ONS Chemotherapy Immunotherapy Certificate Exam
Questions/Answer Graded A+ 2025/2026
Common platinum-based agents: - Cisplatin (Platinol)
Carboplatin (Paraplatin)
What is unique about nitrosoureas agents? - Able to cross the blood-brain barrier; can
be effective in treating some brain tumors
Common nitrosoureas agents: - Carmustine (BiCNU)
Lomustine (CeeNu)
Streptozocin (Zanosar)
Hypersensitivity can occur with late doses of: - Carboplatin
These agents are typically categorized as highly emetogenic: - 1. Alkylating agents
2. Nitrosoureas
Pre-administration labs for alkylating agents and nitrosoureas: - BUN
Creatinine
CBC w/ diff
What is the medication Mesna used for? - Bladder protectant with administration of
cyclophosphamide or ifosfamide
Instruct pts receiving ________ to avoid exposure to cold air and consuming cold fluids
for 3-4 days following treatment - Oxaliplatin
How do antimetabolites function? - By blocking DNA and RNA growth by interfering with
enzymes needed for normal cell metabolism
Antimetabolites work in the ___ phase. - S
Common side effects of antimetabolites: - Myelosuppression
GI toxicities
Photosensitivity
Hand-foot syndrome
Common antimetabolite drugs: - Azacitidine
Capecitabine
5-FU
Cytarabine
Decitabine
Methotrexate
, The institute for Safe Medication Practices recommends what route of administration for
vincristine? - IV piggyback via gravity
Anthracycline antitumor abx work by: - Interfering with enzymes necessary for DNA to
replicate in ALL phases of the cell cycle
The two major classifications of antitumor antibiotics are: - Anthracyclines
Non-anthracyclines
Common anthracycline antitumor abx: - Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
The antitumor abx ___________ is not an anthracycline, but has anthracycline-type
properties. - Mitoxantrone
Common non-anthracycline antitumor abx: - Actinomycin D
Mitomycin C
Bleomycin
Monitoring necessary with doxorubicin: - Vesicant --> extravasation
Cardiac function
Lifetime dose tracking (cardiotoxicity)
Lifetime dose of doxorubicin should not exceed: - 550 mg/m^2
What cardiac protectant medication can be administered prior to doxorubicin? -
Dexrazoxane
Significant side effects of doxorubicin are: - Cardiotoxicity
N/V
Mucositis
Diarrhea
Severe myelosuppression
Hepatic impairment
Secondary cancers
Monitoring necessary with bleomycin: - Pulmonary toxicity
Hypersensitivity reactions (esp. in lymphoma patients)
Cutaneous reactions
Lifetime dose tracking (pulmonary toxicity)
Pulmonary fibrosis is possible when the lifetime dose of bleomycin exceeds: - 400 units
What 6 patient characteristics make CINV more likely? - 1. Younger than 50 years
Questions/Answer Graded A+ 2025/2026
Common platinum-based agents: - Cisplatin (Platinol)
Carboplatin (Paraplatin)
What is unique about nitrosoureas agents? - Able to cross the blood-brain barrier; can
be effective in treating some brain tumors
Common nitrosoureas agents: - Carmustine (BiCNU)
Lomustine (CeeNu)
Streptozocin (Zanosar)
Hypersensitivity can occur with late doses of: - Carboplatin
These agents are typically categorized as highly emetogenic: - 1. Alkylating agents
2. Nitrosoureas
Pre-administration labs for alkylating agents and nitrosoureas: - BUN
Creatinine
CBC w/ diff
What is the medication Mesna used for? - Bladder protectant with administration of
cyclophosphamide or ifosfamide
Instruct pts receiving ________ to avoid exposure to cold air and consuming cold fluids
for 3-4 days following treatment - Oxaliplatin
How do antimetabolites function? - By blocking DNA and RNA growth by interfering with
enzymes needed for normal cell metabolism
Antimetabolites work in the ___ phase. - S
Common side effects of antimetabolites: - Myelosuppression
GI toxicities
Photosensitivity
Hand-foot syndrome
Common antimetabolite drugs: - Azacitidine
Capecitabine
5-FU
Cytarabine
Decitabine
Methotrexate
, The institute for Safe Medication Practices recommends what route of administration for
vincristine? - IV piggyback via gravity
Anthracycline antitumor abx work by: - Interfering with enzymes necessary for DNA to
replicate in ALL phases of the cell cycle
The two major classifications of antitumor antibiotics are: - Anthracyclines
Non-anthracyclines
Common anthracycline antitumor abx: - Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
The antitumor abx ___________ is not an anthracycline, but has anthracycline-type
properties. - Mitoxantrone
Common non-anthracycline antitumor abx: - Actinomycin D
Mitomycin C
Bleomycin
Monitoring necessary with doxorubicin: - Vesicant --> extravasation
Cardiac function
Lifetime dose tracking (cardiotoxicity)
Lifetime dose of doxorubicin should not exceed: - 550 mg/m^2
What cardiac protectant medication can be administered prior to doxorubicin? -
Dexrazoxane
Significant side effects of doxorubicin are: - Cardiotoxicity
N/V
Mucositis
Diarrhea
Severe myelosuppression
Hepatic impairment
Secondary cancers
Monitoring necessary with bleomycin: - Pulmonary toxicity
Hypersensitivity reactions (esp. in lymphoma patients)
Cutaneous reactions
Lifetime dose tracking (pulmonary toxicity)
Pulmonary fibrosis is possible when the lifetime dose of bleomycin exceeds: - 400 units
What 6 patient characteristics make CINV more likely? - 1. Younger than 50 years
