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دوزج فورم mcq جابتر New drug development https://t.me/ksoIiee/3758

5- human papillomavirus (HPV) --cervical cancers, 6- Epstein-Barr virus -- lymphomas 7- hepatitis B virus -- liver cancers 8- aniline -- bladder cancer 9- benzene -- leukemia 10- Anticancer agents such as the alkylating agents (eg, melphalan), anthracyclines (eg, doxorubicin), and epipodophyllotoxins (eg, etoposide) can cause secondary malignancies (eg, leukemias) years after therapy has been completed.

كيسات Depressive Disorders 1- SSRIs 🟡 firstline antidepressants because of their relative safety in overdose and improved tolerability compared with earlier agents 🟢 Any antidepressant that enhances serotonergic activity can be associated with serotonin syndrome 🔵 Citalopram and escitalopram may to an increase in QT interval at doses above 40 mg/day. 2- SNRI 🟡 Venlafaxine may have a slight efficacy advantage compared to other antidepressants 🟢 adverse effects hyperhidrosis. 3- Antidepressants with Mixed Serotonin Effects a) Mirtazapine : option for patients experiencing sexual dysfunction with other antidepressants b) Levomilnacipran : for fibromyalgia c) Trazodone : causes Priapism d) nefazodone : Do not give with liver disease or elevated serum transaminases. e) Vilazodone : for depressed patients with anxiety f) vortioxetine : for depressed patients with cognitive difficulties 4- Bupropion : contraindicated in patients with bulimia or anorexia nervosa, due to a higher risk for seizures. It causes less sexual dysfunction than SSRIs 5- Monoamine Oxidase Inhibitors 🟣 Isocarboxazide, phenelzine, and tranylcypromine nonselective inhibitors of MAOA and MAOB 🟡 Selegiline, available as a transdermal patch for treatment of major depression, inhibits brain MAOA and MAOB but has reduced effects on MAOA in the gut 6- Tricyclic Antidepressants 🔴 Desipramine carries an increased risk of death in patients with a family history of sudden cardiac death, cardiac dysrhythmias, or cardiac conduction disturbances 7- Ketamine 🟤 treatment resistant depression (TRD) ⚫ Intranasal esketamine is FDA approved and requires supervised, in-clinic self administration (1–3 sprays in each nostril per session) followed by 2 hours of in- clinic observation. 8- Brexanolone : FDA approved for postpartum depression 9- Fluoxetine and escitalopram are FDA approved for patients below 18 years of age 10- The SSRIs are often considered first choice antidepressants for older patients

كيسات ANXIETY DISORDERS 1- Paroxetine should be avoided in pregnancy (cardiovascular malformation risk) 2- SSIR and SNRIs and TCA يسببون jitteriness syndrome 3- fluoxetine, sertraline, or citalopram for pregnant 4- Intermediateor short acting benzodiazepines are preferred for chronic use in older patients 5- Benzodiazepine teratogenic “floppy baby syndrome,” and neonatal withdrawal 6- Diazepam and clorazepate (high lipophilicity. They have rapid antianxiety effects, but a shorter duration of effect 7- Lorazepam and oxazepam ( are less lipophilic, have a slower onset, but a longer duration of action. They are not recommended for immediate relief of anxiety ) 8- حتى نقطع Benzodiazepine نقلل 25% كل اسبوع لمدة اسبوعين يعني نقلل 50% (اول اسبوعين ) بعدها نقلل 1/8 كل 4-7 ايام 9- pregabalin use to reduce withdrawal symptoms during the benzodiazepine taper 10- Buspirone is an option for patients who fail other anxiolytic therapies or patients with a history of unhealthy alcohol or substance use. It does not provide rapid or “as needed” antianxiety effects. 11- Benzodiazepines are more effective for somatic and autonomic symptoms of GAD 12- antidepressants are more effective for the psychic symptoms (eg, apprehension and worry

كيسات ANXIETY DISORDERS 1- Paroxetine should be avoided in pregnancy (cardiovascular malformation risk) 2- SSIR and SNRIs and TCA يسببون jitteriness syndrome 3- fluoxetine, sertraline, or citalopram for pregnant 4- Intermediateor short acting benzodiazepines are preferred for chronic use in older patients 5- Benzodiazepine teratogenic “floppy baby syndrome,” and neonatal withdrawal 6- Lorazepam, Oxazepam (high lipophilicity. They have rapid antianxiety effects, but a shorter duration of effect 7- Lorazepam and oxazepam ( are less lipophilic, have a slower onset, but a longer duration of action. They are not recommended for immediate relief of anxiety ) 8- حتى نقطع Benzodiazepine نقلل 25% كل اسبوع لمدة اسبوعين يعني نقلل 50% (اول اسبوعين ) بعدها نقلل 1/8 كل 4-7 ايام 9- pregabalin use to reduce withdrawal symptoms during the benzodiazepine taper 10- Buspirone is an option for patients who fail other anxiolytic therapies or patients with a history of unhealthy alcohol or substance use. It does not provide rapid or “as needed” antianxiety effects. 11- Benzodiazepines are more effective for somatic and autonomic symptoms of GAD 12- antidepressants are more effective for the psychic symptoms (eg, apprehension and worry

كيسات ALZHEIMER DISEASE 1- Cholinesterase Inhibitors a) Donepezil, rivastigmine, and galantamine for mild to moderate AD b)donepezil for severe AD 2- N Methyl D Aspartate (NMDA) Receptor Antagonist Memantine combination with a cholinesterase inhibitor and is indicated for moderate to severe AD 3- Anti amyloid Monoclonal Antibody aducanumab, lecanemab, donanemab, and gantenerumab aducanumab for cognitive impairment (MCI) 4- SSIR (sertraline and citalopram) for depression 5- carbamazepine, lamotrigine, pregabalin, and gabapentin, may be alternatives for agitation,

الادوية الي تسبب الادفرس افكت (كل سنة درجة لو درجتين حرامات يضيعن ) 1- Nausea and vomiting (Agents with a “high” emetic risk cause emesis in more than 90% of cases if not given any prophylaxis (such as cisplatin) 2- Mucositis taxanes, anthracyclines, platinum analogues, methotrexate, and the fluoropyrimidines. مرات يجيبون اسماء من عوائل الادوية ركزوا بيهم 3- Febrile neutropenia (FN) common adverse effect after administration of cytotoxic chemotherapy 4- Hemorrhagic cystitis Alkylating agents (cyclophosphamide and ifosfamide)

كيسات بروستات مهمة CRPC = castration resistant prostate cancer 1- patients with metastatic CRPC with symptomatic primary bone metastases (Radium223) 2- metastatic CRPC with BRCA1 and BRCA2 (olaparib and rucaparib) 3- improves survival in CRPC ( Docetaxel, combined with prednisone ) 4- improves progression free and overall survival in patients previously treated with docetaxel and prednisone (Cabazitaxel with prednisone) 5- patients with metastatic castration naïve prostate cancer or metastatic CRPC (Abiraterone) 6- non-metastatic CRPC. (Darolutamide) 7- non-metastatic CRPC, as well as metastatic castration naïve and metastatic CRPC (Enzalutamide)

case : A 45-year-old woman with HER2-positive breast cancer receives neoadjuvant therapy with trastuzumab, pertuzumab, and chemotherapy. At the time of surgery, residual invasive disease is found in the breast tissue

FCR

Outcome evaluation اهم شغلة لازم نقيس BCR-ABL1 1- خلال 3 او 6 اشهر يكون 10% معناها نستمر بالعلاج وفعال 2- خلال 12 شهر تكون نسبة 0.1% وكذلك نستمر على العلاج اذا لا النسب مختلفة  1- Assess medication adherence 2- Evaluate drug interactions Consider mutational analysis 3- Consider changing to alternate TKI Additional options: Ponatinib if T315ł mutation, evaluate for allogeneic HSCT or clinical trial هذا شرح التيبل بنهاية CML

TKI 1- ponatinib for T315I mutation 2- imatinib and dasatinib side effect of pleural effusions 3- nilotinib side effects QT prolongation 4- ponatinib side effects arterial thrombotic events