Term
| A pharmacist receives an order for Avastin. Which of the following should be dispensed? |
|
Definition
|
|
Term
| A patient gave the pharmacist a prescription for Soltamox. Which of the following is an appropriate generic substitution? |
|
Definition
|
|
Term
A pharmacist has filled a prescription for Femara. She should include the following points in her counseling to the patient
A
Ensure adequate calcium intake.
B
Ensure adequate vitamin D supplementation.
C
Ensure adequate iron intake.
D
Get immediate help if the patient notices any new or worsening chest pain or becomes short of breath.
E
The patient may experience weakness, extreme fatigue and a desire to eat non-food substances such as paper. If this happens, report these symptoms immediately to a physician. |
|
Definition
|
|
Term
| This medication should be used in combination with antiandrogen therapy. |
|
Definition
|
|
Term
| Mosteller Formula for calculating BSA |
|
Definition
BSA (m2) = square root of (height (cm) x weight (kg)/3600)
Note:
- Use ABW
- 1 cm = 2.54 in
- 1 lb = 2.2 kg |
|
|
Term
A 62 year old patient with lymphoma and an extensive cardiac history is scheduled to receive the CVP chemotherapy regimen today.
The CVP regimen includes cyclophosphamide 750 mg/m^2 IV on day 1, vincristine 1.4 mg/m2 IV on day 1 and prednisone 40 mg/m^2 PO on days 1-5. Patient weighs 175 pounds and is 6'1" tall.
Calculate the patient's BSA using the Mosteller Formula. |
|
Definition
175 lb/2.2 = 79.5 kg
(6 ft x 12 inch/ft) + 1 inch = 73 in
73 in x 2.54 in/cm = 185.4
BSA (m2) = square root of (185.4 cm x 79.5 kg /3600) = 2.02 |
|
|
Term
A 62 year old patient with lymphoma and an extensive cardiac history is scheduled to receive the CVP chemotherapy regimen today. The CVP regimen includes cyclophosphamide 750 mg/m^2 IV on day 1, vincristine 1.4 mg/m2 IV on day 1 and prednisone 40 mg/m^2 PO on days 1-5. Patient weighs 175 pounds and is 6'1" tall.
What is the most appropriate dose of cyclophosphamide for this patient? |
|
Definition
Using the BSA of 2.02, the dose of cyclophosphamide would be 1,515 mg.
cyclophosphamide 750 mg/m^2 IV x 2.02 m^2 = 1,515 mg |
|
|
Term
A 62 year old patient with lymphoma and an extensive cardiac history is scheduled to receive the CVP chemotherapy regimen today. The CVP regimen includes cyclophosphamide 750 mg/m^2 IV on day 1, vincristine 1.4 mg/m2 IV on day 1 and prednisone 40 mg/m^2 PO on days 1-5. Patient weighs 175 pounds and is 6'1" tall.
What is the most appropriate dose of vincristine for this patient? |
|
Definition
| Using the BSA of 2.02, the dose would calculate out to 2.8 mg. However, the max single dose of vincristine is 2 mg due to the risk of neuropathy. |
|
|
Term
| Mechanism of action for tamoxifen |
|
Definition
| Selective estrogen receptor modulators, or SERMs, such as tamoxifen block estrogen in breast tissue and at other tissues, but can act as estrogen agonists elsewhere. They are used if the tumor is estrogen-receptor positive. |
|
|
Term
A patient is using IV methotrexate for cancer treatment. Choose the correct boxed warnings for methotrexate: (Select ALL that apply.)
A
Pancreatitis
B
Myelosuppression
C
Cardiac toxicity
D
Stomatitis and diarrhea
E
Pulmonary, hepatic and renal toxicity |
|
Definition
B,D,E
Myelosuppression, stomatitis (also called oral mucositis) and lung/liver/kidney toxicity are all boxed warnings associated with methotrexate. |
|
|
Term
A patient is receiving ifosfamide therapy. The patient should receive the following agent(s) to reduce the risk of hemorrhagic cystitis (Select ALL that apply.)
A
Mesna
B
Loop diuretics
C
Dexrazoxane
D
Hydration
E
Dimethyl sulfoxide |
|
Definition
A and D
Mesna is given with all doses of ifosfamide. Aggressive hydration with fluids to flush the drug out of the bladder is also recommended to reduce the risk of this toxicity. |
|
|
Term
|
Definition
| The generic name of Trexall is methotrexate. |
|
|
Term
| Mechanism of action for the aromatase inhibitors |
|
Definition
| Aromatase inhibitors block aromatase, the enzyme responsible for conversion of androstenedione to estrone, and of testosterone to estradiol. Estrone and estradiol are estrogens. |
|
|
Term
| What is the maximum single dose of vincristine? |
|
Definition
| Due to the risk of neuropathy, the maximum single dose of vincristine is 2 mg. |
|
|
Term
| The generic name of Adriamycin |
|
Definition
| The generic name of Adriamycin is doxorubicin. |
|
|
Term
Which of the following agents is not an alkylating agent?
A
Cyclophosphamide
B
Fluorouracil
C
Carmustine
D
Melphalan
E
Ifosfamide |
|
Definition
B
Fluorouracil is an anti-metabolite agent.
Next |
|
|
Term
Which of the following chemotherapeutic drug classes are cell cycle non-specific? (Select ALL that apply.)
A
Anthracyclines
B
Vinca alkaloids
C
Alkylating Agents
D
Topoisomerase I inhibitors
E
Platinum-based agents |
|
Definition
A,C,E
The alkylating agents, anthracycline agents and the platinum-based agents are all cell cycle non-specific in their activity. |
|
|
Term
| Generic substitution for Gleevec |
|
Definition
|
|
Term
| Form of etoposide that requires refrigeration |
|
Definition
Etoposide capsules (VePesid)
When a capsule requires refrigeration (such as etoposide (VePesid capsules), it is important to know. We do not regularly refrigerate capsules and therefore it is easy for pharmacy staff to leave the product out of the refrigerator; this will ruin valuable medication. |
|
|
Term
Which of the following statements regarding methotrexate is/are true? (Select ALL that apply.)
Answer
A
Doses used for rheumatoid arthritis and are much lower than those used for cancer and are dosed once weekly, not daily.
B
Hydration and IV sodium bicarbonate are given to alkalinize the urine to reduce risk of nephrotoxicity.
C
Preservative-free formulations are used for intrathecal administration.
D
NSAIDs and salicylates can reduce the clearance, leading to methotrexate toxcity.
E
Glucarpidase administration is required following methotrexate to reduce toxicities. |
|
Definition
A B C D
Methotrexate (MTX) has many toxicities; alkalization of the urine helps to reduce nephrotoxicity. There are other (cheaper) agents to reduce MTX toxicities other than glucarpidase. NSAIDs and salicylates (as well as some other medications) can increase concentrations of MTX by reducing clearance. |
|
|
Term
Which of the following is the appropriate chemotherapeutic agent and significant toxicity pair?
Answer
A
Doxorubicin: renal toxicity
B
Vinblastine: myelosuppression
C
Vincristine: myelosuppression
D
Cisplatin: hand-foot syndrome
E
Capecitabine: bladder toxicity |
|
Definition
B
Vinblastine is myelosuppressive while vincristine is not.
Think myelo'blast' as a reminder |
|
|
Term
| A pharmacist receives an order for Cytoxan. What is the generic name? |
|
Definition
|
|
Term
| What should the a patient's pharmacogenomics testing show in order to use rituximab? |
|
Definition
| Patients must be B-cell antigen CD20 positive in order to use rituximab. |
|
|
Term
| likely side effects from the use of aromatase inhibitors |
|
Definition
| These drugs cause significant lethargy and fatigue, hot flashes, nausea and vomiting. Aromatase inhibitors should not be taken along with tamoxifen or any form of estrogen. |
|
|
Term
| What is the maximum lifetime dose of bleomycin? |
|
Definition
| Bleomycin has a maximum lifetime dose of 400 units due to risk of pulmonary toxicity. |
|
|
Term
| A pharmacist has a prescription for Xeloda. Which of the following is an appropriate generic substitution for Xeloda? |
|
Definition
| Capecitabine (Xeloda), oral prodrug of 5-FU (Adrucil)a pyrimidine analog antimetabolite that targets S phase |
|
|
Term
A patient is receiving chemotherapy and her urine turns red. Which of the following chemotherapeutic agents can cause red urine?
A
Doxorubicin
B
Paclitaxel
C
Cytarabine
D
Fluorouracil
E
Mitoxantrone |
|
Definition
| Doxorubicin, idarubicin, daunorubicin, and epirubicin are all red in color and can discolor the urine with a pink-reddish tint up to 48 hours after treatment. |
|
|
Term
LP is a 44 year old female who is prescribed Revlimid as part of a regimen for treatment of diffuse large B cell lymphoma. Which of the following are required before she can receive this drug?
A
Echocardiogram
B
Urinalysis
C
Pregnancy test
D
Audiogram
E
Serum creatinine |
|
Definition
C
Revlimid (lenalidomide) is an analog of thalidomide (available as Thalomid) and both of these drugs, along with pomalidomide (Pomalyst), are known teratogens that can cause severe birth defects. These drugs have REMS programs and pregnancy testing is required in females of childbearing potential. |
|
|
Term
Arsenic trioxide, often used as second line therapy for acute promyelocytic leukemia, has which of the following boxed warning?
A
GI bleeding
B
Hypersensitivity reactions
C
Prolonged prothrombin time
D
QT prolongation
E
Neurotoxicity |
|
Definition
|
|
Term
A patient is receiving chemotherapy and her urine turns blue. Which of the following chemotherapeutic agents can cause blue urine?
A
Doxorubicin
B
Fulvestrant
C
Mitoxantrone
D
Etoposide
E
Dasatinib |
|
Definition
Mitoxantrone
Mitoxantrone is an anthracycline-like agent that is dark blue/purple in color and may discolor the urine to a bluish color. |
|
|
Term
| an appropriate generic substitution for Femara? |
|
Definition
|
|
