Chemotherapy Certification Exam Latest 2024

Chemotherapy Certification Exam Doxorubicin - ✔Cardiotoxic TISSUE VESICANT Baseline MUGA and total dose (CONCERN at 550 mg/m2) URINE=RED IF EXTRAVASATION OCCURS= cool/ice + Totect Idamycin - ✔Cardiotoxic (cardiomyopathy) Bleomycin - ✔AVOID oxygen supplementation Methotrexate - ✔*Leukovorin decreases cytotoxicity* Pemetrexed - ✔Vitamin B12 & folic acid supplements to decrease toxicity Fludarabine - ✔Immunosuppression Thioguanine - ✔Bone Marrow Suppression Stomatitis/Mucositis 5-FU - ✔*Stomatitis Bone marrow depression *Diarrhea Mucositis Capeticibine - ✔***Pro-drug that converts 5FU in liver Stomatitis & mucositis Palmar-plantar erythrodysthesias (hand foot syndrome) Cytarabine or Cytosine Arabinoside - ✔Cerebellar neurotoxicity Gemcitabine - ✔Radiosensitizer DO NOT GIVE W/ RADIATION, except at very low doses Carmustine - ✔***Solvent is alcohol Alcohol sensivity is an issue Mix ONLY in 0.9% NaCl Carboplatin - ✔Dose by CALVERT formula Allergic reaction increased from 1-27% in pts receiving >6-7 courses

Cisplatin - ✔Renal toxicity Kidney protection w/ fluids & sometimes AMIFOSTINE MONITOR MAGNESIUM levels Oxaliplatin - ✔NEUROTOXICITY AVOID COLD (neuropathies exacerbated by cold exposure) Dilute with D5W* Cyclophosphamide - ✔HEMMORRAGHIC CYSTITIS Blood in urine -> fluids (sometimes Mesna) Temazolamide - ✔Headache (crosses into CNS)*** Interferons - ✔ACUTE: Flu-like Syndrome CHRONIC: Depression- BLACK BOX WARNING Interleukin-2 - ✔Flu-like Syndrome Capillary Leak Syndrome Cabazitaxel - ✔No PVC bags or tubing!

Docetaxel - ✔No PVC bags or tubing!

Paclitaxel - ✔Glass or Polyolefin container. NO PVC container or tubing.

0.22 in-line filter Etoposide - ✔Alopecia Hypotension Can cause hypotension w/ rapid infusion Monitor for hypersensitivity reactions Irinotecan - ✔EARLY diarrhea -> give atropine LATE diarrhea -> give Imodium Vincristine - ✔Neurotoxicity Peripheral Neuropathy Constipation Monitor LFTs FOR IV USE ONLY!!! FATAL IF GIVEN INTRATHERCALLY Cetuximab - ✔Acneform rash Ipilimumab - ✔Immune mediated S/E TX= STEROIDS

Pembrolizumab - ✔Immune mediated toxicities: Manage immune mediated toxicities with high dose steroids Rituximab - ✔for CD20+ lymphocytes Trastuzumab - ✔Cardiac issues Administered in HER 2+ disease Erlotinib - ✔Rash (75% of pts) Arsenic trioxide - ✔Serum electrolyte Mg Thalidomide - ✔Teratogenicity BLACK BOX WARNING: DO NOT GIVE TO WOMEN WITH RISK OF PREGNANCY Hydroxyurea - ✔Radiosensitizer Bicalutamide - ✔MOA-> blocks effects of androgens on prostate LHRH Agonists and LHRH Antagonists - ✔ACUTE: Increases in hormones- hot flashes, osteoporosis, high cholesterol, wt gain, depression CHRONIC: effects from decreased hormone production- loss of muscle mass, cognitive changes, anemia, sexual dysfunction, gynecomastia Aromatase inhibitors- Anastrazole - ✔Osteoporosis Give to post-menopausal women only SERMS (Tamoxifen) - ✔Menopausal symptoms Risk of endometrial cancer Thrombosis risk Amifoxtine - ✔Tissue protectant: nephrotoxicity & neurotoxicity w/ cisplatin Radiation protection: prevents acute or late xerostomia when radiation field includes parotids Dexrazoxane (Totect) - ✔indicated for the treatment of extravasation resulting from intravenous anthracycline chemotherapy Dexrazoxane (Zinecard) - ✔Decreases risk of cardiomyopathy with doxorubicin Leucovorin - ✔Potentiates 5FU, suppresses methotrexate Provenge (sipuleucel-T) - ✔treatment vaccine

Mesna - ✔Decreases risk of hemorrhagic cystitis with ifosfamide and high dose cyclophosphamide Positive Blood Return - ✔required to administer vesicant 2 Nurses - ✔Required to check chemotherapy orders Rash Causing Drugs - ✔-erlotinib (tarceva) -hydroxurea (hydrea) -sunitinib (sutent) Asparaginase - ✔Requires full risk level precautions and excretion precaution for 7 days Steroids - ✔can be used to treat immune mediated organ toxicities Tyrosine Kinase Inhibitors - ✔Should be used in caution with strong inhibitors of inducers of the CYP3A4 pathway Monoclonal Antibodies that target VEGF - ✔should be held before or after surgery LHRD Agonists - ✔first line-hormonal treatment for prostate cancer Early Hypersensitivity Reactions - ✔-paclitaxel -rituximab -traztuzumab