ONS/ONCC Chemotherapy Immunotherapy
Certificate Exam Latest 2023-2024
Questions And Answers (Verified Answers)
Define mutations – ANSWER- Variations in the nucleotide sequence of a gene
3 main goals of treatment: – ANSWER- Cure
Control
Palliation
Define neoadjuvant therapy – ANSWER- Treatment is given prior to surgery to
shrink the tumor
Define adjuvant therapy – ANSWER- Additional cancer treatment given after the
primary treatment to lower the risk that the cancer reoccur
Define conditioning/preparative therapy – ANSWER- Treatments used to prepare a
patient for stem cell transplantation
2 types of conditioning therapies: – ANSWER- Myeloablative
Nonmyeloablative
Define dose density – ANSWER- Drug dose per unit of time
Define dose intensity – ANSWER- Amount of drug delivered over time
How is relative dose intensity (RDI) calculated? – ANSWER- By comparing the
dose that the patient ACTUALLY received to the planned dose of the standard
regimen
How do alkylating agents work? – ANSWER- By causing a break in the DNA
helix strand, interfering with DNA replication and causing cell death
3 subcategories of alkylating agents: – ANSWER- 1. Nitrogen mustards
- Platinum-based agents (do not possess an alkyl group but still termed alkylating
agents as they work similarly) - Nitrosoureas
Most common subcategory of alkylating agents: – ANSWER- Nitrogen mustards
Common alkylating agents: – ANSWER- Cyclophosphamide (Cytoxan)
Ifosfamide (Ifex)
Bendamustine (Treanda)
Common platinum-based agents: – ANSWER- Cisplatin (Platinol)
Carboplatin (Paraplatin)
What is unique about nitrosoureas agents? – ANSWER- Able to cross the bloodbrain barrier; can be effective in treating some brain tumors
Common nitrosoureas agents: – ANSWER- Carmustine (BiCNU)
Lomustine (CeeNu)
Streptozocin (Zanosar)
Hypersensitivity can occur with late doses of: – ANSWER- Carboplatin
These agents are typically categorized as highly emetogenic: – ANSWER- 1.
Alkylating agents - Nitrosoureas
Pre-administration labs for alkylating agents and nitrosoureas: – ANSWER- BUN
Creatinine
CBC w/ diff
What is the medication Mesna used for? – ANSWER- Bladder protectant with
administration of cyclophosphamide or ifosfamide
Instruct pts receiving to avoid exposure to cold air and consuming cold
fluids for 3-4 days following treatment – ANSWER- Oxaliplatin
How do antimetabolites function? – ANSWER- By blocking DNA and RNA
growth by interfering with enzymes needed for normal cell metabolism
Antimetabolites work in the _ phase. – ANSWER- S
What types of cells are best affected by antimetabolites? – ANSWER- Cells with
high division rates
Common side effects of antimetabolites: – ANSWER- Myelosuppression
GI toxicities
Photosensitivity
Hand-foot syndrome
Common antimetabolite drugs: – ANSWER- Azacitidine
Capecitabine
5-FU
Cytarabine
Decitabine
Methotrexate
The institute for Safe Medication Practices recommends what route of
administration for vincristine? – ANSWER- IV piggyback via gravity
Anthracycline antitumor abx work by: – ANSWER- Interfering with enzymes
necessary for DNA to replicate in ALL phases of the cell cycle
The two major classifications of antitumor antibiotics are: – ANSWERAnthracyclines
Non-anthracyclines
Common anthracycline antitumor abx: – ANSWER- Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
The antitumor abx _ is not an anthracycline, but has anthracyclinetype properties. – ANSWER- Mitoxantrone
Common non-anthracycline antitumor abx: – ANSWER- Actinomycin D
Mitomycin C
Bleomycin
Monitoring necessary with doxorubicin: – ANSWER- Vesicant –> extravasation
Cardiac function
Lifetime dose tracking (cardiotoxicity)
Lifetime dose of doxorubicin should not exceed: – ANSWER- 550 mg/m^2
What cardiac protectant medication can be administered prior to doxorubicin? –
ANSWER- Dexrazoxane
Significant side effects of doxorubicin are: – ANSWER- Cardiotoxicity
N/V
Mucositis
Diarrhea
Severe myelosuppression
Hepatic impairment
Secondary cancers
Monitoring necessary with bleomycin: – ANSWER- Pulmonary toxicity
Hypersensitivity reactions (esp. in lymphoma patients)
Cutaneous reactions
Lifetime dose tracking (pulmonary toxicity)
Pulmonary fibrosis is possible when the lifetime dose of bleomycin exceeds: –
ANSWER- 400 units
What 6 patient characteristics make CINV more likely? – ANSWER- 1. Younger
than 50 years
- Hx of low alcohol intake
- Female gender
- Hx of morning sickness during pregnancy
- Prone to motion sickness
- Previous chemotherapy
Types of CINV: – ANSWER- Acute
Delayed
Breakthrough
Anticipatory
Refractory
Define acute CINV – ANSWER- Occurring within 24 hours of chemotherapy
Define delayed CINV – ANSWER- Occurring from 24 hours to 5 days after
treatment