Oncology

Pregunta	Respuesta
ANC Formula	[ ( % segs + % bands ) / 100 ] x WBC
BSA Formula	Sq Rt of [ ( kg x cm ) / 3600 ]
Inches (in) --> Centimeters (cm)	in x 2.54 = cm
Pounds (lb) --> Kilograms (kg)	lb / 2.2 = kg
Drugs associated w/ pneumonitis & pulmonary fibrosis	Bleomycin; Busulfan; Methotrexate
Brand of busulfan	Busulfex
Brand of methotrexate	Trexall; Rheumatrex
Brand of bleomycin	Blenoxane
Generic of Platinol-AQ	cisplatin
Generic of Adriamycin	doxorubicin
Cardiomyopathies	Doxorubicin (Adriamycin)
2 "types" of dexrazoxane	Zinecard = Prophylaxis of doxorubicin-induced cardiomyopathy; Totect = Treatment of anthracycline extravasation
Cell Cycle Specific Agents	Vincas; Taxanes; Topo-Inhibitors; Pyrimidines; Folate Antimetabolites
Vinca Alkaloids ("Vincas")	Vinblastine; Vincristine; Vinorelbine
Vincristine	Top3 TidBits = (1) 2 mg/dose cap; (2) Constipation; (3) Use WARM compresses [not cold] if extravasation
Vinblastine	Top2 TidBits = (1) Myelosuppressive [as well as vinorelbine]; (2) Use WARM compresses
Taxanes	Docetaxel; Paclitaxel
Docetaxel = Taxotere	Top3 TidBits = (1) Severe fluid retention; (2) Infusion-related HSR; (3) Peripheral sensory neuropathies
Paclitaxel = Taxol	Top2 TidBits = (1) Premedicate w/ diphenhydramine, corticosteroid, H2RA; (2) Albumin-bound version "Abraxane" needs no premedication [i.e. low allergic reaction]
Topoisomerase I Inhibitors (Topo1-Inhibitors)	Irinotecan; Topotecan
Irinotecan = Camptosar	Top4 TidBits = (1) N/V/D; (2) Homozygous for UGT1A1*28 at inc. risk for neutropenia, delayed diarrhea; (3) Use only when ANC > 1,500; (4) Myelosuppression
Topotecan = Hycamtin	Top2 TidBits = (1) Use only when ANC > 1,500 and PLT > 100,000; (2) Myelosuppression
Topoisomerase II Inhibitors (Topo2-Inhibitors)	Etoposide CAPSULES; Etoposide IV; Etoposide Phosphate
Etoposide CAPSULES = VePesid	Require refrigeration (RARE!); Divide doses > 200 mg; Myelo; HSR
Etoposide IV = Toposar	Rate-related hypotension (i.e. infuse over 30-60 minutes); Non-PVC bag/tubing due to DEHP leaching
Pyrimidine Analog Antimetabolites ("Pyrimidines")	Fluorouracil ("5-FU"); Capecitabine; Cytarabine; Gemcitabine
Fluorouracil (5-FU) = Adrucil	Top3 TidBits = (1) Given w/ LEUCOVORIN to inc. EFFICACY (think booster); (2) DPD deficiency inc. risk of severe toxicity; (3) "Efudex" brand also used for BCC
Capecitabine = Xeloda	Top3 TidBits = (1) C/I in CrCL < 30 mL/min); (2) PO prodrug of 5-FU; (3) *HAND-FOOT SYNDROME*
Cytarabine = "ara-C"	"Cytarabine Syndrome" (fever, flu-like, myalgia, bone pain, rash); Pulmonary toxicity; *HAND-FOOT SYNDROME*
Folate Antimetabolites	Methotrexate (MTX); Pemetrexed
MTX = Trexall; Rasuvo; etc.	"High-Dose MTX" (> 500 mg/m^2) requires LEUCOVORIN "rescue"; HYDRATION & NaHCO3 to dec. nephrotoxicity risk; Glucarpidase (Voraxaze) is the expensive rescue agent
METHOTREXATE DOSING	Cancer Dosing is MUCH HIGHER than Rheumatoid Arthritis or Psoriasis Dosing --> Daily v. Weekly (respectively)
Pemetrexed = Alimta	Give folic acid, vit. B12, dexamethasone to dec. risk of side effects
INTRATHECAL administration of MTX...	Use ONLY the *Preservative-Free* formulation!!!
M Phase Agents --> (These inhibit microtubule function...)	Vincas (vinblastine, vincristine); Taxanes (docetaxel, paclitaxel)
S Phase Agents	Topo1-Inhibitors (irinotecan, topotecan); Pyrimidines (5-FU, capecitabine, cytarabine, gemcitabine); Folate Antimetabolites (MTX, pemetrexed)
G2 Phase Agents --> (There is only one...)	Topo2-Inhibitors (etoposide)
Any phase-specific cancer drug that can cause pulmonary complications (e.g. pneumonitis, fibrosis, toxicity, etc.)	Bleomycin; Busulfan; MTX; Cytarabine (toxicity)
Phase-specific cancer drugs in which a "dose cap" or "pre-requisite" should be associated	Vincristine (2 mg/dose cap); Irinotecan = Camptosar (ANC must > 1,500); Topotecan = Hycamtin (ANC must > 1,500; PLT must > 100,000); Capecitabine = Xeloda (C/I in CrCL < 30); MTX (>500 mg dose BSA req. Leucovovrin and/or Glucarpidase = Voraxaze)
"Rare capsules" that require refrigeration	Etoposide = VePesid
Biggest culprit of hand-foot syndrome	Capecitabine = Xeloda; Cytarabine = "ara-C"
LEUCOVORIN pairings...	If leuco is given w/ 5-FU = *BOOSTER* If leuco is given w/ MTX = *RESCUER*
Which of the Taxanes typically requires pre-medication?	Paclitaxel = Taxol [However, albumin-bound Abraxane needs no pre-medication!]
The AE profile of Platinol-AQ (cisplatin)...	N/V/D; Dose-limiting nephrotoxicity; Ototoxicity (e.g. tinnitus); Neurotoxicity
Maximum Lifetime Dose of Adriamycin (doxorubicin)?	550 mg dose BSA

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