1. No category

Cytotoxic(Chemotherapy(
Subclass(
Alkylating((CCNS)(
(Nitrogen(Mustard)(
Alkylating((CCNS)(
(Platinums)(
Antimetabolite((CCS)(
(Pyrimidine(Analog)(
Antimetabolite((CCS)(
(AntiNfolate)(
(
Microtubule((CCS)(
(Vinca(alkaloids)(
Block(polymerization(
Generic((Brand)(
Cyclophosphamide(
(Cytoxan)(
Cisplatin(
(Platinol)(
Carboplatin(
(Paraplatin)(
Oxaliplatin(
(Eloxatin)(
Gemcitabine(
(Gemzar)(
Fluorouracil(IV(
(5NFU,(Adrucil)(
Capecitabine(PO(
(Xeloda)(
Pemetrexed(
(Alimta)(
Vincristine(
(Oncovin)(
Vinorelbine(
(Navelbine)(
Paclitaxel(
(Taxol)(
Docetaxel(
Microtubule((CCS)(
(Taxotere)(
(Taxanes)(
Block(depolymerization( Carbazitaxel(
(Jevtana)(
Main(Uses(
NHL,(breast(
Lung,(head,(neck(
Lung,(ovarian(
Colorectal/GI(
Pancreatic,(Lung(
Colorectal(
Colorectal(
Lung,(
mesothelioma(
Leukemias,(
Lymphomas(
Lung(
Lung,(breast(
Lung,(breast,(
prostate(
nd
2 (line(prostate(
(metastatic)(
rd
Adverse(Effects(
Myelosuppression((NTP),(N/V,(
Bladder(toxicity(
Severe(N/V,(renal(failure,(
ototoxicity,(electrolyte(loss(
Thrombocytopenia,(
Moderate(N/V(
Acute/persistent(
peripheral(neuropathy(
Myelosuppress((NTP),(rash,(
flu(like(syndrome(48N72(hrs(
Hand/Foot,(Diarrhea,(
Myelosuppression,(Mucositis(
Premeds(
May(use(MESNA(for(
bladder(toxicity(
High(risk(antiNemetics((3)(
Pre/Post(NS(+/N(Mg&K+(
Mod(risk(antiNemetics(
Mod(risk(antiNemetics(
Myelosuppression(usually(due(to(bolus(
Similar(to(5FU(
N/A(
Oral(proNdrug(of(5FU(
Renal(dose(adjust(
Rash((generalized)(
Dexameth.(day(0,1,2(BID(
Folic(acid(+(Vit(B12(
Hold(for(CrCl(<(50(or(Bilirubin(>(2(
Constipation,(peripheral(
neuropathy,(nephrotoxic(
Myelosuppression((NTP),(
peripheral(neuropathy(
Myelosuppression((NTP),(
anaphylaxis,(alopecia,(
peripheral(neuropathy(
Myelosuppression,(edema,(
skin/nail(toxicity(
Myelosuppression((NTP),(
diarrhea(
NONE(needed(
Low(risk(antiNemetics(
H2RA(+(Diphenhydramine(
Dexamethasone(
Low(risk(antiNemetics(
Dexamethasone((edema)(
Low(risk(antiNemetics(prn(
H2RA(+(Diphenhydramine(
Dexamethasone(IV(
Breast,(
Leukemias(
Cardiotoxic,(mucositis,(N/V,(
myelosuppression,(RED(urine(
Alkylating((CCNS)(
(Triazene)(
Temozolomide(
(Temodar)(
Glioblastoma(
Myelosuppress((lymphopenia)( Bactrim(prophylaxis(
(
Neuropathy,(constipation,(
myelosuppression(
DIARRHEA,(N/V,(
myelosuppression(
Myelosuppression,(
hypotension,(infusion(rxn(
NONE(needed(
Doxorubicin(
(Adriamycin)(
Lung(
Dose(w/(calvert(formula(
(Built(in(renal(adjustment)(
*Don’t(touch/consume(anything(cold!!(
*↓Risk(of(nephrotoxicity,(not(ototoxic(
Low(risk(antiemetic(
Anthracycline((CCNS)(
Topo(II(inhibitor((CCS)(
Renal(dose(adjust(
Give(in(<(30(min(for(↓(myelosuppression(
3 (line(breast(
(Metastatic)(
Colorectal,(Lung(
Hepatic:(3A4,(2C9,(2B6(
Low(risk(antiNemetic(
Erbulin(
(Halaven)(
Irinotecan(
(Camptosar)(
Etoposide(
(VePesid)(
Topo(I(inhibitor((CCS)(
Other/Metabolism(
Vinc:(No(myelosuppression!(
(((((((((((Max(dose(2mg/week(in(ALL(pts(
Both(N(NO(INTRATHECAL((DEATH),(vesicant(
Total(3A4(metabolism,(bilirubin(adjust,(IVP(
Hepatic:(CYP(3A4;(adjust(for(↑(bilirubin(
Cremophor(responsible(for(anaphylaxis(
Hepatic:(CYP(3A4(
HOLD(for(bilirubin(>(ULN(or(LFTs(>(1.5(x(ULN(
*Consider(pegfilgrastim(for(febNTP(
Dose(adjust(for(CrCl(
Similar(to(Vinca(alkaloids(
Loperamide(2(mg(q2N4(hr(prn(
Mod(risk(antiNemetics(
Atropine(IVP((acute(diarrhea)(
Renal/hepatic(adjustment(
Low(risk(antiNemetics(
Double(IV(dose(to(give(orally(
2
Max(lifetime(dose!(550(mg/m (
ModNHigh(risk(antiNemetic( Dose(adjust(for(↑(bilirubin((CI(>(5);(vesicant(
Obtain(ejection(fraction(before(starting(
NONE(needed(
Given(w/(radiation(for(first(6(weeks(
(
30
Hormone(Therapy(
Subclass(
LHRH(Agonist(
(aka(GnRH)(
Generic((Brand)(
Leuprolide(SQ/IM(
(Eligard/Lupron)(
Goserelin(SQ(
(Zoladex)(
LHRH(
Antagonist(
Degarelix(SQ(
(Firmagon)(
AntiVandrogen(
Flutamide(PO(
(Eulexin)(
Bicalutamide(PO(
(Casodex)(
Nilutamide(PO(
(Nilandron)(
Enzalatumide(PO(
(Xtandi)(
CYP17(inhibitor(
Abiraterone(PO(
(Zytiga)(
SERM(
Tamoxifen(PO(
(Nolvadex)(
SERD(
Aromatase(
Inhibitors(
(
Fulvestrant(IM(
(Faslodex)(
Anastrazole(PO(
(Arimidex)(
Letrozole(PO(
(Femara)(
Exemestane(PO(
(Aromasin)(
Uses(
Prostate(
&(Breast(
Prostate(
MOA(
Adverse(Effects(
DownNregulation(on(pituitary(to(stop(
LH(release(&(↓(testosterone(production(
*Initial(↑(in(testosterone(
Tumor(flare,(hot(flashes,(
osteoporosis,(etc(
Directly(inhibits(GnRH(receptor(on(the(
anterior(pituitary(to(stop(LH(production(
QTc(prolongation(
Injection(site(rxn,(chills(
Hot(flashes(
Competitively(block(androgen(
receptor(in(the(prostate(
All:(Gynecomastia,(↑LFT,(
hot(flashes,(tenderness(
(
Nil:(alcohol(intolerance(
night(blind,(pneumonitis(
Blocks(androgen(receptor(on(prostate(
cell(AND(receptors(floating(in(cytoplasm(
Inhibition(of(CYP17(in(adrenal(gland((
↓(Testosterone/DHT((ACTH(surge(
Agonism(–(Bone,(Liver,(Uterus(
Antagonism(V(Breast(
Breast(
Metabolism(
?(
Diarrhea,(hot(flashes,(
myalgia,(seizures(
Hyperaldosteronism:(
edema,(HTN,(hypoK+;(
cardiotoxic((↑HR/Afib)(
Hot(flashes,(Cataracts(
VTE,(Uterine(cancer(
Down(regulation(of(estrogen(receptor(
Hot(flashes,(
Injection(site(pain(
Inhibition(of(CYP(19(peripheral(estrogen(
production((NOT(in(ovaries!)(
(
POST(MENOPAUSE(ONLY!((
Hot(flashes,(arthralgia,(
↓(bone(mineral(density,(
HTN,(hyperlipidemia(
CYP(1A2,(3A4(
CYP(3A4(
CYP(2C19(
3A4(inducer(
Hepatic(
(dose(adjust)(
?(
Toxicity(Management(
Hot(Flashes((most(common)(
NVenlafaxine,(Sertraline,(Fluoxetine(
(
Osteoporosis(
NCalcium/Vitamin(D(for(all(>(50yo(
NZoledronic(acid,(alendronate,(or(
denosumab(if(needed(
(
Sexual(Dysfunction(
NPDE(inhibitors((Vardenafil)(
(
Metabolic(Complications(
NMonitor(obesity,(BG,(lipids,(CVD(
(
Hyperaldosteronism((abiraterone)(
VAlways(given(w/(prednisone(
Hot(Flashes(
–(Venlafaxine,(Pregabalin(
(
Bone(Loss((Not(needed(w/(SERMS)(
–(Bisphosphonates(or(denosumab(
(
31
(Targeted(Therapy:(Monoclonal(Antibodies(
Target(
Hematologic(
CD(20(inhibitor(
EGFR(inhibitors(
VEGF(inhibitor(
(AntiNangiogenesis)(
RANK(L(inhibitor(
Generic((Brand)(
Rituximab(
(Rituxan)(
Cetuximab(
(Erbitux)(
Panitumumab(
(Vectibix)(
Trastuzumab(
(Herceptin)(
Bevacizumab(
(Avastin)(
ZivVAflibercept(
Denosumab(
(Xgeva)(
Basic(MOA(
Binds(CD20(on(B(cell(lymphoma((
antibody/complement(cytotoxicity(
Blocks(all(EGFR,(ADCC,(CDC(
↓(Mitogenic(activity(&(angiogenesis(
HER2(specific(blockade,(ADCC,(CDC(
↓(Proliferation,(survival,(angiogenesis(
Bind(VEGF(to(prevent(binding(on(
endothelial(cells;(↓(blood(vessel(growth(
Fusion(protein(binding(to(VEGF(
Binds(RANKL(R(on(osteoclast(
↓(maturation(&(bone(breakdown(
NHL(=(Non(Hodgkin’s(Lymphoma(
(
Targeted(Therapy:(TK(Inhibitors(
Subclass(
HN(=(Head&Neck(
Generic((Brand)(
Dasatinib((Sprycel)(
BCRVABL(inhibitors(
Adverse(Effects(
Tumor(Lysis(Syndrome(
Infusion(Rxn(
PreVmeds(
Acneiform(rash,(
infusion(rxn,(↓(Mg,(
Diarrhea,(fatigue(
Benadryl(w/(1 (dose(
BC,(GIST(
Cardiotoxic((reversible)(
Infusion(rxns((rare)(
Loratadine(or(
APAP/Benadryl(
CRC,(GBM,(
NSCLC,(RCC(
CRC(
Bone(
metastases(
Both:(HTN,(proteinuria,(( None(
GI(perforation,(VTE,((
Ziv:(Diarrhea(
None(
Hypocalcemia,(ONJ,(
None(
Infections,(Dermatitis(
NHL,(CLL(
CRC,(HN(
CRC(
GBM(=(Glioblastoma(
Basic(MOA(
Uses(
Erlotinib((Tarceva)(
Inhibits(EGFR(TK(intracellularly(
↓(Activity,(survival,(angiogenesis(
NSCLC(
Lapatinib((Tykerb)(
Inhibits(HER2(and(EGFR(TK(
HER2(MBC(
Oral(VEGF(TK(inhibitors;(bind(
endothelial(cells(intracellularly(
RCC(
Broad(spectrum(of(activity(
including(VEGFR(TK(inhibition(
CRC(
Pazopanib((Votrient)(
Sunitnib((Sutent)(
Sorafenib((Nexavar)(
Regorafenib((Stivarga)(
**These(are(oral(medications(and(do(not(require(premeds(
(
(
(
(
Targeted(Therapy:(Misc.(
Generic(
Basic(MOA(
Uses(
Adverse(Effects(
Lenalidomide( Immunomodulators( MM,(MDS( Both:(Neutropenia,(VTE(
Broad(spectrum(
Thal:(Peripheral(neuropathy(
Thalidomide(
MM(
(
Other(
IV(steroid(for(infusion(rxn(
st
1 (dose(=(highest(rxn(risk(
st
May(need(electrolytes(
None(
Adverse(Effects(
Pleural(Effusion,(
Pulmonary(HTN(
QTc(prolongation(
Periorbital(edema((Loops)(
CML(
Nilotinib((Tasigna)(
Imatinib((Gleevec)(
APAP/Benadryl(
NSCLC(=(Lung( CRC(=(Colorectal(
Blocks(binding(site(on(BCRNABL(and(
shuts(off(signal(for(molecular(growth(
EGFR(inhibitors(
VEGFR(inhibitors(
(antiNangiogenesis)(
Uses(
Acneiform(rash,(Diarrhea(
Acneiform(rash,(Diarrhea,(
Hepatotoxicty,(Cardiotoxicity(
HTN,(Diarrhea,(Fatigue,(
HandVFoot(Syndrome(
Pazo:(Hepatotoxicity((BBW)(
Sunitinib:(Skin/Nail(toxicity(&(
hair(discoloration((reversible)(
HTN,(Diarrhea,(Fatigue,(
HandVFoot(Syndrome(
Do(not(give(with(
anthracyclines!!(
Hold(28(days(prior(to(any(
major(surgery(
D/c(for(serious(ADR(
Dental,(CrCl,(
2+
Ca ,(Mg,(K+(
GIST(=(GI(
BC(=(Breast(
Other(
N/A(
Take(on(empty(stomach(
Take(with(food(
Take(on(empty(stomach;(
Dose(adjust(for(hepatic(Dz/DI(
(
Lap:(monitor(LVEF(
Take(on(empty(stomach(
Cycled(dosing(instead(of(daily(
Take(on(empty(stomach(
Cycled(dosing(
**All(of(these(are(major(CYP(3A4(substrates(
REMS(
RevAssist(
STEPS(
Requirements(
Registered(parties,(forms,(phone(
survey,(2(negative(preg(tests,(etc(
32