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3b_Boards - SketchyPharm > (8) Antineoplastics: DNA & Cell... (2.1-2.5) > Flashcards

(8) Antineoplastics: DNA & Cell... (2.1-2.5) Flashcards

1
Q

MOA: Cyclophosphamide

A

Cytotoxic alkylating agent

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2
Q

Suffix: Nitrosoureas

A

“-mustine”

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3
Q

MOA: Busulfan

A

Cytotoxic alkylating agent

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4
Q

MOA: Nitrosoureas

A

Cytotoxic alkylating agent

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5
Q

How is Cyclophosphamide activated?

A

Hepatic CYP450 system

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6
Q

Indication - Non-neoplastic: Cyclophosphamide

A

Immunosuppressive agent

(Note: According to Golan, suppresses B-cell response, but actually potentiates T-cell response)

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7
Q

Adverse Effects (5) : Cyclophosphamide

A

(1) Myelosuppression
(2) Hemorrhagic cystitis
(3) Bladder cancer (transitional cell)
(4) SIADH
(5) Infertility

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8
Q

How can you prevent hemorrhagic cystitis when administering Cyclophosphamide?

A

Hydration + MESNA

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9
Q

Indication: Busulfan

A

Bone marrow depletion

(Also CML)

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10
Q

Adverse Effects (2) : Busulfan

A

(1) Pulmonary fibrosis
(2) “Busulfan tan”
* (Severe myelosuppression, blurs the line between effect and adverse effect)*

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11
Q

Which Nitrosourea does not have the “-mustine” suffix?

A

Streptozocin

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12
Q

Which class of alkylating agents can cross the blood-brain barrier?

A

Nitrosoureas

(Require O-6 alkylation before they’re cytotoxic)

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13
Q

Adverse Effect (1) : Nitrosoureas

A

Neurotoxicity

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14
Q

Cell Cycle Specificity: Alkylating agents

A

Cell cycle non-specific

(Includes platinum analogs)

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15
Q

What type of cancers does Cyclophosphamide treat?

A

(1) Hematologic
(2) Solid malignancies

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16
Q

MOA: Platinum analogs

A

Cross-link DNA

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17
Q

Adverse Effects (5) : “-platins”

A

(1) Ototoxicity
(2) Peripheral neuropathy
(3) Nephrotoxicity
(4) Acute tubular necrosis
(5) Myelosuppression
* (Oto-/Nephrotoxicity: Cisplatin > Carboplatin >>> Oxaliplatin)*

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18
Q

Name 2 ways to prevent Cisplatin-induced nephrotoxicity

A

(1) Co-administer Amifostine
(2) IV Saline diuresis

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19
Q

MOA: Amifostine

A

Neutralizes free-radicals (in kidney)

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20
Q

What type of cancers do “-platins” treat?

A

Various solid malignancies

(Most notably BEP therapy for testicular cancer)

21
Q

MOA: Bleomycin

A

Binds DNA then produces free radical ⇒ Cleaves DNA

22
Q

Cell Cycle Specificity: Bleomycin

A

G2

23
Q

Adverse Effects (4) : Bleomycin

A

(1) Pulmonary toxicity
(2) Skin toxicity
(3) Stomatitis/Mucositis
(4) Alopecia
* (Bleomycin is activated by oxygen ∴ highly oxygenated environment of lung predisposes to collateral damage)*

24
Q

Suffix: Anthracyclines

A

“-rubicin”

25
Q

MOA: Anthracyclines

A

(1) Produce free radicals
(2) Intercalate DNA

26
Q

Adverse Effects (4) : Anthracyclines

A

(1) Dilated cardiomyopathy
(2) Myelosuppression
(3) Stomatitis/Mucositis
(4) Alopecia

27
Q

What drug can prevent Anthracycline-induced cardiotoxicity?

A

Dexrazoxane

28
Q

MOA: Dexrazoxane

A

Iron chelator

(Scavenging iron prevents the Fenton reaction from generating free radicals)

29
Q

MOA: Actinomycin D

A

Intercalates DNA

30
Q

What type of cancers does actinomycin D treat?

A

Numerous pediatric malignancies

(i.e., Wilms tumor, Ewing sarcoma, rhabdomyosarcoma)

31
Q

What type of cancers does Bleomycin treat?

A

(1) Hematologic
(2) Solid malignancies
* (Same for anthracyclines)*

32
Q

Suffix: Topoisomerase II Inhibitors

A

“-poside”

33
Q

Suffix: Topoisomerase I Inhibitors

A

“-tecan”

34
Q

What is the function of Topoisomerase II?

A

Induces dsDNA nicks ⇒ Relieves supercoiling stress

(Topoisomerase I ⇒ ssDNA nicks)

35
Q

MOA: Etoposide

A

Inhibits religation of dsDNA breaks created by Topoisomerase II

36
Q

Cell Cycle Specificity: Topoisomerase inhibitors

A

(1) S
(2) G2

37
Q

Adverse Effects (3) : Topoisomerase II inhibitors

A

(1) Myelosuppression
(2) ⇒ Immunosuppression
(3) Alopecia

38
Q

MOA: Irinotecan

A

Inhibits Topoisomerase I

39
Q

Are Topoisomerase I or II inhibitors associated with severe, potentially life-threatening, diarrhea?

A

Topoisomerase I inhibitors

40
Q

What type of cancers do “-posides” treat?

A

(1) Hematologic
(2) Solid malignancies

41
Q

What type of cancers does Topotecan treat?

A

(1) Ovarian cancer
(2) Small cell lung cancer

42
Q

What type of cancers does Irinotecan treat?

A

Colon cancer

43
Q

MOA: Vinca alkaloids

A

Inhibits microtubule assembly

(∝ Inhibiting kinesin ∝ Colchicine, which all have the ‘kuh’ sound)

44
Q

Cell Cycle Specificity: Microtubule inhibitors

A

M phase

45
Q

Adverse Effects (4) : Vinca alkaloids & Taxanes

A

(1) Peripheral neuropathy
(2) Paralytic ileus/Constipation
(3) Alopecia
(4) Myelosuppression

46
Q

Which Vinca alkaloid is known for significant myelosuppression?

A

Vinblastine

(“Vinblastine blasts your bone eye marrow”)

47
Q

MOA: Taxanes

A

Inhibit microtubule degradation

(∝ Inhibiting dynein ∝ C. Diff exotoxins B’s effect on actin)

48
Q

What type of cancers do Vinca alkaloids treat?

A

(1) Hematologic
(2) Solid malignancies

3b_Boards - SketchyPharm (32 decks)

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