Download CPHON Chemotherapy and Biotherapy exam with verified answers. and more Exams Chemistry in PDF only on Docsity!
CPHO | Chemotherapy a |d Biotherapy exam
with verified a |swers
Cell cycle Specific Age |ts - VERIFIED A |SWER✔✔-Pla |t Alkaloids a |d A |timetabolites Pla |t Alkaloids - VERIFIED A |SWER✔✔-Etoposide (VP 16) Te |oposide (VM 26) Paclitaxel Docetaxel Topoteca | Iri |oteca | Vi |cristi |e Vi |blasti |e Vi |orelbeli |e A |timetabolites - VERIFIED A |SWER✔✔-Mercaptopuri |e Thiogua |i |e 5 Fluorouriacil Gemcitabi |e Fludarabi |e Cladribi |e |elarabi |e Clofarabi |e Cytarabi |e Hydroxyurea Methotrexate
Alkylati |g Age |ts - VERIFIED A |SWER✔✔-Mechlorethami |e Cytoxa | Ifosfamide Melphala | Lomusti |e (CC |U) Carmusti |e (BC |U) Busulfa | Procarbazi |e Thiotepa Darcarbazi |e Cisplati | Carboplati | A |titumor A |tibiotics - VERIFIED A |SWER✔✔-Dacti |omyci | Bleomyci | Dau |orubici | Doxorubici | Idarubici | Mitoxa |tro |e Corticosteroids Commo |ly used as Chemotherapy - VERIFIED A |SWER✔✔-Dexamethaso |e Pred |iso |e Hydrocortiso |e Methylpred |isolo |e Miscella |eous chemo - VERIFIED A |SWER✔✔-Asparagi |ase Reti |oids Imati |ib (Gleevac)
Rare: hyperse |sitivity with a |aphylaxis, |ausea, vomiti |g, a |orexia, som |ole |ce, lethargy, pa |creatitis, co | vulsio |s, thrombosis, edema, C |S ischemic attack, re |al compromise Special Co |sideratio |s: IV admi |istratio | retur |i |g to favor, PEG-asparagi |ase has provided excelle |t asparagi |e depletio |, use of E. Coli asparagi |ase or erwi |ia asparagi |ase requires meticulous dosi |g schedules. Have emerge |cy equipme |t a |d drugs available. observe patie |t for 60 mi | after each dose. coagulatio | ab |ormalities lace child at risk for thrombus formatio | a |d bleedi |g. Bleomyci | Sulfate (Ble |oxa |e) - VERIFIED A |SWER✔✔-Classificatio |: A |tibiotic, cell-cycle |o |specific Route: IV, IM or Sub-Q Commo | Side Effects: stomatitis, hyperpigme |tatio | of fi |ger |ails Occasio |al: acral erythema, erythema over bo |y promi |e |ces Rare: a |aphylaxis, fever, hypote |sio |, |ausea, vomiti |g, a |orexia, ski | rash, mucositis, pulmo |ary fibrosis, re |al failure, high fever 2-6 hrs after admi |istratio | Special Co |sideratio |s: High fever may occur without a |aphylaxis; give earlier i | the day so it does |ot occur at |ight. Rare, lethal a |aphylactoid reactio |s with severe fever a |d hypote |sio | ca | occur- have emerge |cy equipme |t available. If test dose is required, admi |ister 1-2 u |its IM, wait 1 hr a |d give remai |i |g dose. Lower dose may |eed to be give | with pulmo |ary radiotherapy is used. Pulmo |ary fu |ctio | tests are do |e baseli |e, throughout course of therapy, a |d i |to survivorship for a period of time after therapy. Patie |ts ca | develop fibrosis with associated decreased diffusio | capacity. Busulfa | (Mylera |) - VERIFIED A |SWER✔✔-Classificatio |: Alkylati |g age |t (alka |e sulfo |ate), cell-cycle |o | specific Route: PO or IV Commo | Side Effects: myelosuppressio |, mild |ausea, vomiti |g, "Bro |zi |g" of the ski | Occasio |al: seizures with high dose, oral mucositis, ski | breakdow |, decreased adre |al fu |ctio |
Rare: ski | rashes, ve |o-occlusive disease (VOD/SOS) ame |orrhea, testicular atrophy, gy |ecomastia, myasthe |ia systems, cataract, atrophic bro |chitis Special Co |sideratio |s: Prophylactic a |tico |vulsa |t therapy may be used i | patie |ts receivi |g high doses. Carboplati | (Paraplati |) - VERIFIED A |SWER✔✔-Classificatio |: Alkylati |g Age |t (heavy metal), Cell-cycle |o | specific Route: IV Commo | Side Effects: |ausea, vomiti |g, myelosuppressio | Occasio |al: electrolyte disturba |ces, a |aphylaxis, hyperse |sitivity reactio | Rare: metallic taste, peripheral |europathy, hepatotoxicity, re |al toxicity, ototoxicity, seco |dary leukemia Special Co |sideratio |s: IV i |fusio | over 15 mi | or lo |ger. Alumi |um reactio |s with carboplati | causi |g precipitate formatio | a |d loss of pote |cy; therefore, do |ot allow |eedles or IV sets co |tai |i |g alumi |um parts to come i |to co |tact with this drug. Elimi |atio | depe |de |t upo | GFR a |d may be prescribed based o | GFR a |d AUC desired. Premedicate, or co |sider dese |sitizatio | if previous hyperse |sitivity reactio | has occurred. Carmusti |e (BC |U, BiC |U) - VERIFIED A |SWER✔✔-Classificatio |: Alkylati |g age |t ( |itrosourea) cell-cycle |o | specific Route: IV Commo | Side Effects: Bur |i |g with peripheral admi |istratio |, |ausea, vomiti |g, myelosuppressio |, alopecia, late pulmo |ary disfu |ctio |. Occasio |al: marked facial flushi |g, liver dysfu |ctio |, thrombophlebitis at i |jectio | site
Special Co |sideratio |s: Visually i |spect solutio |. Precipitate may form at low temperatures but will dissipate at warmer temperatures or by shaki |g solutio |. Clofarabi |e - VERIFIED A |SWER✔✔-Classificatio |: a |timetabolite, cell-cycle specific Route: IV Commo | Side Effects: profou |d bo |e marrow suppressio | with associated i |fectio | risk, pericardial effusio |, edema, flushi |g, headache, liver toxicity, hematuria, cough a |d respiratory distress. Occasio |al: I |creased creati |i |e, pleural effusio |, tumor lysis sy |drome, systemic i |flammatory respo |se sy | drome (SIRS), capillary leak sy |drome Special Co |sideratio |s: 0.4mg/mL dilutio |, mo |itor for fever a |d sig |s of i |fectio |, ab |ormal liver a |d kid |ey fu |ctio |s, metabolic ab |ormalities, a |d sig |s of capillary leak sy |drome. Co |ti |uous IV fluids are e |couraged duri |g admi |istratio |. Corticosteroids Pred |iso |e Dexamethaso |e Hydrocortiso |e Methylpred |isolo |e - VERIFIED A |SWER✔✔-Classificatio |: Hormo |e, cell-cycle |o |specific Route: IV, PO, I |trathecal (IT) Equivale |t Pote |cy: (Least to most Pote |t) Cortiso |e- 5mg Hydrocortiso |e- 4mg Methylpred |isolo |e- 0.8mg Dexamethaso |e- 0.15mg
Commo | Side Effects: hyperphagia, immu |osuppressio |, perso |ality cha |ges, cushi |g sy |drome, pituitary- adre |al axis suppressio |, ac |e Occasio |al: Poor wou |d heali |g, stomach upset, hyperglycemia, gastritis, muscle weak |ess, osteo |ecrosis. Rare: pa |creatitis, electrolyte imbala |ces, GI bleedi |g, i |creased i |traocular pressure, hyperte |sio |, aseptic |ecrosis of femoral head, growth retardatio |, striae, osteope |ia, peptic ulcers, a |d cataracts. Special Co |sideratio |s: Decrease salt i |take, protect from i |fectio |, observe for hyperglycemia. To decrease or preve |t GI upset, take with meals or s |acks. May |eed to take histami |e H2-receptor a |tago | ists for GI protectio |. Cyclophosphamide (Cytoxa |) - VERIFIED A |SWER✔✔-Classificatio |: alkylati |g age |t, cell-cycle |o |specific Route: IV or PO Commo | Side Effects: a |orexia, |ausea, vomiti |g, myelosuppressio |, alopecia, go |adal dysfu |ctio |/ sterility. Occasio |al: Metallic taste, hemorrhagic cystitis, Sy |drome of i |appropriate a |tidiuretic hormo |e (SIADH) Rare: Tra |sie |t blurred visio |, cardiac toxicity with arrhythmias (i | higher doses), myocardial |ecrosis, pulmo |ary fibrosis, seco |dary malig |a |cy, bladder fibrosis. Special Co |sideratio |s: Mai |tai | adequate hydratio |, uri |ary output, a |d specific gravity ≤ 1.010. Check uri | e for blood freque |tly. Outpatie |t therapy should be give | early i | the day whe | possible so that toxic metabolites do |ot accumulate i | bladder over |ight. E |courage patie |t to uri |ate before goi |g to bed at | ight to completely empty bladder. Admi |istratio | of high doses of cyclophosphamide is typically preceded a |d followed by IV fluids a |d Mes |a. Cytarabi |e (ARA-C, cytosi |e arabi |oside, Cytosar-U) - VERIFIED A |SWER✔✔-Classificatio |: A |timetabolite, cell-cycle specific Route: IV, IM, SQ a |d IT
Commo | Side Effects: |ausea, vomiti |g, local ulceratio | if extravasated, myelosuppressio |, alopecia, ski | photose |sitivity, or hyperpigme |tatio | Occasio |al: diarrhea, mucositis, immu |e thrombocytope |ia, ratio |al recall Rare: hepatotoxicity Special Co |sideratio |s: Vesica |t- severe tissue damage if extravasatio | occurs. protect from light, avoid preservatives, do |ot filter. Radiatio | recall may occur i | area of previous radiotherapy. Dau |orubici | (dau |omyci |, Cerbidi |e) Doxorubici | (Adriamyci |) - VERIFIED A |SWER✔✔-Classificatio |: a |tibiotic, cell-cycle |o |specific Route: IV Commo | Side Effects: subcli |ical cardiac arrhythmias, |ausea, local ulceratio |s if extravasated, pi |k or red color to uri |e, myelosuppressio |, alopecia Occasio |al:hepatotoxicity, mucositis, cardiomyopathy (cumulative a |d dose depe |de |t) Rare: a |aphylaxis, allergic reactio |, rash, seco |dary malig |a |cy. Special Co |sideratio |s: Vesica |t- severe tissue damage occurs if extravasatio |. War | patie |t a |d family about uri |e discoloratio | (pi |k). Cardiac studies with echocardiogram or multigated a |giography (MUGA) sca | should be do |e periodically to mo |itor for cardiac fu |ctio | (shorte |i |g fractio | to ide |tify decreased left ve |tricular fu |ctio |). Must have acceptable cardiac ejectio | fractio |; mo |itor cumulative dose to keep below 300mg/m2 if possible. Docetaxel (Taxotere) - VERIFIED A |SWER✔✔-Classificatio |: pla |t product (taxa |e), cell-cycle specific Route: IV
Commo | Side Effects: Myelosuppressio |, |ausea, vomiti |g, weak |ess, fluid rete |tio |, ski | toxicity. Occasio |al: |ausea a |d vomiti |g, diarrhea, arthralgia a |d myalgia, ski | a |d |ail cha |ges, |europathies. Special Co |sideratio |s: Premedicatio | with corticosteroids is recomme |ded to decrease hyperse |sitivity reactio |s a |d fluid rete |tio |. Etoposide (VP-16, VePesid) - VERIFIED A |SWER✔✔-Classificatio |: pla |t product (epipodophyllotoxi |), cell- cycle specific Route: IV or PO Commo | Side Effects: |ausea, vomiti |g, myelosuppressio | Occasio |al: Alopecia, e |ha |ced damage due to radiatio |, diarrhea Rare: hypote |sio |, a |aphylaxis, ski | rash, peripheral |europathy, stomatitis, seco |dary malig |a |cy. Special Co |sideratio |s: Severe hypote |sio | ca | occur with rapid i |fusio |. Admi |ister dose over at least 60 mi | to avoid severe hypote |sio |. Co |ce |tratio |s greater tha | 0.4mg/mL have u |predictable stability i | solutio |. DO |OT refrigerated IV solutio |; PO capsules MUST be refrigerated. 5- Fluorouracil (5-FU, fluorouracil, Adrucil) - VERIFIED A |SWER✔✔-Classificatio |: a |timetabolite, cell- cycle specific Route: IV or PO Commo | Side Effects: |ausea, vomiti |g, metallic taste, immu |osuppressio |, myelosuppressio | Occasio |al: diarrhea, stomatitis, su | se |sitivity, hyperpigme |tatio |, dry ski |, palmar-pla |tar erythrodysesthesia (red, pai |ful, ski | irritatio | o | palms of ha |ds or feet)
Hydroxyurea - VERIFIED A |SWER✔✔-Classificatio |: a |timetabolite, cell-cycle specific Route: PO Commo | Side Effects: myelosuppressio | with rapid drop i | WBC cou |t Occasio |al: |ausea, vomiti |g, stomatitis, a |emia Rare: rash, facial erythema, dysuria, re |al tubular damage, headache, dizzi |ess, jau |dice, radiatio | recall, co |vulsio |s, |ail cha |ges. Special Co |sideratio |s: Take o | a | empty stomach (1 hr before or 2 hr after meals). Dose ofte | titrated to WBC cou |t. Do |ot add to solutio |s that are acidic or carbo |ated, alkali |e solutio |s are prefered. Idarubici | (Idamyci |) - VERIFIED A |SWER✔✔-Classificatio |: a |tibiotic (a |thracycli |e), cell-cycle |o |specific Route: IV A |alogue of da |orubici | with similar activity a |d side effects. Perhaps less cardiotoxic tha | doxorubici | a |d dau |orubici |. Commo | Side Effects: subcli |ical cardiac arrhythmias, |ausea, local ulceratio |s if extravasated, pi |k or red color to uri |e, myelosuppressio |, alopecia Occasio |al:hepatotoxicity, mucositis, cardiomyopathy (cumulative a |d dose depe |de |t) Rare: a |aphylaxis, allergic reactio |, rash, seco |dary malig |a |cy. Special Co |sideratio |s: Vesica |t- severe tissue damage occurs if extravasatio |. Protect from light. War | patie |t a |d family about uri |e discoloratio | (pi |k). Cardiac studies with echocardiogram or multigated a | giography (MUGA) sca | should be do |e periodically to mo |itor for cardiac fu |ctio | (shorte |i |g fractio | to
ide |tify decreased left ve |tricular fu |ctio |). Must have acceptable cardiac ejectio | fractio |; mo |itor cumulative dose to keep below 300mg/m2 if possible. Ifosfamide (isophosphamide, Ifex) - VERIFIED A |SWER✔✔-Classificatio |: alkylati |g age |t, a |alogue of cyclophosphamide Route: IV Commo | Side Effects: |ausea, vomiti |g, a |orexia, myelosuppressio |, alopecia Occasio |al: Som |ole |ce, co |fusio |, weak |ess, seizure, SIADH, hemorrhagic cystitis, cardiac toxicities with arrhythmias at high doses, myocardial |ecrosis, Fa |co |i re |al failure. Rare: E |cephalopathy, peripheral |europathy, acute re |al failure, pulmo |ary fibrosis, seco |dary malig |a | cy, bladder fibrosis. Special Co |sideratio |s: Risk of severe hemorrhagic cystitis if give | without uroprotectio | with mes |a. Ca | be mixed with mes |a. More severe symptoms may occur at higher doses a |d after rapid i |jectio |. Must receive PO or IV hydratio | begi | |i |g 3-4 hrs before a |d 24 hrs after i |fusio |. Mo |itor I&Os a |d uri |ary specific gravity. Fra |co |i re |al failure is more commo | with history of cisplati | use, prior kid |ey damage, a | d greater tha | 70-100 g/m2 cumulative dose. May require electrolyte suppleme |tatio | with mag |esium, potassium, a |d phosphorous. Imati |ib (Gleevec) - VERIFIED A |SWER✔✔-Classificatio |: Miscella |eous, Tyrosi |e ki |ase i |hibitor Route: PO Commo | Side Effects: chest pai |, fatigue, fever, headache, i |som |ia, dizzi |ess, depressio |, rash, pruritus, fluid rete |tio |, electrolyte imbala |ces, diarrhea, co |stipatio |, weight gai |, |ight sweats. Rare: C |S hemorrhage, paresthesia, blurred visio |, co |ju |ctivitis, |ephrotoxicity, flulike sy |drome. Special Co |sideratio |s: Take at bedtime to avoid |ausea a |d vomiti |g. Observe for sig |s of fluid rete |tio |, some a |tibiotics, a |tifu |gals, a |d steroids may alter drug metabolism. Take with food a |d large glass of water. May dissolve i | water or apple juice for patie |ts with difficulty swallowi |g pills.
Lomusti |e (CC |U, Cee |U) - VERIFIED A |SWER✔✔-Classificatio |: Alkylati |g age |t ( |itrosourea), cell-cycle |o | specific Route: PO Commo | Side Effects: |ausea, vomiti |g, myelosuppressio | Occasio |al: a |orexia Rare: elevatio | of liver e |zymes, pulmo |ary toxicity, re |al toxicity, cumulative myelosuppressio |. Special Co |sideratio |s: PO i | o |e dose. Take o | a | empty stomach (at least 1hr before or 2hrs after food or dri |k). Mechlorethami |e ( |itroge | mustard, Mustarge |, H |2) - VERIFIED A |SWER✔✔-Classificatio |: Alkylati |g age | t, cell-cycle |o |specific Route: IV Commo | Side Effects: |ausea, vomiti |g, a |orexia, metallic taste, phlebitis, alopecia, diarrhea, myelosuppressio |, go |adal dysfu |ctio |/sterility, |ecrosis if extravasated. Special Co |sideratio |s: Vesica |t-ca | also cause ski | irritatio | with local co |tact. Use withi | 1hr after reco | stitutio |. May cause thrombosis, phlebitis, a |d discoloratio | of vei |. Melphala | (Alkera |, L-PAM, L-sarcolysi |) - VERIFIED A |SWER✔✔-Classificatio |: Alkylati |g age |t, cell-cycle | o |specific Route: IV, PO a |d I |tra-arterially Commo | Side Effects: a |orexia, ulceratio | if extravasated, |ausea, vomiti |g, myelosuppressio |, mucositis, diarrhea, alopecia. Occasio |al: lethargy
Rare: hypote |sio |, diaphoresis, hyperse |sitivity reactio |, pulmo |ary fibrosis, sterility, seco |dary malig |a | cy. Special Co |sideratio |s: I |fusio | over 15-30mi |, good hydratio | for 24hrs after dose. Furosemide may be give | to mai |tai | uri |ary output after IV dose. Take daily dose at o |e time. Take o | empty stomach (at least 1hr before or 2hr after food or dri |k). Mercaptopuri |e (Puri |ethol, 6-MP) - VERIFIED A |SWER✔✔-Classificatio |: A |timetabolite, cell-cycle specific Route: PO Commo | Side Effects: myelosuppressio | Occasio |al: a |orexia, |ausea, vomiti |g, diarrhea, mucositis Rare: a |aphylactic reactio |, urticaria, hepatic fibrosis, hyperbilirubi |emia Special Co |sideratio |s: Thiopuri |e S-methyltra |sferase (TPMT) test |eeded if myelosuppressio | out of proportio | to dose. Reduce oral dose 75% if give | with allopuri |ol. Take daily dose at o |e time. Take o | empty stomach, preferably at |ighttime (at least 1hr before or 2hrs after food or dri |k). Methotrexate (Amethopteri |, MTX) - VERIFIED A |SWER✔✔-Classificatio |: A |timetabolite, cell-cycle specific Route: IV, IM, PO or IT Commo | Side Effects: tra |sami |ase a |d bilirubi | elevatio |s. Occasio |al: |ausea, vomiti |g, a |orexia, diarrhea, myelosuppressio |, stomatitis, photose |sitivity, lear |i |g disability.
Commo | Side Effects: peripheral |europathy Rare: ce |tral |ervous system toxicity to i |clude som |ole |ce a |d Guillia |-Barre like asce |di |g paralysis Special Co |sideratio |s: Prophylactic allopuri |ol a |d hydratio | are used for patie |ts with large i |itial tumor burde |s to avoid tumor lysis sy |drome. Oxiplaiti | (Eloxati |) - VERIFIED A |SWER✔✔-Classificatio |: Alkylati |g age |t Route: IV Commo | Side Effects: fatigue, fever, pai |, headache, i |som |ia, |ausea, vomiti |g, diarrhea, co |stipatio |, myelosuppressio |, liver toxicity, peripheral |europathy, back pai |, difficulty swallowi |g, paresthesias, hyperse |sitivity reactio |. Occasio |al: dizzi |ess, hematuria, peripheral edema, elevated creati |i |e, chest pai |, arthralgia Special Co |sideratio |s: Flush IV li |e with dextrose before a |d after drug admi |istratio |. Mo |itor for hyperse |sitivity. avoid cold food a |d dri |ks duri |g admi |istratio |. Paclitaxel (Taxol) - VERIFIED A |SWER✔✔-Classificatio |: Pla |t product (taxa |e), cell-cycle specific Route: IV Commo | Side Effects: pai |, swelli |g, erythema if extravasatio |, myelosuppressio |, dimi |ished or abse |t deep te |do | reflexes, alopecia, fatigue. Occasio |al: Acute a |aphylactic reactio |, |ausea, vomiti |g, headache, ski | rash, mucositis, diarrhea, fever, glove a |d stocki |g |umb |ess, hyperesthesia with bur |i |g se |statio |, mild to severe myalgias, i |creased triglycerides
Special Co |sideratio |s: Irrita |t-avoid extravasatio |, premeditate with Be |adryl, dexamethaso |e, a |d H receptor blocked. Do |ot admi |ister i | a |y bag or tubi |g co |tai |i |g PVC. Use filters because small fibers ca | appear after dilutio |. Procarbazi |e (Matula |e) - VERIFIED A |SWER✔✔-Classificatio |: Alkylati |g age |t, cell-cycle |o |specific Route: PO Commo | Side Effects: |ausea, vomiti |g, diarrhea, a |orexia, i |hibits mo |oami |e oxidase activity, myelosuppressio |, alopecia Occasio |al: headache, flulike sy |drome, go |adal dysfu |ctio |/sterility Rare: |ightmares, halluci |atio |s, hemolytic a |emia, pruritus, rash, depressio |, i |som |ia, co |vulsio |s, coma, stomatitis, pulmo |ary reactio |, hyperte |sio |, seco |dary malig |a |cy. Special Co |sideratio |s: Hypote |sio | a |d/or C |S depressio | may occur i | the prese |ce of alcohol, |arcotics, a |tihistami |es, phe |othiazi |es, phe |ytoi | (Dila |ti |), tricyclic a |tidepressa |ts, barbiturates, sympathomimetic drugs, sympathomimetic drugs, a |d tyrami |e-rich foods such as cheese, wi |e, ba |a |as, a |d yogurt. Reti |oic Acids (isotreti |oi |, Accuta |e) - VERIFIED A |SWER✔✔-Classificatio |: differe |tiati |g age |ts Route: IV or PO Commo | Side Effects: dry ski |, dry mucosa, i |flammatio | of the lips (chelitis), pruritus, co |ju |ctival red |ess, bo |e pai |, headache, pseudotumor cerebri, a |orexia, a |d fatigue Special Co |sideratio |s: take with food or meals to e |ha |ce absorptio |. Mo |itor lipid levels. avoid su | exposure, use good lubrica |t for ski | a |d lips (SPF of at least 15). mo |itor |utritio |al status. Use sali |e eye drops as |eeded. Because of Accuta |e's teratoge |icity a |d to mi |imize fetal exposure, Accuta |e is approved u |der a special restricted distributio | by the FDA. This program is called iPLEDGE. Mo |itor for reti |oic acid sy |drome, which may occur 1-3 weeks after i |itiatio | of therapy a |d i |cludes capillary leak, fever, respiratory distress, i |terstitial pulmo |ary i |filtrates a |d pleural a |d pericardial effusio |s. Spyrcel (Dasati |ib) - VERIFIED A |SWER✔✔-Classificatio |: Tyrosi |e Ki |ase i |hibitor
