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Oncology II

Non-Specific Cell Cycle Cytotoxic Drugs: Anthracyclines

what is the MOA of anthracyclines? 1- intercalation into the DNA 2- inhibits topoisomerase II 3- creating free oxygen radical --> cell destruction
Which common side effect is associated with the use of anthracyclines? Cardiotoxicity
what types of anthracycline induced Cardiotoxicity? 1- cardiomyopathy ( the heart is enlarged and weak) 2- heart failure ( heart doesn't pump strong enough to meet the body needs)
What is the common RISK factor that causes anthracycline induced cardiotoxicity? the life time cumulative dose
Which anthracycline drug has the HIGHEST risk of inducing cardiotoxicity? doxorubicin
Which anthracycline drug has the highest risk of inducing extravasation? doxorubicin
Which chemoprotective drug is used in-conjunction with doxorubicin to prevent cardiotoxicity? Dexrazoxane ( zinecard)
which chemoprotective drug is used in conjucetion with doxorubicin to prevent extravasation? dexrazoxane ( totect)
Which anthracycline drug is NOT vesicants? liposomal doxorubicin
What are the 3 COMMON side effect of anthracycline drugs? (BBW) - myocardial toxicity - myelosuppression - 2nd malignancy
what is a unique BBW associated with the use of liposomal doxorubicin? infusion related reaction
Which anthracycline drug cause infusion- related reaction? liposomal doxorubicin
which anthracycline drug cause hand-foot syndrome ? liposomal doxorubicin
Which anthracycline is not considered vesicant? liposomal doxorubicin
Which anthracycline causes red urine discoloration? all except mitoxantrone ( blue)
What is the max cumulative life dose of doxorubicin? 450-550 mg/m2/ life time
which anthracycline drugs are NOT emetogenic ( low risk CINV)? - liposomal doxorubicin - mitoxantrone: irritant with vesicant like ( no n/v)
what is the CINV classification of anthracycline? moderate to high emetogenic
When is the use of anthracycline except mitoxantrone and liposomal doxorubicin is C/I? - pre- existing myocardial insufficiency - severe hepatic impairment
Which anthracycline associated with HIGH risk of heptotoxtocity? daunorubicin
which anthracycline associated with HIGH risk of renal impairment? daunorubicin and idarubicin
Which anthracycline the dose adjustment in hepatic impairment is NOT needed? valrubicin
List the common anthracycline drugs? - Rubicin: doxorubicin, daunorubicin, epirubicin, idarubicin, and valrubicin - liposomal rubicin: liposomal-doxorubicin anthracenedione: mitoxantrone
which anthracycline is give as bladder instillation ( given directly into the bladder through a urinary catheter)? valrubicin
How dose the pharmacist calculate the life time dose of doxorubicin? - dose mg/m2/cycle X # cycles = cumulative lifetime dose mg/m2 - max lifetime dose of doxorubicin is 450mg/m2-550mg/m2
what are some prophylactic considerations of using doxorubicin? - max lifetime dose 450-550mg/m2 - if the cumulative dose > 300 ---> use Dexrazoxane chemo-protectant ( Zinecard)
what are some common monitoring parameters if patient to receive doxorubicin? LVEF before and after
Created by: Smoham38



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