ONS CHEMO/BIO QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT!!!
Aklylating Agents -ANSWER✔✔-Cyclophosphamide
-Cisplatin
-Carboplatin
-Oxaliplatin
Cyclophosphamide (Cytoxan) -ANSWER✔✔Alkylating agent (cytotoxic
antineoplastic)
Kills rapidly growing cells by interrupting DNA/RNA synthesis
Can cause bone marrow suppression, *N/V, *acute hemorrhagic cystitis*, alopecia
*Aggressive hydration pre and post infusion*
Cisplatin -ANSWER✔✔Vesicant
Severe n/v
Renal failure (hydration and electrolyte replacement)
Ototoxicity, peripheral neuropathy
Carboplatin -ANSWER✔✔Irritant
Calculated dose with AUC
Anaphylactic events have been noted
Alopecia
Myelosuppression
,Oxaliplatin -ANSWER✔✔Treat like vesicant
Part of FOLFOX (5FU, Leucovorin, Oxali) for colorectal
Pregnancy risk factor D
--> Pulmonary fibrosis, hepatotoxicity, sensoral peripheral neuropathy (acute and
long acting)
Antimetabolites -ANSWER✔✔Interfere at cell cycle in 'S' PHASE
5-fluorouracil
Azacitidine
Capecitabine
Cytarabine
Fludarabine
Hydroxyurea
Leucovorin
Methotrexate
Methotrexate -ANSWER✔✔Not irritant or vesicant
IV, IM, IT, IA
Can be used to treat RA
Acute: arachnoiditis (after IT), pneumonitis
Serious: renal failure/azotemia (increase BUN/CR, decrease UO)
Other: use with Leucovorin and hydration to protect kidneys
5FU -ANSWER✔✔Not a vesicant or irritant
,Contraindicated: poor nutritional status, depressed bone marrow function, infection
Acute: severe diarrhea, mucositis,
Serious: CARDIAC ie MI, arrhythmias, angina, hypotension
*Given with leucovorin... increases risk for diarrhea and mucositis
Antitumor Antibiotics -ANSWER✔✔Bleomycin
Dactinomycin
Mitomycin
Mitoxantrone
Anthracyclines -ANSWER✔✔Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Doxorubicin -ANSWER✔✔VESICANT
IV push, short infuse, continuous infuse
Maximum cumulative dose: 450-550mg/m2
Maximum cumlative dose with cyclophos or XRT is 450mg/m2
Contraindicated for EF <45%
CARDIOTOXIC
Serious: local tissue (extravasation)
SE: alopecia, n/v/d, esophagitis, stomatitis, anorexia, myelosupression
*urine will be red/orange tinged
, Nitrosoureas -ANSWER✔✔*able to cross blood brain barrier*
Carmustine
Lomustine
Streptozocin
Carmustine -ANSWER✔✔Irritant
Cumulative max dose of 1400mg/m2
Pulmonary toxicity (PFT's throughout entire course of treatment)
Renal toxicity with prolonged therapy
Other: hypotension, alopecia, facial flush
Camptothecins -ANSWER✔✔Irinotecan
Topotecan
Irinotecan -ANSWER✔✔Irritant
DIARRHEA-- use of atropine, IV hydration, anti-diarrheals
Severe anaphylactic reactions noted
Other: vasodilation, alopecia, stomatitis,
Plant Alkaloids -ANSWER✔✔Epipodophyllotoxins work in the S and G2 phases
to inhibit DNA synthesis. The taxanes stabilize microtubules in the G2 and M
phases, inhibiting cell division. The vinca alkaloids work late in the G2 phase by
blocking DNA production and preventing cell division in the M phase.
Epipodophyllotoxins: etoposide, teniposide
Taxanes: paclitaxel, docetaxel, cabazitaxel
ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT!!!
Aklylating Agents -ANSWER✔✔-Cyclophosphamide
-Cisplatin
-Carboplatin
-Oxaliplatin
Cyclophosphamide (Cytoxan) -ANSWER✔✔Alkylating agent (cytotoxic
antineoplastic)
Kills rapidly growing cells by interrupting DNA/RNA synthesis
Can cause bone marrow suppression, *N/V, *acute hemorrhagic cystitis*, alopecia
*Aggressive hydration pre and post infusion*
Cisplatin -ANSWER✔✔Vesicant
Severe n/v
Renal failure (hydration and electrolyte replacement)
Ototoxicity, peripheral neuropathy
Carboplatin -ANSWER✔✔Irritant
Calculated dose with AUC
Anaphylactic events have been noted
Alopecia
Myelosuppression
,Oxaliplatin -ANSWER✔✔Treat like vesicant
Part of FOLFOX (5FU, Leucovorin, Oxali) for colorectal
Pregnancy risk factor D
--> Pulmonary fibrosis, hepatotoxicity, sensoral peripheral neuropathy (acute and
long acting)
Antimetabolites -ANSWER✔✔Interfere at cell cycle in 'S' PHASE
5-fluorouracil
Azacitidine
Capecitabine
Cytarabine
Fludarabine
Hydroxyurea
Leucovorin
Methotrexate
Methotrexate -ANSWER✔✔Not irritant or vesicant
IV, IM, IT, IA
Can be used to treat RA
Acute: arachnoiditis (after IT), pneumonitis
Serious: renal failure/azotemia (increase BUN/CR, decrease UO)
Other: use with Leucovorin and hydration to protect kidneys
5FU -ANSWER✔✔Not a vesicant or irritant
,Contraindicated: poor nutritional status, depressed bone marrow function, infection
Acute: severe diarrhea, mucositis,
Serious: CARDIAC ie MI, arrhythmias, angina, hypotension
*Given with leucovorin... increases risk for diarrhea and mucositis
Antitumor Antibiotics -ANSWER✔✔Bleomycin
Dactinomycin
Mitomycin
Mitoxantrone
Anthracyclines -ANSWER✔✔Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Doxorubicin -ANSWER✔✔VESICANT
IV push, short infuse, continuous infuse
Maximum cumulative dose: 450-550mg/m2
Maximum cumlative dose with cyclophos or XRT is 450mg/m2
Contraindicated for EF <45%
CARDIOTOXIC
Serious: local tissue (extravasation)
SE: alopecia, n/v/d, esophagitis, stomatitis, anorexia, myelosupression
*urine will be red/orange tinged
, Nitrosoureas -ANSWER✔✔*able to cross blood brain barrier*
Carmustine
Lomustine
Streptozocin
Carmustine -ANSWER✔✔Irritant
Cumulative max dose of 1400mg/m2
Pulmonary toxicity (PFT's throughout entire course of treatment)
Renal toxicity with prolonged therapy
Other: hypotension, alopecia, facial flush
Camptothecins -ANSWER✔✔Irinotecan
Topotecan
Irinotecan -ANSWER✔✔Irritant
DIARRHEA-- use of atropine, IV hydration, anti-diarrheals
Severe anaphylactic reactions noted
Other: vasodilation, alopecia, stomatitis,
Plant Alkaloids -ANSWER✔✔Epipodophyllotoxins work in the S and G2 phases
to inhibit DNA synthesis. The taxanes stabilize microtubules in the G2 and M
phases, inhibiting cell division. The vinca alkaloids work late in the G2 phase by
blocking DNA production and preventing cell division in the M phase.
Epipodophyllotoxins: etoposide, teniposide
Taxanes: paclitaxel, docetaxel, cabazitaxel
