 4 weeks
Term
capecetibine
Definition
converted to 5-FU enzymatically; equivalent to 5-FU in stage III colorectal cancer
Term
vistonouridine
Definition
rescue therapy for 5-FU, prevents dose limiting incorporation of 5-FU into RNA through enzymatic conversion to uridine
Term
bendamustine
Definition
alkylating agent; used in chronic lymphoctyic leukemia
Term
oxaliplatin
Definition
platinum based; generally well tolerated; causes neurotoxicity; acute 56%, resolves 2 weeks; avoid cold air/drink; if chronic need glutathione for tx
Term
carmustine, lomustine
Definition
nitrosourea; lipophilic, cross BBB; crosslink DNA and disable repair enzyme
Term
streptazocin
Definition
nitrosourea used in islet cell carcinoma
Term
bevacizumab role in stage III colorectal cancer
Definition
unclear, provides benefit in first two years of tx
Term
first line tx for metastatic colorectal cancer
Definition
FOLFOX + bevacizumab/switch bev to cetuximab in KRAS wild type.

oxaliplatin + irinotecan 2nd line +/- bev
a couple of other options
Term
irinotecan
Definition
topo I inhibitor; active metabolite is SN 38; ketoconazole increases this reaction, st. john's wort decreases it; infusion-related diarrhea managed w/atropine
Term
1st line in metastatic
Definition
Term
cetuximab w/mutant KRAS
Definition
cannot be combined, cetuximab only works with native KRAS. cetuximab works well w/KRAS wild type
Term
panitumumab
Definition
recombinant EGFR monoclonal antibody; indicated last line in wild type KRAS mCRC for improved PFS (not OS) after failure of fluoropyrimidine, oxaliplatin, irinotecan
Term
maximum BSA for dosing chemo drugs
Definition
2 m^2
Term
what are the risks w/intrathecal infusion
Definition
drug cannot be removed or reversed once administered. always a time out for intrathecal administrations
Term
with multidrug regimens when are taxanes administered
Definition
first (pay your taxes first)
Term
vesicants
Definition
cisplatin, dacarbazine, dactinomycin, daunorubicin, doxorubicin, epirubicin, idrarubicin, mechlorethamine, mitomycin c, stroptazosin, vinblastine, vincristine, vindesine, vinorelbine
Term
risk factors for extravasation
Definition
age, vasculature, education, skill of practicioner, method of administration
Term
extravasation preventino
Definition
avoid extremities, poorly vascularized regions, central if possible,
Term
cisplatin remedy for extravasation
Definition
sodium thiosulfate
Term
most likely female cancers by age
Definition
<20: leukemia, <60 breast, >60 lung
Term
pemetrexed role in stage III/IV lung cancer
Definition
maintenance or initial tx w/cisplatin for non-squamous NSCLC
Term
APL (promyelocytic acute leukemia) tx
Definition
add ATRA; causes tumor lysis syndrome so monitor for coaguolopathies
Term
1st line treatment for acute myeloid leukemia
Definition
&+3 cytarabine for 7 days, anthracycline (daunorubicin, idrarubicin, mitoxantrone) for 3 days
Term
5-FU alerts/toxicities
Definition
hepatic dysfunction
Term
2nd line tx for SCLC
Definition
topotecan; myelosuppression, caution in renal
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