Updated: 12/31/2021

Oncology Medications

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  • Oncology Drug Introduction
    • Oncology medications can be broken down into the following categories
      • alkylating agents
      • antimetabolites
      • microtubule inhibitors
      • topoisomerase inhibitors
      • antibiotics
      • immunomodulators
  • Oncology Drug Table
    • Alkylating Agents
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Busulfan 
        • Cross links DNA
        • CML
        • Bone marrow ablation
        • Pulmonary fibrosis
        • Bone marrow suppression
        • Carboplatin
        • Cisplatin
        • Oxaliplatin
        • Cross links DNA
        • Testicular cancer
        • Ovarian cancer
        • Bladder cancer
        • Lung cancer
        • Ototoxicity
        • Nephrotoxicity
        • Peripheral neuropathy
        • Cyclophosphamide
        • DNA cross linkage at guanine residues
        • Leukemia
        • Lymphoma
        • Solid tumors
        • Myelosuppression
        • Hemorrhagic cystitis (prophylaxis with mesna)
        • Chlorambucil
        • Inhibits DNA replication
        • Causes DNA damage
        • CLL
        • Myelosuppression
    • Antimetabolites
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Methotrexate
        • Dihydrofolate reductase competitive inhibitor
        • Leukemia
        •   Lymphoma
        •   Sarcoma
        •   Ectopic pregnancy
        •   Abortion
        •   Psoriasis
        •   Rheumatoid arthritis
        • Myelosuppression (reverse with leucovorin)
        •   Megaloblastic anemia (prevent with folate) 
        •   Mucositis/stomatitis
        • Cytarabine
        • Pyrimidine analogue
        • Leukemia
        •   Lymphoma
        • Pancytopenia
        • Fludarabine
        • Purine analogue
        • Leukemia
        • Lymphoma
        • Lymphopenia
        •   Infection
        • 6-Mercaptopurine
        • Purine analogue
        • Immunosuppressant
        • Inflammatory bowel disease
        • SLR
        • Myelosupppression
        • 5-Fluorouracil 
        • Pyrimidine analogue
        • Colon cancer
        •   Basal cell carcinoma
        •   Pancreatic cancer
        • Myelosupppression
    • Microtubule Inhibitors
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Vinblastine
        • Microtubule inhibitor
        • Lymphoma
        •  Leukemia
        •  Solid tumors
        • Peripheral neuropathy
        •  Neurotoxic
        • Vincristine
        • Microtubule inhibitor
        • Lymphoma
        •  Leukemia
        •  Solid tumors
        • GI problems
        •  Hair loss
        •  Peripheral neuropathy
    • Topoisomerase Inhibitors
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Irinotecan
        • DNA topoisomerase inhibitor
        • Colon cancer
        •  Ovarian cancer
        •  Small cell lung cancer
        • Myelosuppression
    • Antibiotics
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Bleomycin 
        • Free radical DNA damage
        • Hodgkin lymphoma
        •  Testicular cancer
        • Pulmonary fibrosis
        •  Myelosuppression
        • Dactinomycin (actinomycin D) 
        • Intercalates between DNA base pairs
        • Ewing sarcoma
        •  Wilms tumor
        •  Rhabdomyosarcoma
        • Myelosuppression
        • Doxorubicin
        • Free radical damage
        •  Intercalates between DNA base pairs
        • Leukemia
        •  Lymphoma
        • Cardiotoxicity
        • Mitomycin
        • DNA-cross linkage
        • Adenocarcinoma of the stomach, pancreas
        • Myelosuppression
        •  Nephrotoxic
        •  Pulmonary toxicity
        •  Cardiotoxicity
    • Immunomodulators
        • Name
        • Mechanism of Action
        •  Key Indication
        •  Key Toxicity
        • Interferon 
        • IFN-α analogue
        • Cancer
        •  Viral infections (Hep B/C)
        • Flu-like syndromes
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(M2.PH.16.4671) A 32-year-old male patient presents to your clinic with nontender unilateral testicular swelling which was first noted by his partner one week ago. After extensive workup and orchiectomy, the patient is diagnosed with testicular seminoma stage IIB. The patient undergoes three cycles of etoposide, bleomycin and cisplatin. In addition, the patient also decides to supplement his treatment regimen with vitamin D and garlic based upon his readings on the internet. Four months later, the patient develops a nonproductive cough, shortness of breath with exertion, and occasional fever. A chest x-ray is shown (Figure A). What is the likely cause for the patient’s current symptoms?

QID: 107171
FIGURES:

Etoposide

4%

(1/23)

Bleomycin

74%

(17/23)

Cisplatin

9%

(2/23)

Vitamin D

4%

(1/23)

Garlic

0%

(0/23)

M 7 E

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(M3.HE.15.55) A 64-year-old woman presents to her primary care physician with complaints of fatigue, a sore mouth, as well as occasional abdominal pain and diarrhea for the past several months. She denies any loss of balance, trouble walking, numbness, pain, or tingling in her hands or feet. She has a past medical history of morbid obesity, depression, rheumatoid arthritis, suicide, anxiety, hypertension, diabetes, and factor V Leiden being managed by her PCP. Her temperature is 99.4°F (37.4°C), blood pressure is 154/94 mmHg, pulse is 87/min, respirations are 18/min, and oxygen saturation is 98% on room air. Physical examination is significant for the finding in Figure A. The patient's creatinine is 2.0 mg/dL at this visit. Which of the following is most likely to be found in this patient?

QID: 102684
FIGURES:

Aplastic anemia

5%

(1/22)

Hemolytic anemia

0%

(0/22)

Megaloblastic anemia

9%

(2/22)

Microcytic anemia

9%

(2/22)

Polycythemia

73%

(16/22)

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(M3.ON.12.23) A 51-year-old woman presents to your office with 2 weeks of fatigue and generalized weakness. She has a past medical history of diabetes, hypertension, and hyperlipidemia. She was recently diagnosed with rheumatoid arthritis and started on disease-modifying therapy. She states she has felt less able to do things she enjoys and feels guilty she can't play sports with her children. Review of systems is notable for the patient occasionally seeing a small amount of bright red blood on the toilet paper. Laboratory studies are ordered as seen below.

Hemoglobin: 12 g/dL
Hematocrit: 36%
Leukocyte count: 7,700/mm^3 with normal differential
Platelet count: 207,000/mm^3
MCV: 110 fL

Which of the following is the most likely etiology of this patient's fatigue?

QID: 102777

Depression

0%

(0/6)

Gastrointestinal bleed

17%

(1/6)

Iron deficiency

0%

(0/6)

Medication side effect

50%

(3/6)

Vitamin B12 deficiency

33%

(2/6)

M 10 E

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