CPHON Review Chemotherapy Exam 93 Questions with Verified Answers
Cyclophosphamide - CORRECT ANSWER High doses should be preceded and followed by IV
... [Show More] hydration and mesna
Vincristine - CORRECT ANSWER Fatal if administered intrathecally
Busulfan - CORRECT ANSWER Prophylactic anticonvulsant therapy for patients receiving high doses
Busulfan - CORRECT ANSWER Requires PK studies
Temozolomide - CORRECT ANSWER Can only be mixed in applesauce or apple juice
Procarbazine - CORRECT ANSWER Hypertension and/or CNS depression may occur in the presence of alcohol, (MAO) inhibitors,phenothiazines, dilantin, tricyclic antidepressants, barbiturates and tyramine rich food (aged cheeses, wine, bananas, yogurt and chocolate)
Carboplatin - CORRECT ANSWER Nephrotoxicity and ototoxicity
Oxaliplatin - CORRECT ANSWER Avoid cold drinks/food during administration
Vincristine - CORRECT ANSWER Loss of deep tendon reflexes
Constipation
Jaw Pain
Paclitaxel - CORRECT ANSWER Premedicate with Benadryl, dexamethasone and an H2-receptor blocker
Etoposide - CORRECT ANSWER Monitor for hypotension
Irinotecan - CORRECT ANSWER Major side effect is diarrhea
Treat early onset diarrhea with atropine and late onset diarrhea with loperamide
Doxorubicin - CORRECT ANSWER Monitor cardiac function
Mitoxantrone - CORRECT ANSWER Turns urine green
Bleomycin - CORRECT ANSWER Can cause pulmonary fibrosis
Should never scuba dive
Methotrexate - CORRECT ANSWER Discontinue bactrim during high dose administration
Cytarabine - CORRECT ANSWER Administer steroid eye drops to prevent conjunctivitis with high IV doses
Gemcitabine - CORRECT ANSWER Infuse over 60 minutes - longer infusions linked with increased toxicity
Mercaptopurine - CORRECT ANSWER Take on an empty stomach - Do not take with dairy products
Fludarabine - CORRECT ANSWER Do not use at the same time as pentostatin as this can increase pulmonary toxicity
Clofarabine - CORRECT ANSWER Watch for capillary leak syndrome
Nelarabine - CORRECT ANSWER Closely monitor for neurological toxicity
Hydroyurea - CORRECT ANSWER Indicated for CML and Sickle Cell Disease
Retinotic Acids - CORRECT ANSWER For children who can not swallow capsules whole squeeze out the contents into a high fat food such as ice cream, peanut butter or safflower oil.
Asparaginase - CORRECT ANSWER Coagulation abnormalities place child at risk for thrombus formation or bleeding
Imatinib Mesylate - CORRECT ANSWER Indicated for Philadelphia + ALL
Take with food and a large glass of water
Thalidomide - CORRECT ANSWER Causes birth defects if given to a pregnant woman
Corticosteroids and Busulfan - CORRECT ANSWER Long term use associated with cataracts
Ifosfamide and Cyclophosphamide - CORRECT ANSWER Associated with Hemorrhagic Cystitis
Administer with fluids and mesna
Alkylating Agents - CORRECT ANSWER Cause abnormal hormonal function, delayed or absent puberty, subfertility or infertility and early menopause in young women
Epipodophyllotoxins - CORRECT ANSWER Increased risk for AML and MDS
Methotrexate and Cytarabine - CORRECT ANSWER Loss of neurocognitive function
Corticosteriods - CORRECT ANSWER Stunting of growth
Osteoporosis
Avascular necrosis
Anthracyclines - CORRECT ANSWER Cardiomyopathy and congestive heart failure
Cisplatin - CORRECT ANSWER Electrolyte replacement often required
Thiotepa - CORRECT ANSWER Bath 3-4 times a day when receiving this drug
Carboplatin and cisplatin - CORRECT ANSWER should not come in contact with aluminum
Asparaginase, Bleomycin and Teniposide - CORRECT ANSWER Have the potential for severe anaphylactic reaction
Always have emergency equipment and medications available
growth factor GM-CSF - CORRECT ANSWER Associated with the "first dose phenomenon"
Symptoms: flushing, rapid heart rate and hypoxia
GCSF - CORRECT ANSWER Side effects include joint pain, fever and rash
Erythropoietin - CORRECT ANSWER Can cause elevated blood pressure, headache, fever, muscle soreness and skin changes
Monoclonal Antibodies - CORRECT ANSWER Work by targeting specific cells and modifying these cells to effect cell death
Rituximab - CORRECT ANSWER Targets CD20 and used against non hodgkin lymphoma
Gemtuzumab ozogamicin - CORRECT ANSWER Targets CD33 and used against AML
Alemtuzumab - CORRECT ANSWER Targets CD52 and used against CLL
Daclizumab - CORRECT ANSWER Targets CD25 and used both for adult T cell leukemia and prophylaxis agaiinst renal transplant rejection
Pegfilgrastim (Neulasta) - CORRECT ANSWER What is the name of the pegylated form of granulocyte colony stimulating factor given once per cycle for patients > 40kg?
Intrathecal - CORRECT ANSWER Which route of chemotherapy is used to treat/prevent CNS leukemia?
Chemical Conjunctivitis - CORRECT ANSWER Steroid eye drops are given along with high dose cytrabine in order to prevent what adverse event?
Proton pump inhibitors (omeprazole)
NSAIDS (ibuprofen)
Sulfa (Bactrim) - CORRECT ANSWER Which medication (or class of medications) can cause prolonged excretion of high dose methotrexate?
Vinblastine - CORRECT ANSWER Unlike Vincristine, myelosuppression is a common side effect of which vinca alkaloid?
Mesna - CORRECT ANSWER Which medication binds the metabolite (acrolein) of ifosfamide and cyclophosphamide, thus preventing hemorrhagic cystitis?
Vincristine
Cyclophosphamide
Ifosfamide - CORRECT ANSWER Name 3 chemotherapy agents that cause SIADH
Magnesium - CORRECT ANSWER What supplement might be needed to be given because of depletion from cisplatin?
Carboplatin - CORRECT ANSWER Which chemotherapy agent is less nephrotoxic, less ototoxic, and less ematogenic than cisplatin, but is more myelosuppressive?
Vesicants - CORRECT ANSWER Which drugs can cause burning, pain and tissue necrosis if extravasated from a blood vessel?
Etoposide - CORRECT ANSWER Which drug needs to be prepared at a concentration of 0.4mg/ml because it can precipitate at higher concentrations?
It is a cardioprotectant - CORRECT ANSWER Why is dexrazoxane given with doxorubicn on some treatment regimens?
Leucovorin - CORRECT ANSWER What drug is given after methotrexate to prevent severe toxicity and rescue the cells?
Rapidly dividing cells - CORRECT ANSWER Chemotherapy has the most adverese effects on which type of cells?
The cell cycle - CORRECT ANSWER G1, S, G2, M and G0 are collectively referred to as ?
Mitosis and cell division - CORRECT ANSWER What happens during the M phase of the cell cycle?
Vinka alkaloids (vincristine, vinblastine and vinorelbine) - CORRECT ANSWER Which class of chemotherapy agents binds to tubulin, disrupts microtubules and causes mitotic arrest? They are M phase specific
Allopurinol - CORRECT ANSWER What medication decreases uric acid production by blocking xanthine breakdown?
5-HT3 receptor antagonists
(ondansetron/ granisetron) - CORRECT ANSWER Which class of drugs controls nausea and vomiting by blobking the serotonin effect of the vagal afferents and the chemotherapy zone?
Mercaptopurine, cytarabine, methotrexate and thioguanine - CORRECT ANSWER Anti - metabolites
Cell Cycle Specific - CORRECT ANSWER Are the anti-metabolites cell cycle specific or cell cycle nonspecific?
Delayed nausea and vomiting - CORRECT ANSWER What type of nausea and vomiting occurs more than 2 days after receiving chemotherapy?
Cardiac abnormalities and allergic reactions - CORRECT ANSWER What are 2 adverse effects of DMSO?
To destroy any remaining cancer cells
To provide immunosupression
To prepare space for the transplanted cells - CORRECT ANSWER What are the 3 purposes of the conditionng regimens used in bone marrow transplant?
Gemtuzumab (Mylotarg) - CORRECT ANSWER What is the name of the monoclonal antibody that may be used to treat AML?
Anticipatory nausea and vomiting - CORRECT ANSWER What is the conditioned response to receiving chemotherapy that can be managed by ativan or behavioral modification?
Headache - CORRECT ANSWER What is a common side effect of ondansetron?
Cisplatin - CORRECT ANSWER What is the most ematogenic agent?
Selective 5-HT3-receptor antagonist, blocking serotonin, both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone - CORRECT ANSWER What is the mechanism of action for Ondansetron?
Cyclosporin - CORRECT ANSWER Hirtuism is a side effect of which immunosuppressant?
sensorineural hearing loss - damage to the sensory hair cells in the inner ear - CORRECT ANSWER What type of hearing loss occurrs from chemotherapy agents?
Potassium - monitor for signs of hypokalemia (muscle weakness, cramping, drowsiness, ECG changes) - CORRECT ANSWER When administering amphotericin, which electrolyte should be monitored closely?
Rasburicase is a recombinant urate-oxidase enzyme, which converts uric acid to allantoin (an inactive and soluble metabolite of uric acid); it does not inhibit the formation of uric acid. - CORRECT ANSWER What does rasburicase do?
Uric acid levels need to be sent to the lab on ice immediately - CORRECT ANSWER When drawing labs in a patient receiving rasburicase, what special handeling is required?
Phase I - CORRECT ANSWER Determine the maximum tolerated dose of an investigational drug or combination of drugs
Identify dose-limiting toxicities
Phase II - CORRECT ANSWER Efficacy of a new agent in the treatment of specific types of cancer
Toxicity and dosage data
Phase III - CORRECT ANSWER To determine the value of a new agent in relation to existing treatments
Overall response, toxicity, survival and quality of life are examined
Phase IV - CORRECT ANSWER Involve post-marketing studies
Designed to answer questions regarding other uses or different doses and schedules of commercially available agents
Weight lifting - CORRECT ANSWER After receiving anthracyclines, what exercise should be avoided?
Treatment of diabetes insipidus
Control of bleeding in hemophilia A (with factor VIII levels >5%)
Mild to moderate type I von Willebrand disease thrombocytopenia
primary nocturnal enuresis - CORRECT ANSWER Desmopressin (DDAVP) is indicated for the treatment of the following:
SLAPP
S= Stop
L= Leave the needle
A = Aspirate as much as possible
P= Pull the needle
P= Provider notification - CORRECT ANSWER How do you manage an extravasation?
Kidney - CORRECT ANSWER Which organ needs to monitored closely when a patient is receiving amphotericin?
List Vesicants - CORRECT ANSWER Vincistine
Vinblastine
Doxorubicin
Daunorubicin
List Irritants - CORRECT ANSWER Carboplatin
Carmustine
Dacarbazine
Etoposide
Ifosfamide
Teniposide
5-Fluorouacil
Hydroyurea
Lomustine
Melphalan
Mercaptopurine
Procarbazine - CORRECT ANSWER Should be given on an empty stomach (1 hour before or 2 hours after eating)
Corticosteroids - CORRECT ANSWER Should be taken with food to avoid stomach upset
Retinoic acids - CORRECT ANSWER Should be administered with food to facilitate absorption [Show Less]