Jeopardy: The Oncologic Pharmacist Edition

Mechanism of Action

100

This pharmacologic class competitively inhibits androgens by binding to androgen receptors.

What is an anti-androgen?

Reference: Lexicomp-Pharmacology and Pharmacokinetics

200

This drug class covalently binds to DNA, interfering with the function of DNA by producing interstrand DNA cross-links (non-specific).

What are Alkylating Agents?

Reference: Lexicomp-Pharmacology and Pharmacokinetics

300

This drug will bind to CTLA-4, allowing for enhanced T-cell activation and proliferation.

What is ipilimumab or tremelimumab?

Reference:  Lexicomp-Pharmacology and Pharmacokinetics

400

This drug has an active metabolite named SN-38 that binds reversibly to topoisomerase 1-DNA complex.

What is Irinotecan, Topoisomerase inhibitor?

Reference: Lexicomp-Pharmacology and Pharmacokinetics

500

This drug is an agent that bind to PD-L1.

What is Atezolizumab, Avelumab, or Durvalumab?

Reference:  Lexicomp-Pharmacology and Pharmacokinetics

Drug Pearls

100

Regimen containing paclitaxel requires this to prevent hypersensitivity.

What is famotidine, diphenhydramine, and dexamethasone?

Reference: Drug Package Insert

200

This drug requires premedication that includes folate, vitamin B12 and dexamethasone.

What is Pemetrexed?

Reference: Lexicomp-Dosing (adult)

300

This must be given before and after every cisplatin infusion in order to prevent nephrotoxicity.

What is Fluid (NS)?

Reference: Lexicomp-Administration

400

This oral drug is used in EGFR positive, non-small cell lung , and can cross the blood brain barrier.

What is Osimertinib?

References: "Overall Survival with Osimertinib in Resected EGFR-Mutated NSCLC." New England Journal of Medicine, vol. 389, no. 2, 2023, pp. 137-147.

500

This pharmacogenomic mutation causes an increased risk of hemolytic anemia in those who are deficient if they receive rasburicase.

What is G6PD?

Reference:  Lexicomp-Pharmacogenomics

Supportive Care

100

A patient is taking cisplatin and paclitaxel. This regimen falls under one of the three emetic risks.

What is high emetic risk?

Reference: National Comprehensive Cancer Network, www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf.

200

This is the recommended timeframe for giving Hematopoietic Growth Factors to patients after chemotherapy.

What is at least 24 hours after and no more than 72 hours after?

Reference: NCCN Hematopoietic Growth Factor Guidelines

300

A patient is receiving paclitaxel. She is having trouble  buttoning her shirt and experiencing numbness and tingling in her hands. The pharmacist recommended this drug for her problem.

What is pregabalin, gabapentin, duloxetine, or venlafaxine?

Reference: National Comprehensive Cancer Network, www.nccn.org/professionals/physician_gls/pdf/immunotherapy.pdf.

400

This agent is used to treat anthracycline extravasation.

What is dexrazoxane, cold compress, or DMSO? 

Reference:  Lexicomp-Administration

500

This is the antidote for extravasation in a patient receiving a vinca alkaloid.

What is hyaluronidase, heat compress?

References: Lexicomp-Administration

Oncologic Emergencies

100

This antibiotic is a recommended monotherapy agent for neutropenic fever high-risk empiric therapy.

What is antipseudomonal beta-lactam, Cefepime, Imipenem/Cilastin, Meropenem, Piperacillin/Tazobactam, or Ceftazidime?

Reference: IDSA Neutropenic Patients with Cancer

200

This drug is used to treat spinal cord compression.

What is Dexamethasone?

References: Higdon, M. L., Atkinson, C. J., & Lawrence, K. V. (2018). Oncologic Emergencies: Recognition and Initial Management. American Family Physician, 97(11), 741-748. https://www.proquest.com/scholarly-journals/oncologic-emergencies-recognition-initial/docview/2454235560/se-2

300

This agent is added to bisphosphonates for hypercalcemia of malignancy and can cause tachyphylaxis.

What is calcitonin?  

Reference: Endocrine Society Hypercalcemia of Malignancy Guidelines

400

These specific electrolytes are increased during tumor lysis syndrome.

What is Potassium, Phosphorus, and Uric Acid?

References: Lamont, E. B., et al. "Diagnosis and Management of Oncologic Emergencies." Oncologic Therapies, 2003, pp. 105-114.

500

This allele is responsible for increased risk of severe cutaneous reactions in a medication that is used in the prevention and treatment of Tumor Lysis Syndrome.

What is HLAB*5801?

Reference:  Lexicomp-Pharmacogenomics

Miscellaneous

100

This common side effect increases symptoms of prostate cancer when GnRH agonists are administered.

What is tumor flare?

Reference: Lexicomp-Adverse Effects

200

This drug has a pharmacogenomic consideration of UGT1A1*28 or *6.

What is Irinotecan?

References: Veilleux C, Boulanger A. Perineal pruritus in epidural dexamethasone injections. Can J Pain. 2019 Aug 28;3(1):167-168. doi: 10.1080/24740527.2019.1650614. PMID: 35005405; PMCID: PMC8730584.

300

This agent is the recommended regimen for PCP prophylaxis and can cause hemolytic anemia in a G6PD deficient patient.

What is sulfamethoxazole/trimethoprim (Bactrim)?

Reference: Lexicomp-Pharmacology and Pharmacokinetics

400

Doxorubicin has the side effect of heart failure at this lifetime dose.

What is 450-550 mg/m²?

Reference: Lexicomp

500

This is the only carbapenem that does not provide pseudomonal coverage.

What is ertapenem?

Reference: Lexicomp-Pharmacology and Pharmacokinetics