Solutions
____ is the most common dose-limiting adverse effect of
chemotherapy Correct Answer Myelosuppression
___% of Americans will contract cancer in their lifetimes
Correct Answer 38%
Angiogenesis Correct Answer Solid tumors create a new
capillary network to feed themselves; formation of new blood
vessels
Benign Correct Answer Slow growing, localized, rarely cause
death
Biologic Response Modifiers Correct Answer Drugs have
been developed that are identical or nearly identical to the
endogenous hormones and proteins that trigger differentiation of
hematopoietic stem cells
Biologic Response Modifiers (BRMs) Medications Correct
Answer Hematopoietic Agent- Epotein Alfa (Epogen, Procrit)
Colony Stimulating Factors- Filgrastim (Neupogen)
Platelet Enhancers- Romiplostim (Nplate)
Chemotherapy Correct Answer Systemic treatment
Non-specific cell destruction
The goal is to kill as many cancer cells as possible while sparing
as many normal cell as possible.
Given for cure, control, and palliation.
,Can be given via all routes.
Myelosuppression often limits the dose.
Chemotherapy Medications Correct Answer
Cyclophosphamide (Cytoxan)
Methotrexate (MTX)
Doxorubicin (Adriamycin)
Tamoxifen (Nolvadex)
Vincristine (Oncovin)
Chemotherapy will cause blood counts to decrease until they
reach their ___ Correct Answer Nadir (lowest point)
Cyclophosphamide (Cytoxan) Adverse Effects Correct Answer
Headache, N/V, anorexia, stomatitis, rash, fluid retention,
myelosuppression (can be a dose-limiting toxicity), alopecia
(50% total baldness), jaundice, acne, blistered, darkened, or
thickened skin; associated with increased risk of secondary
malignancies, cardiotoxicity, pulmonary fibrosis
Causes hemorrhagic cystitis- can be life-threatening.
Med should always be given with increased fluids, urine dipstick
monitoring and a bladder-protectant drug (Mesna)
Cyclophosphamide (Cytoxan) Contraindications Correct
Answer Pregnancy, lactation, severe myelosuppression, recent
steroid use, caution with renal or hepatic impairment.
Cyclophosphamide (Cytoxan) Drug Interactions Correct
Answer Other drugs with hepatic metabolism, additive
immunosuppressive effects with other agents that cause bone
, marrow toxicity, increases anticoagulation effect with other
anticoagulants, St. John's Wort may increase the toxic effects.
Cyclophosphamide (Cytoxan) Indications Correct Answer
Alkylating Agent
Cell cycle non-specific drug
Very broad spectrum of action; approved in combination with
other antineoplastics
Treats Hodgkin's and NHL, leukemia, ovarian, breast, multiple
myeloma, neuroblastoma, sarcomas and others
Off-label uses are many, immunosuppressive indications for
prophylaxis of organ transplant rejection, nephrotic syndrome,
severe rheumatoid arthritis, lupus, and scleroderma
Cyclophosphamide (Cytoxan) Reproduction Warning Correct
Answer May cause sterility in both males and females; very
dangerous during pregnancy
Cyclosporine (Sandimmune) Adverse Effects Correct Answer
Primary adverse effect is nephrotoxicity; up to 75% of patients
experience a reduce in urine flow
Over half of the patients will experience HTN and tremor
Other common adverse effects are elevated hepatic enzymes,
mild to moderate HTN, headache, and gingival hyperplasia
Infections are common during treatment, including reactivation
of herpes or varicella
Anaphylaxis reported with IV administration
Long-term therapy increases the risk of cancer
Cyclosporine (Sandimmune) Black Box Warning Correct
Answer Only administered by PCP with experience with