Liver toxicity. Reversible, but Liver fx should be monitored.
Examples of BRM?
Cytokines:
Interleukin-2
Alpha interferon
Topical agent:
Imiquimod (Aldara)
Interleukin AE?
Fluid retention
Skin changes
Kidney fx
Examples of antibodies
Herceptin
Trastuzumab
Rituximab
Bevacizumab
Cetuximab
Herceptin dose
LD= 8mg/kg followed by 2mg/kg weekly
or
LD= 8mg/kg followed by 6mg/kg q3 weeks
Antibody that can cause tumor lysis syndrome and fatal infusion rxns
Rituximab
Examples of enzyme inhibitors and receptors down regulators?
Anastrozole
Exemestane
Fulvestrant
Letrozole
Synthetic analog of progesterone used as additional hormonal treatment?
Megestrol
In case of extravasation use warm compression
Vinka alkLoids
Lomustine PO or IV?
PO
After infusion the urine may have a temporary blue-green tinting and sclera may turn blue
Mitoxantrone
Lifetime dose for epirubicin?
900mg/m2
Lifetime dose for doxarubicin and daunorubicin?
550mg/m2
Needs premed with phenytoin to prevent seizures?
Busulfan
Give dexamethasone ophthalmic to prevent conjunctivitis
Cytarabine
Tablet that converts to 5-FU
Capecitabine
Can cause hand and feet syndrome (palmar-plantar erythrodysethesias)?
5-FU
Folic acid increase or decrease the effect of MTX?
Decrease
Give dexamethasone ophthalmic to prevent conjunctivitis
Cytarabine
Avoid cold drinks or food during infusion due to spasm
Oxaliplatin
Fatal if given intrathecal
Vincristine
Do not PVC bag
Paclitaxel and docetaxel
Can cause pulmonary fibrosis and lifetime dose is 400units
Bleomycin
Rapid infusion causes HTN. Also increases coumadin INR
Etoposide
Drugs that can cause hemorrhagic cystitis
Cyclophosphamide and ifosfamide
Dose of Mesna to prevent hemorrhagic cystitis with Ifex
20% of ifex dose
Can cause kidney damage . So pre hydrate with K and Mg
Cisplatin
Given with leucovorin to increase it's activity
5-FU
How to diagnose colon polyps
CT colonography
FOBT
Colonoscopy
Risk factors for lung cancer
Smoking
Chronic lung disease
Asbestos
Radon
Fhx of lung cancer
Risk factors for colon cancer
Fhx
Age
Diet
Obesity
Smoking
Major colorectal cancer susceptibility syndromes are
Familial adenomatous polyposis(FAP)
Hereditary non- polyposis colorectal cancer (HNPCC)
Carcinogens highly associated with lung cancer
Benzopyrene
N-nitrosamine NNK
Most common type of noninvasive breast cancer
Ductal carcinoma in situ
Most common type of breast cancer
Infiltrating ductal carcinoma
Hypercalcemia in malignancy treatment
Pamidronate disodium
Zolendric acid
Given as CIV 1mg/ml infused > 1h
Cisplatin
Administered along with MTX to reduce anemia
Leucovorin
Fludarabine main side effect
Strong bone marrow suppressor
Given IV over 30 min
Gemcitabine
Given intravesical to treat small bladder papilloma
Mitomycin C
Can cause diarrhea and abdominal cramps (life threatening)
Irinotecan. Give loperamide 4mg first onset, 2mg q2hs until diarrhea free for 12h. Atropine 0.25-1mg IV for prophylaxis
Pre-med for paclitaxel
Decadron 20mgIV
Benadryl 50mg IV
Zantac 50mg IV
Risk factors for breast cancer in men
Fhx
Alcohol
Radiotherapy
Testicular abnormality or damage
Liver damage or dysfunction
Obesity
Klinefelter's syndrome
Prostate cancer risk factors
Fhx
Age
Race
Diet
Metabolic abnormalities of TLS
Hyperkalemia
Hyperuricemia
Hyperphosphatemia with secondary hypocalemia
TLS is seen more often in which kind of tumors?
Tumors with high growth factor and high sensitivity to chemo (burkitt lymphoma and T cell acute lymphoblastic leukemia)
Main types of lymphedema?
Primary and secondary
Class of drugs hepatically adjusted according to bilirrubin level
Vinca alkaloids
Antetabolites that can be given as IV push
MTX
5-FU
Cytarabine
Drugs with high emetic risk
AC combination
Carmustine > 250mg/ m2
Cisplatin >= 50
cyclophosphamide > 1500
Altretamine
Dacarbazine
Mechloretamine
Procarbazine
Streptozocin
Treatment for low risk emetic chemo
Metoclopramine +/- diphenhydramine or
Dexamethasone 12mg or
Prochlorperazine +/- lorazepam
Types of lung cancer
Small cell and non-small vell
Kinds of non-small lung cancer
Squamous cell carcinoma
Adenocarcinoma
Large cell carcinoma
Which of the non-small cell lung cancer is associated with rapid tumor growth and poor prognosis
Large cell carcinoma
Lung cancer that develop in the central region of the lungs
Squamous cell carcinoma
Advanced lung cancer symptoms
Persistent cough
Sputum streaked with blood
Chest pain
Voice change
Recurrent pneumonia or bronchitis
Common types of polyps
Adenomatous
Hyperplastic
Inflammatory
Lynch syndrome is also known as
Hereditary non-polyposis colorectal cancer
Dietary factors associated with decreased risk of colorectal cancer
Diet rixh in fruits and vegetables and calcium
Symptoms associated with advanced stages of colorectal cancer
Rectal bleeding
Blood in the stool
Change in bowel habits
Cramping pain in lower abdomen
What's the difference between in situ breast cancer and infiltrating
Insitu is confined to ducts and lobules of breast, while invasive spreads to the surrounding connective tissue
Breast cancer risk factors
Hx of breast cancer
Fhx
Age
Diet
Race
Radiation exposure
Reproductive and menstrual hx
Ptns thy impact cancer risk
Alpha-fetoprotein
hCG
Sumptoms of breast cancer in men
Painless lump in the breast
Nipple retraction, discharge or ulceration
Painful lump in the breast
Paget's disease (skin rash around nipple)
Majority of breast cancer in men is
Invasive ductal carcinoma and ER positive
Dietary factors associated with prostate cancer
Diet rich in dairy and meat are associated with higher risk
Diet rich in fish and tomato based products are associated with lower risk
Prostete cancer symptoms associated with late stage
Inability to pee
Discontinuous or weak urine flow
Frequent urination
Blood in urine
Pain or burning with urination
Continuous back, pelvis or upper thigh pain
Difficulty in starting or stopping urine flow
Monoclonal antibody used to treat of squamous cell carcinoma of Rhadamanthus and neck that can cause dermatological toxicity such as acne like rash, pruritus and nail changes