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Oncology Drugs

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yekiriku's version from 2017-06-30 01:55

Breast Cancer

genericbrandDrug Classclinical pearls
tamoxifenNolvadex, Soltamoxselective estrogen receptor modulators (SERM)20mg qd, 2D6 substrate, venlafaxine for hot flash, risk of uterine & endometrial cancers, thromboembolic events VTE or PE or stroke
fulvestrantFaslodexEstrogen receptor antagonist500mg IM days 1,15,29 then monthly, painful
raloxifenEvistaselective estrogen receptor modulators (SERM)60mg qd, risk of uterine & endometrial cancers, thromboembolic events VTE or PE or stroke
toremifeneFarestronselective estrogen receptor modulators60mg PO qd, QT prolong
anastrozoleArimidexaromatase inhibitor1mg qd, arthralgia/myalgia - osteoporosis - consider vitD and calcium supp, higher CVD risk
letrozoleFemaraaromatase inhibitor2.5mg qd, arthralgia/myalgia - osteoporosis - consider vitD and calcium supp, higher CVD risk
exemestaneAromasinaromatase inhibitor25mg qd, arthralgia/myalgia - osteoporosis - consider vitD and calcium supp, higher CVD risk
palbociclibIbrance (capsule)Cyclin-dependent kinase inhibitor125mg qd for 21 of 28-day cycle (use with fulvestrant 1st line for metastatic cx), blurred vision
trastuzumabHerceptinHER2 inhibitortumor is overexpressing HER2/neu, also pertuzumab, lapatinib, adotrastuzumab
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Prostate cancer

genericbrandDrug Classclinical pearls
leuprolideLupron, Lupron depot, Eligardgonadotropin-releasing hormone agonist GnRHSQ or IM qmonth, ***Tumor Flare, osteoporosis risk - consider vit D and Calcium supp, cat X, vaginal bleeding
goserelinZoladexgonadotropin-releasing hormone agonistSQ or IM qmonth, ***Tumor Flare, osteoporosis risk - consider vit D and Calcium supp, cat X, vaginal bleeding
degarelixFirmagongonadotropin-releasing hormone antagonistSQ qmonth, ***NO tumor flare, osteoporosis risk - consider vit D and Calcium supp, cat X, vaginal bleeding
bicalutamideCasodex1st gen antiandrogens50mg PO qd, cat X, ONLY used with GnRH agonists - NO monotherapy
flutamideEulexin1st gen antiandrogens250mg PO q8h, more diarrhea, hepatic impairment, ONLY used with GnRH agonists - NO monotherapy
nilutamideNilandron1st gen antiandrogensnight blindness and disulfiram rxn, hepatic impairment, ONLY used with GnRH agonists - NO monotherapy
enzalutamideXtandi2nd gen antiandrogens4 cap qd, cat X, seizure, mono-therapy OK
abirateroneZytigaandrogen biosynthesis inhibitor4tab qd on empty stomach, given with prednisone 5mg BID to prevent hyperaldosteronism and cortisol replacement, cat X
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Cell cycle non-specific agents - Alkylating Agents

genericbrandDrug Classclinical pearls
cyclophosphamideCytoxanalkylating agentshemorrhagic cystitis - Mesna
ifosfamideIfexalkylating agentshemorrhagic cystitis - Mesna
carmustineBiCNUalkylating agentsuse NON-PVC bag and tubing, pulmonary toxicity
dacarbazineDTIC-Domealkylating agentsprotect from light, decomposed drug turns PINK
procarbazineMatulanealkylating agentsMAOI, avoid food/drug interaction
bendamustineBendeka, Treandaalkylating agents
busulfanMyleran, Busulfexalkylating agentspulmonary toxicity
lomustineCeeNU, Gleostinealkylating agentsonly 1 dose q6w, pulmonary toxicity
melphalanAlkeran, Evomelaalkylating agents
temozolomideTemodaralkylating agents
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Cell cycle non-specific agents - Platinum Based - BBW "anaphylactic-like reactions"

genericbrandDrug Classclinical pearls
cisplatinPlatinolplatinum-based**nephrotoxicity - use chemoprotectant "amifostine" (Ethyol), ototoxicity --> doses <100mg/m2/cycle , highly emetogenic
carboplatinParaplatinplatinum-basedmyelosuppression, Calvert formula - total dose = target AUC x (GFR + 25) with AUC from 2-8 mg/mLxmin
oxaliplatinEloxatinplatinum-basedacute sensory neuropathy - ***exacerbated by exposure to cold
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Cell cycle non-specific agents - Anthracyclines - BBW "myocardial toxicity, vesicant"

genericbrandDrug Classclinical pearls
doxorubicinAdriamycinanthracyclinesmyocardial toxicity, vesicant, red urine discoloration, dexrazoxane (Totect) for extravasation & (Zinecard) for cardioprotection
daunorubicinCerubidineanthracyclinesmyocardial toxicity
epirubicinEllenceanthracyclinesmyocardial toxicity
idarubicinIdamycinanthracyclinesmyocardial toxicity
valrubicinValstaranthracyclinesmyocardial toxicity
doxorubicin liposomalDoxil, Lipodox50anthracyclinesnot a vesicant, red urine discoloration, not interchangeable with non-liposomal
mitoxantroneNovantroneanthracenedione related to anthracyclinesvesicant like, blue urine discoloration
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