Cancer and RA pharm

quickster2008's version from 2016-11-06 21:06

Section 1

Question Answer
Methotrexate MOAinhibits dihydrofolate reductase
Methotrexate indicationRA, molar pregnancies, cancer
Methotrexate SEmacrocyctic anemia
drug used in combo with Methotrexate to offset the SE'sleucovorin (replenishes folate which is recognized by body but not cancer
Adriamycin SEcardiotoxicity, or heart failure (ATRIA-mycin)
drug used in combo with adriamycin to offset SE'sdexrazoxane aka DEX
other name for adriamycindoxorubicin
bleomycin SEpulmonary fibrosis (Blowmycin)
Anti-Metabolites tx which type of cancerfast growing cancer
Alkylating agents tx which type of cancerslow growing cancer
cisplatin side effectsototoxicity and nephrotoxicity
drug used in combo with cisplatin to offset SE'samifostine (sounds like foster home)
cyclophosphomide SEhemorrhagic cystitis bc it penetrates the bladder
cyclophosphomide rescue drugMESNA "when u are cyco(psyco) you are a MESS
busulfan SEpulmonary fibrosis (busulfan causes breathing problems like bleomycin)
11 yo child presents with a chronic non healing ulcer on his foot. img shows small calcified spleen. Diag / Drug?sickle cell use hydroxyurea
Multiple myeloma tx used in older patients or in those who are too fragile to undergo bone marrow transplantation.melphalan or prednisone
Anti-metabolites drugsmethotrexate, adriamycin, 6-mercaptopurine, 6-thioguanine, 5-flourouracil
alkylating agentscisplatin, cyclophosphomide, busulfan, hydroxyurea, melphalan, nitrosureas, chlorambucil,
vinblastine SEbone marrow suppression (blasts bone marrow)
vincristine SEneurotoxicity (vinCRESTine to remember neuro)
cancer drugs used for osteoporosistamoxifen/raloxifene
tamoxifenused for osteoporosis and breast cancer that can cause endometrial carcinoma
raloxifeneused for osteoporosis that will not cause endometrial carcinoma (raloxifene-RELAXifene)
prednisone side effectscushinon's syndrome
6-Mercaptopurine SEgout (6-mercap-TOE-purine)
Do not give this drug with allopurinol bc it needs xanthine oxidase for metabolism and allopurinol inactivates it6-mercaptopurine
anti-metabolite agent used in cancer or RA that can be given with allopurinol6-thioguanine
Etoposide SEalopecia(round patches of hair loss) "affects eTOPoside of your head
Etoposide MOAinhibits TOPoisomerase II & increases DNA degradation
prednisone txRSD, acute gout attacks
365. Pt is going to sx. What would you the most worry about?: pt was taking high dose of prednisone and stopped 4 weeks ago
SE includes slowing a person's ability to heal and fight off infectionprednisone
SE osteoporosisprednisone(worry about plate failure)
injectable corticosteroidprednisone
when should you discontinue methotrexate before surgeryyou dont have to
SE cushion syndromelong term prednisone therapy, pituitary adenoma, adrenal cortical adenoma
Risk factor for GERDprednisone, obesity, smoking
38. This patient is sent to a rheumatologist and he makes a diagnosis, begins treatment, and refers her back to you for surgical correction of her problems. She is being treated with prednisone along with acetaminophen. She is not on any other anti-inflammatory medication. She has been on the prednisone for approximately one year. Postoperatively, due to this patient’s condition and treatment, you have concerns about all of the following except for: a. Infection b. Delayed wound healing c. Excessive bleeding d. Reoccurrence of the deformitiesdelayed wound healing
A 30-year-old patient is scheduled to have major rearfoot reconstruction. The patient has a history of asthma and is currently on an albuterol nebulizer and has taken prednisone, 7.5 milligrams, daily for the past 2 years. Prior to surgery, the podiatric physician should do which of the following? (A) Begin aspirin therapy 24 hours prior to surgery. (B) Begin antibiotic prophylaxis to prevent endocarditis. (C) Increase the prednisone dose to at least 20 milligrams per day. (D) Stop the prednisone 2 days prior to surgery to aid in wound healing.Long-term steroid usage suppresses the hypothalamic-pituitary axis (HPA) and increases the risk for hypotensive shock. Preoperative supplementation with high-dose steroids will help avert this complication.
All of the following are appropriate drugs for the treatment of rheumatoid arthritis EXCEPT (A) penicillamine (B) prednisone (C) pentoxifylline (D) piroxicamPentoxifylline is used for the treatment of arterial insufficiency.
tx for wegener's takayasu'sprednisone
tx for lichen planusprednisone
pt presents with multiple mononeuropathies what is dx and txperiarteritis nodosa, tx prednisone
OPD patients take prednisone! = raise glucose and decrease insulin sensi! Therefore give em more insulin!
Who Needs Perioperative Steroid Tx and Why?Any pt taking at least 5mg/day of prednisone (or equivalent) for at least 5 days within the past 2 weeks or at least 1 month of sustained cortocosteroid therapy within past year considered at risk for acute post­op adrenal insufficiency * Without dose, pt may not be able to respond to surgical stress, resulting in consequences such as hypotension or death
Antimetabolite of folic acidmethotrexate

Section 2

Question Answer
tx for psoriasismethotrexate
MCV is increased with what medicationmethotrexate
Could lead to a normal WBC in the presence of infectionmethotrexate-causes leukopenia
methotrexate toxicity when combined with ? NSAIDS(Effect is increased methotrexate toxicity, mechanism is decreased renal clearance of methotrexate)
mmunosuppressive drugs commonly used for RA patients that might make them more prone to infectionmethotrexate
SE osteoporosismethotrexate
43. Your patient does not respond to nonsteroidal medication and you elect to refer her to a rheumatologist for further treatment. What medication might be considered to treat this patient? a. Methotrexate b. Humira c. Penecillamine d. All of the above d. all of the above
Macrocytic anemia induced bymethotrexate
surgical prophylaxis needed for pt on this drugmethotrexate
methotrexate is predominantly eliminated through kidney or liver thus its clearance is significnatly reduced by coadministration of an NSAIDkidney
cause megaloblastic anemiamethotrexate
how does NSAID affect methotrexatedecreases its clearance
because the tx of DMARD for RA takes so long what medication is used to bridge with DMARD medicationprednisone
49. Peripheral neuropathy is characteristic of the toxicity displayed by which of the following? (A) 6-Mercaptopurine (B) Daunorubicin (C) Vincristine (D) MechlorethamineVincristine
tx for wartbleomycin
causes of dilated cardiomyopathy ABCDs - Alcohol - Beriberi (wet) - Coxsackie B virus - Chagas’ disease - Cocaine - Doxorubicin

Section 3

Question Answer
As a general rule, the alkylating agents typically produce severe immunosuppressive effects.
Drugs that cause pulmonary fibrosisUBAB bleomycin amiodarone busulfan nitrosureas(end in ustine)
Older pt w/ generalized pruritis and flushing after hot bath. Hct of 60%.polycythemia vera- Hydroxyurea can prevent thromboses that is associated with PV(high yield)
doxorubicin secardiotoxicity