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CSO EXAM WITH VERIFIED QUESTIONS AND 100% LATEST CORRECT ANSWERS GRADED A+ Alkylating agents - ANS-synthetic chemicals containing alkyl groups that attack DNA, causing strand breaks thus preventing replication and transcription of RNA Examples: Bendamustine (Treanda), Busulfan (Myleran PO/...

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  • June 18, 2024
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  • 2023/2024
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CSO EXAM 2024-2025 WITH VERIFIED
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Alkylating agents - ANS-synthetic chemicals containing alkyl groups that attack DNA, causing strand
breaks thus preventing replication and transcription of RNA



Examples: Bendamustine (Treanda), Busulfan (Myleran PO/Busulflex IV, Carboplatin (paraplatin),
Carmustine (BCNU), Chlorambucil (Leukeran), Ciosplatin (Platinol, CDDP), Cyclophosphamide (Cytoxan,
CTX), Dacarbazine (DTIC), Ifosfamide (Ifex), Mechlorethamine (nitrogen mustard), Melphalan (Alkeran),
OXaliplatin (Eloxatin), Temozolomide (temodar), Thiotepa (Thioplex)



Bendamustine (treanda) - ANS-Treanda (alkylating agent)

- IV only

-B cell, NHL, CLL



SE: myelosuppression, mild N/V, fatigue, fever, Hypersensitivity infusion reactions, tumor lysis syndrome



Busulfan (Myleran) - ANS-Myleran (alkylating agent)

-CML, stem cell transplant preparation, polycythemia vera

Side effects:

,-Myelosuppresion

-NVD, Mucositis

-Hepatic toxicity

- Adrenal insufficiency

-other: pulm symptoms, insomnia, dizziness, anxiety, alopecia

Additional SE:

- increases uric acid! (use allopurinol, and watch for DDIs w/ thiazides, loops, niacin, low dose ASA)

- Pulmonary fibrosis!! (SOB -> CXR -> d/c Myleran)

- Seizures! (pre-medicate with anticonvulsant 12hr before and 24hr after

- Hyperpigmentation of skin



Carboplatin (Paraplatin) - ANS-Paraplatin

Platinum complex alkylating agent

-breast, bladder, cervix, endometrial, esophagus, germ cell, H/N, lung, ovarian



SE:

-myelosuppresion

-low Mg

-N/V

-renal toxicity

-Other: hypersensitivity reaction, mild alopecia, peripheral neuropathy, taste change



Carmustine (BCNU) - ANS-BiCNU (alkylating agent)

-brain, NHL, T-cell lymphoma

SE:

-myelosuppression

-N/V

-liver, renal, lung toxicity

,Chlorambucil (Leukeran) - ANS-Leukeran (alkylating agent)

-oral

-CLL, HD, NHL, breast, ovary, testies

SE:

-N/V

-high uric acid (low purine diet)

--> high purine foods: organ meat, meat, anchovies, sardines, beer

-seizure risk in children

-lung toxicity



Cisplatin (Platinol) - ANS-Platinol (alkylating agent)

-bladder, cervix, esophagus, H/N, lung, prostate, stomach

SE:

- Nephrotoxic!! Treat with hydration to maintain renal blood flow, mannitol to promote excretion, and
amiphostine (Ethyol) to prevent nephrotoxicity

- Ototoxic

- Peripheral neuropathy

- Electrolyte abnormalities (decreases PO4, K, Ca, Mg)

- GI upset

- causes the most N/V!

-SIADH

-metallic taste



Cyclophosphamide (Cytoxan) - ANS--Alkylating agent (cytotoxic antineoplastic)

-can be used intrapleural

-breast, lung, ovary, CLL, NHL

SE:

-myelosuppresion

-N/V

, -flu like

-CNS toxicity

-photosensitivity



Ifosfamide (Ifex) - ANS-Alkylating Agent

SFX: n/v, anorexia, SIADH



Methotrexate (nitrogen mustard) - ANS-alkylating agent

-CLL, CML, HD, NHL, breat, lung

Toxic to just about every organ except to heart, toxicity made worse with aspirin

SE:

-N/V

-hyperuricemia



Melphalan (Alkeran) - ANS-alkylating agent

-breast, ovarian, neuroblastoma

SE: N/V



Oxaliplatin (Eloxatin) - ANS-alkylating agent

-colorectal, pancreatic

SE:

-N/V/D

- sensitivity to cold

-hepatic and neurotoxic

-allergic reaction

-laryngopharyngeal dysesthesia (A disorder characterized by an uncomfortable persistent sensation in
the area of the laryngopharynx)



Temozolomide (Temodar) - ANS-alkylating agent

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