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Filgrastim (G-CSF)
Neupogen

5mcg/kg SC weekly

bone pain, fever
PEG-filgrastim
Neulasta

6mg SC x1dose

bone pain, fever

do not use 14days before and 24hr after cytotoxic chemotherapy
Sargramostim (GM-CSF)
Leukine

stimulates neutrophils

250mg/m2 SC daily

bone pain, fever, hypotension
Epoeitin-alpha
Procrit, Epogen

stimulate RBC production

150u/kg SC TID
or 40,000u SC weekly

HTN, HA, fever

monitor H/H, ferritin, transferritin

supplement Fe if needed

DO NOT USE IF HGB>12
Darbepoeitin
Aranesp

stimulate RBC production

2.25mcg/kg weekly

HTN, HA, fever

monitor H/H, ferritin, transferritin

supplement with Fe if needed

DO NOT USE IF HGB>12
Oprelvekin
Neumega

stimulates megakaryocytopoeisis, thrombopoeisis

50mcg/kg SC daily days 10-21

arrhythmias, palpitations, peripheral edema, dizziness, fluid retention
Asparaginase
Elspar

enzyme, hydrolyzes aspargine AA

ALL, lymphoma

HSR, hypofibrinogenemia, use test dose
Bleomycin
Blenoxane

intercalation, free radicals

testicular, lymphoma

pulmonary fibrosis, use test dose, avoid O2 therapy
Bortezomib
Velcade

Proteosome inhibitor

Multiple myeloma

may cause neuropathy
Capecitabine
Xeloda

PO prodrug of 5-FU

breast/colorectal cancer

hand-foot syndrome, diarrhea
Cisplatin
Platinol

DNA crosslinker

highly emetogenic, nephrotoxic, ototoxic, peripheral neuropathy, hypokalemia, hypomagnesemia

requires vigorous hydration
Cyclophosphamide
Cytoxan

alkylating agent

hemorrhagic cystitis, neutropenia, delayed nausea, mucositis, alopecia, SIADH
Docetaxel
Taxotere

microtubule stabilizer

breast/lung/ovarian cancer

peripheral edema, peripheral neuropathy, HSR

premed with dexamethasone
Doxorubicin
Adriamycin

topoisomerase I/II inhibitor

breast, solid tumor, sacroma, leukemia, lymphoma

cardiotoxicity, vesicant
Fluorouracil
Adrucil

pyrimidine analog

neutropenia, hand foot syndrome

leucovorin increase efficacy and toxicity
Ifosfamide
Ifex

alkylating agent

hemorrhagic cystitis, requires hydration and MeSNA
Irinotecan
Camptosar

Topoisomerase I inhibitor

colorectal cancer

early cholinergic effects, late diarrhea, acute diarrhea treatable with atropine.
Methotrexate
antifolate

myelosuppression, mucositis, diarrhea, stomatitis, renal failure

leucovorin rescue
Oxaliplatin
Eloxatin

DNA crosslinker

Colorectal, esophageal, gastric

fatigue, anemia, N/V, pain, neuropathy

cold increases risk of neuropathy
Paclitaxol
Taxol

microtubule stabilizer

breast, ovarian, lung cancer

HSR, peripheral neuropathy, arthralgias, myalgias

premed with dexamethasone, H2-antagonist
Vincristine
Oncovin

blocks microtubule assembly

neurotoxic, peripheral neuropathy, constipation, vesicant, low emetogenicity, low myelosuppresion
Zolendronic acid
Zometa

osteolytic boney metastasis

Inhibits osteoclast bone resporption, osteoclast apoptosis

renal toxicity
Pamidronate
Aredia

osteolytic boney metastasis

inhibits osteoclast bone resorption, osteoclast apoptosis

renal toxicity
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