31c - Brain Tumor ChemRx Flashcards
MOA of carmustine
Nitrosourea. alkylator AND its decomposition products carbamoylate proteins to inhibit DNA repair
ADE of carmustine?
thrombocytopenia, leucopenia, pulmonary fibrosis, endocrine dysfunction
encephalopathy and seizures
elevated LFT and hyperbilirubinemia
MOA of temozolomide
DNA methylator. non-enzymatically activated pro-drug
ADE of temozolomide
N/v chills, fever, malaise, myalgia,
DOSE DEPENDENT myelosuppessive effects due to low MGMT production by hamtopoietic stem cells (they get killed)
Should chemo be used to treat brain mets?
lack of evidence to support treatment of patients with brain mets
What are mechanisms of brain tumor drug resistance?
BBB, epxression of PgP by metastatic cells, and astrocyte mediated resistance