CSO Exam 2024 Study Guide with Compete

CSO Exam 2024 Study Guide with Compete Solutions Alkylating agents - Correct Answer synthetic chemicals containing alkyl groups that attack DNA, causing strand breaks thus preventing replication and transcription of RNA Examples: Bendamustine (Treanda), Busulfan (Myleran PO/Busulflex IV, Carboplatin (paraplatin), Carmustine (BCNU), Chlorambucil (Leukeran), Ciosplatin (Platinol, CDDP), Cyclophosphamide (Cytoxan, CTX), Dacarbazine (DTIC), Ifosfamide (Ifex), Mechlorethamine (nitrogen mustard), Melphalan (Alkeran), OXaliplatin (Eloxatin), Temozolomide (temodar), Thiotepa (Thioplex) Bendamustine (treanda) - Correct Answer Treanda (alkylating agent)

• IV only

-B cell, NHL, CLL SE: myelosuppression, mild N/V, fatigue, fever, Hypersensitivity infusion reactions, tumor lysis syndrome Busulfan (Myleran) - Correct Answer Myleran (alkylating agent) -CML, stem cell transplant preparation, polycythemia vera

Side effects:

-Myelosuppresion -NVD, Mucositis -Hepatic toxicity

• Adrenal insufficiency

-other: pulm symptoms, insomnia, dizziness, anxiety, alopecia

Additional SE:

• increases uric acid! (use allopurinol, and watch for DDIs w/ thiazides, loops, niacin, low dose ASA)
• Pulmonary fibrosis!! (SOB -> CXR -> d/c Myleran)
• Seizures! (pre-medicate with anticonvulsant 12hr before and 24hr after
• Hyperpigmentation of skin

Carboplatin (Paraplatin) - Correct Answer Paraplatin 1 / 4

Platinum complex alkylating agent -breast, bladder, cervix, endometrial, esophagus, germ cell, H/N, lung, ovarian

SE:

-myelosuppresion -low Mg -N/V -renal toxicity -Other: hypersensitivity reaction, mild alopecia, peripheral neuropathy, taste change Carmustine (BCNU) - Correct Answer BiCNU (alkylating agent) -brain, NHL, T-cell lymphoma

SE:

-myelosuppression -N/V -liver, renal, lung toxicity Chlorambucil (Leukeran) - Correct Answer Leukeran (alkylating agent) -oral -CLL, HD, NHL, breast, ovary, testies

SE:

-N/V -high uric acid (low purine diet)

--> high purine foods: organ meat, meat, anchovies, sardines, beer

-seizure risk in children -lung toxicity Cisplatin (Platinol) - Correct Answer Platinol (alkylating agent) -bladder, cervix, esophagus, H/N, lung, prostate, stomach

SE: 2 / 4

• Nephrotoxic!! Treat with hydration to maintain renal blood flow, mannitol to promote excretion,

and amiphostine (Ethyol) to prevent nephrotoxicity

• Ototoxic
• Peripheral neuropathy
• Electrolyte abnormalities (decreases PO4, K, Ca, Mg)
• GI upset
• causes the most N/V!

-SIADH

-metallic taste Cyclophosphamide (Cytoxan) - Correct Answer -Alkylating agent (cytotoxic antineoplastic) -can be used intrapleural -breast, lung, ovary, CLL, NHL

SE:

-myelosuppresion -N/V -flu like -CNS toxicity -photosensitivity Ifosfamide (Ifex) - Correct Answer Alkylating Agent

SFX: n/v, anorexia, SIADH

Methotrexate (nitrogen mustard) - Correct Answer alkylating agent -CLL, CML, HD, NHL, breat, lung Toxic to just about every organ except to heart, toxicity made worse with aspirin

SE:

-N/V -hyperuricemia Melphalan (Alkeran) - Correct Answer alkylating agent 3 / 4

-breast, ovarian, neuroblastoma

SE: N/V

Oxaliplatin (Eloxatin) - Correct Answer alkylating agent -colorectal, pancreatic

SE:

-N/V/D

• sensitivity to cold

-hepatic and neurotoxic -allergic reaction -laryngopharyngeal dysesthesia (A disorder characterized by an uncomfortable persistent sensation in the area of the laryngopharynx) Temozolomide (Temodar) - Correct Answer alkylating agent -oral -astrocytoma, glioblastoma

SE:

-N/V, fatigue -headache -constipation Thiotepa (Thioplex) - Correct Answer - alkylating antineoplastic agent

• cancer in the membranes that cover and protect the brain and spinal cord (the meninges)

- Side effects: alopecia, neutropenia, thrombocytopenia

-bronzing of skin -N/V/mucositis Antimetabolites - Correct Answer chemotherapeutic agents that interfere with DNA synthesis by acting as false metabolites, incorporated into DNA strands or black essential enzymes Azacitidine (Vidaza) - Correct Answer Antimetabolite -CML, MDS

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