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73 terms

ChemoMan

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Which anti-cancer may cause <color orange>M</color>yelosuppression
<color orange>M</color>ucositis
Pulmonary Fibrosis?
<color orange>MTX</color>
Which anti-neoplastic agent causes <color orange>M</color>ucositis & Hand-Foot Syndrome
<color orange>5-FU</color>
What can be used to tx Hand-Foot syndrome caused by 5-FU?
pyridoxine (Vit B6)
What can be used for mucositis caused by 5-FU?
ice chips
What can be used to treat MTX toxicity?
"Leucovorin Rescue" after 24 hrs
What can be used to ↑ 5-FU conc?
leucovorin
<color purple>C</color>NS-Neurotox, visual & personality Δ; Give steriods paralysis & alopecia
<color purple>Cytarabine</color>
cytarabine
(Ara-C)

Anti-metabolite: Pyrimidine Analog
* C = pyrimidine (C & T)
Which anti-cancer drugs req chest x-ray (CXR) & may cause pulmonary fibrosis.
Think <color blue>BlungB</color>

Busulfan
Bleomycin
Which anti-cancer agent can cause hyperpigmentation / Δ in nail bed & pulmonary fibrosis?
Think <color blue>BlungB</color>

Bleomycin
damages the pancreas resulting in IDDM (dose-limiting)
<color brown>Streptozocin</color>
What is streptozocin used to treat?
Treatment of metastatic islet cell carcinoma of the <color brown>pancreas</color>
Which anti-neoplastic agent causes
nephrotoxicity
hepatotoxicity
pulmonary fibrosis
<color green>carmustine</color>
Which drugs are used to treat ↑Ca++ of malignancy?
plicamycin
mitomycin
Which anti-neoplastic agent may cause hemolytic cystitis "dose-limiting"
<color pink>cyclophosphamide</color>
What can be used to pre-treat hemorrhagic cystitis caused by cyclophosphamide?
mesna
prehydrate
what are the metabolites to cyclophosphamide?
<color pink><b>acrolein</b></color>
4-aldophosphamide
4-hydroperoxycyclophosphamide
& nor-nitrogen mustard
Which anti-neoplastic agent causes altered mental status (psychosis)
Think <color pink> C </color> w/ cyclophosphamide that causes hemorrhagic cystitis

<color pink>ifosphamide</color>
peripheral neuropathy "dose-limiting"
<color grey>Vin<color red>c</color>ristine / Vin<color blue>b</color>lastine/Vinorelbine</color>

Vin<color red>C</color>ristine
<color red>C</color>NS
<color red>C</color>onstipation
causes <color red>SIADH</color>

Vin<color blue>B</color>lastine
<color blue>B</color>lood dyscrasia
<color blue>B</color>one Marrow Suppression
Which anti-neoplastic agent causes ↑ LFTs, cholinergic early/late onset of diarrhea
<color brown>irinotecan</color>
What can be used to treate early onset of diarrhrea caused by irinotecan?
atropine 1 mg
What can be used to tx late onset of diarrhea caused by irinotecan?
loperamide [no real max]
which onset of diarrhea, early or late, caused by irinotecan can be lethal?
late
Which anti-cancer medications are nephrotoxic?
Remember <color green>green Cs</color> on chemo Man near the kidneys - 2 platins + carmustine

<color green>cisplatin
carboplatin</color> (less nephortox than cisplatin)
<color green>carmustine</color>
What agent is used to reduce the incidence of moderate-to-severe xerostomia in patients undergoing postoperative radiation treatment for head and neck cancer, where the radiation port includes a substantial portion of the parotid glands?

What agents is used as pre-tx when a pt is on platinum anti-neoplastic agents?
amifostine

also hydrate pts

* amifostine is also used reduce the cumulative renal toxicity associated with repeated administration of cisplatin
Which agents causes cardiotoxicity (CHF)
- cause cardiomegaly → irreversible CHF

Liposomal forms = less toxic
<color red>daunorubicin
doxorubicin</color>
What can be used for pre-treatment to prevent cardiotoxicity caused by daunorubicin & doxorubicin?

or what cardioprotective drug can be given with daunorubicin & doxorubicin?
dexrazoxane (Zine<u>card</u>)

* <u>card</u>ioprotective
What chemo agents cause <color orange>alopecia</color>?
Think VIP CTC

Vinorelbine
Ifosfamide
Paclitaxel

Cyclophasphamide
Topatecan
Cytarabine
Which anti-neoplastic agent causes
OTOtoxicity
neurotoxicity
nephrotoxicity
light sensitivity
↓ electrolytes
Remember the C in the chemo man head

<color purple>cisplatin</color>
What is the BBW for Xeloda?
Severe DDI capecitabine + coumadin = ↑↑↑ INR & PT [Hand-Foot Syndrome]
Which chemo agent are red in color?
daunorubicin (also causes red-pink urine = normal)

doxorubicin
Which chemo agent causes Blue-green coloration: May cause urine, saliva, tears, and sweat to turn blue-green for 24 hours postinfusion; whites of eyes may have blue-green tinge?
<color blue>mitoxantrone</color>
What is the life time does of doxorubicin?
450 - 500 mg/m2
daunorubicin citrate (liposomal)
(DaunoXome)

Antineoplastic Agent: Anthracycline
daunorubicin <u>HCl</u>
(Cerubidine) ← inj [pwd & soln]

Antineoplastic Agent: Anthracycline
What is the lifetime dose of daunorubicin?
550 mg/m2

* has a higher cumulative lifetime dose than doxorubicin
doxorubicin
(Adriamycin, Doxil [liposomal]) ← both = inj

Antineoplastic Agent: Anthracycline
(Doxil)
doxorubicin liposomal

Antineoplastic Agent: Anthracycline
(Adriamycin)
doxorubicin

Antineoplastic Agent: Anthracycline
(Cerubidine)
daunorubicin <u>HCl</u>

Antineoplastic Agent: Anthracycline
(DaunoXome)
daunorubicin <u>citrate</u> (liposomal)

Antineoplastic Agent: Anthracycline
bleomycin
(Blenoxane)

Antineoplastic, Abx
(Blenoxane)
bleomycin

Antineoplastic, Abx
Which anti-neoplastic agent has a BBW for pulmonary fibrosis?
bleomycin

* busulfan, MTX, Carmustine != BBW but does cause
Which agent can cause interstitial pneumonitis (AE)?
bleomycin
Mitomycin is used for treatment of __________
adenocarcinoma of stomach/pancreas (treats hypyercalcemia caused by malignancy)
mitoxantrone
(Novantrone®)

Antineoplastic Agent: Anthracenedione
(Novantrone®)
<color blue>mitoxantrone</color>

Antineoplastic Agent: Anthracenedione
busulfan
(Myleran [tabs], Busulfex [inj])

Antineoplastic Agent: Alkylating Agent
Which anti-cancer agent has a BBW for bone marrow suppression?
busulfan

carboplatin

* Vinblastine causes bone marrow suppression
Both busulfan & bleomycin may cause pulmonary fibrosis but what is the difference?
busulfan (alkylating agent)
- ↑ uric acid (pt often placed on allopurinol)
- S/Sx = SOB
- BBW = bone marrow suppression
- PO & IV

bleomycin (antineoplastic, abx)
- BBW = pulmonary fibrosis
- inj only
(Myleran)
busulfan tabs

Antineoplastic Agent: Alkylating Agent
Which anti-neoplastic platinum agent is a better choice of drug in pts w/ kidney dysfcn?
carboplatin

cisplatin has BBW for renal toxicity
Both carboplatin & cisplatin are
available IV,
may cause nephrotox,
BBW = anaphylactic & experienced MD,
tx ovarian cancer & has off-label use w/ head & neck cancer, what is the difference?
carboplatin
- ototox = reversible
- BBW = vomiting, bone marrow suppression
- causes N/V if pre-tx w/ emetogenic

cisplatin
- ototox = permanent
- BBW = ototox, renal tox, med safety (max dose/cycle)
- requires tx of N/V b/f tx b/c it's a potent emotogenic drug
- neurotoxicity, light sensitivity, ↓ eletrolytes
Which agents are anti-neoplastic, platinum analog?
carbo<u>platin</u>
cis<u>platin</u>
oxali<u>platin</u> (Eloxatin)
Which anti-neoplastic, platinum analog has a BBW for ototoxicity, renal toxicity, anaphylaxis, max dose per cycle, experience physician?
cisplatin

* ALL platinum analog has BBW for anaphylaxis
amifostine
(Ethyol)

Adjuvant, Chemoprotective Agent (Cytoprotective); Antidote
(Ethyol)
amifostine

Adjuvant, Chemoprotective Agent (Cytoprotective); Antidote
What is the MOA of mesna?
Remember mesna is used to pre-tx pts taking cyclophasphamide to prevent hemorrhagic cystitis

MOA = binds to acrolein (cyclophosphamide metabolite)
Which anti-cancer drug may cause pulmonary fibrosis?
The B drugs

Bleomycin & busulfan
MTX
carmustine

* note docetaxel causes pulmonary <u>edema</u>
Which anti-cancer drugs on the chemo man has neurotoxicity?
Remember the 2 <color purple>C</color> as the ears

Cytarabine & cisplatin
What kind of tubing should be avoided w/ paclitaxel?
PVC
What should we worry abt when a pt is on paclitaxel & what should we do?
hypersensitivty rxn

Pre-tx w/ anti-emetic, benadryl, cimetadine & dexamethasone 8 mg BID x 5 days

<color red>Avoid</color> PVC tubing
What SE are seen with docetaxel?
fluid retention & pulmonary edema
What is used for pre-tx for pts on docetaxel?
dexamethasone 8 mg BID x 5 days

* same as paclitaxel
What are some pt education for pts on anti-cancer meds?
- maintain hydration (2 - 3 L/day)
- maintain nutrition (eat sm freq meals to ↓ N/V)
- Notify MD if persistent cough, sore throat, fever, sores on mucous membranes
- freq oral care (good hygiene)
- wear sunscreen
capecitabine
(Xeloda)

Anti-neoplastic Agent: Antimetabolite (Pyrimidine analog)
Which anti-neoplastic agents are pyrimidine analogs?
capecitabine
cytarabine
Which anti-neoplastic drugs may cause Hand-Foot Syndrome?
5-FU
capecitabine
Which anti-neoplastic agent causes red-pink urine?
daunorubicin
dexrazoxane
(Zinecard)

Cardioprotective use in pre-tx of daunorubicin & doxorubicin
(Zinecard)
dexrazoxane

Cardioprotective use in pre-tx of daunorubicin & doxorubicin
(Xeloda)
capecitabine

Anti-neoplastic Agent: Antimetabolite (Pyrimidine analog)