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July > 8.7.2013(pharm-anticancer Drugs) 60 > Flashcards

8.7.2013(pharm-anticancer Drugs) 60 Flashcards

0
Q

Most susceptible atom to Alkylating agents

A

N7 of guanine

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1
Q

Gompertzian model

A

Growth fraction peaks when tumor is approx 37% of its maximum size

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2
Q

Mesna

A

Mercaptoethane sulfonic acid

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3
Q

Mechlorethamine is used in

A

Hodgkin lymphoma

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4
Q

Adverse effects of cyclophosphamide

A

Cardiac dysfunction
Pulmonary toxicity
SIADH

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5
Q

Anticancer drugs that cause delayed neutropenia

A

Nitrsoureas

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6
Q

Adverse effects of busulfan

A

Adrenal insufficiency
Pulmonary fibrosis
Skin hyperpigmentation
Hyperuricemia

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7
Q

CNS side effects of procarbazine

A

Hypnosis

Vivid dreams

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8
Q

Drug used for CLL

A

Chlorambucil

As it spares myelocytes

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9
Q

Cisplatin nephrotoxicity can be prevented by

A

Chloride diuresis

Doesnot help against ototoxicity

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10
Q

Cisplatin is inactivated by

A

Aluminium

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11
Q

Drug that can be given to prevent cisplatin induced nephrotoxicity

A

Amifostine

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12
Q

Electrolyte abnormalities associated with cisplatin

A 
Reduces all ions 
Hypomagnesimia 
Hypokalemia
Hypophosphatemia
Hypocalcemia
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13
Q

Anticancer drugs with strong vesicant properties

A

Nitrosoureas

Mechlorethamine

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14
Q

Alkylating agent with less chance of secondary leukemia

A

Cyclophosphamide

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15
Q

Anticancer drugs causing veno occlusive disease

A

All Alkylating agents in high doses

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16
Q

Alkylating agents causing pulmonary fibrosis

A

All Alkylating agents

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17
Q

Mechanisms of MTX resistance

A 
Decreased MTX transporter
Decreased formation of MTX polyglutamate
Increased levels of DHFR due to GENE AMPLIFICATION 
altered DHFR
Increased drug efflux transporter
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18
Q

Enzyme required for activation of MTX and pemetrexed

A

Folylpolyglutamate synthase

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19
Q

MTX is DOC for

A

Choriocarcinoma

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20
Q

Pemetrexed is approved for treatment of

A

Mesothelioma

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21
Q

Citrovorum factor

A

N10 formyl THF

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22
Q

Rx of MTX toxicity

A

Citrovorum factor
Alkalinisation of urine
Dialysis
Glucarpidase

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23
Q

Glucarpidase

A

MTX cleaving enzyme

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24
Pralatrexate is used for Rx of
Peripheral T cell lymphoma
25
Adverse effects of MTX
Hepatotoxicity Pulmonary infiltrates and fibrosis Bone marrow supression Mucositis
26
DOC for CLL
Fludarabine
27
Purine analogs
6MP 6TG Cladribine Fludarabine
28
DOC for Hairy cell leukemia
Cladribine(resistant to degradation by ADA)
29
Drug that must be given to longterm purine analog users
Cotrimoxazole for PCP prophylaxis as long term purine analog use leads to Immunosuppression
30
Dose of which anti metabolites should be reduced when given along with allopurinol
6-MP | azathioprine
31
Pyramidine analogs
``` 5FU cytarabine Capecitabine Gemcitabine 5-azacytidine Decitabine ```
32
Single most effective agent for induction of remission in AML
Cytarabine
33
Anticancer drug eliminated by lungs
5FU | converted to CO2
34
Adverse effect of capecitabine
Hyperbilirubinemia
35
Metabolism of thiopurines
TPMT | thiopurine methyl transferase
36
5FU is catabolised by
Dihydropyramidine dehydrogenase
37
5FU action is augmented by
Leukovorin
38
DOC for pancreatic cancer
Gemcitabine
39
Adverse effect of thiopurines
Hepatotoxicity
40
Adverse effects of 5FU
Neurotoxicity | Hand foot syndrome
41
Side effect of fludarabine
Arthralgia
42
Side effect of gemcitabine
Diarrhoea
43
Marrow sparing cytotoxic drugs
Vincristine Bleomycin L-asparaginase
44
Diff btw vincristine and vinblastine
Vinblastine causes bone marrow supression | Vincristine has bone marrow sparing effect but dose limiting neurotoxicity
45
Use of vinblastine
Metastatic testicular tumors
46
Use of vincristine
Induction of remission in childhood leukemias | Pediatric solid tumors-Wilms,neuroblastoma,rhabdomyosarcoma
47
Taxanes that causes hypersensitivity reactions
Paclitaxel
48
Taxanes that don't cause hypersensitivity reactions
Docetaxel | Nabpaclitaxel(protein bound paclitaxel)
49
Adverse effect of Taxanes
Bone marrow suppression | Neurotoxicity
50
Taxanes drug interactions
Cisplatin decreases paclitaxel clearance | Paclitaxel decreases doxorubicin clearance
51
Use of Cabazitaxel
Rx of refractory metastatic prostate cancer in combination with prednisone
52
MOA of action of Ixabepilone
Microtubule stabilisation
53
Estramustine is combination of
Estrogen and Mechlorethamine
54
Use of estramustine
Prostatic Ca
55
Side effects of estramustine
Gynacomastia | Impotence
56
MOA of camptothecins
Inhibits topoisomerase 1
57
Elimination of camptothecins
Irinotecan eliminated in bile | Topotecan eliminated by renal route
58
Rx of choice for advanced colorectal carcinoma
Irinotecan+5FU
59
Dose limiting toxicities of camptothecins
Irinotecan-diarrhoea | Topotecan- neutropenia
60
Adverse effects of irinotecan
Diarrhoea Myelosuppression Cholinergic syndrome(inhibits acetyl choline esterase)
61
MOA of etoposide and teniposide
Inhibit topoisomerase 2
62
Use of etoposide
Testicular Ca Prostate Ca Small cell Ca of lung
63
Etoposide induced secondary leukemia
Develops at short interval Not preceded by myelodysplasia It's acute non lymphocytic type
64
Toxicity of etoposide
Hepatotoxicity
65
All anti tumor antibiotics are obtained from
Streptomyces
66
Cardiotoxicity of anthracyclins can be reduced by
Alpha tocopherol | Dexrazoxane
67
MOA of anthracyclins
Inhibits topoisomerase 2
68
Less cardiotoxic anthracyclin
Mitoxantrone
69
Radiation recall reaction is seen with
Anthracyclins
70
Use of Mitoxantrone
Hormone resistant prostate cancer AML SPMS(secondary progressive MS)
71
Leukemia caused by Mitoxantrone
Acute promyelocytic leukemia
72
Use of valrubicin
BCG refractory urinary bladder Ca insitu
73
Radiosensitizers
``` Hydroxy urea Gemcitabine Metronidazole 5FU dactinomycin ```
74
Use of dactinomycin
Solid tumors in children
75
Nature of Bleomycin
Glycopeptide
76
Earliest indicator of adverse effect of Bleomycin
Decreased DLco
77
Adverse effects of Bleomycin
``` Cutaneous Hyperpigmentation Hyperkeratosis Erythema Ulcers Pneumonitis Pulmonary fibrosis Hypersensitivity ```
78
Bleomycin is metabolised by
Bleomycin hydrolase | It's concentration is less in skin and lungs
79
Bleomycin toxicity is ________ dependant
Oxygen
80
Hypoxic tumor cells can be killed by
Mitomycin
81
Adverse effect of mitomycin
HUS | delayed bronchospasm
82
Use of mitomycin
Superficial Bladder Ca Anal Ca Tracheal and laryngeal stenosis
83
Adverse effects of docetaxel
Peripheral neuropathy | Fluid retention
84
Imatinib is the drug of choice for
CML | GIST
85
MOA of Imatinib
Competitive inhibitor of ATP binding of the abl kinase
86
Erlotinib pharmacokinetics
Food increases absorption by 100% | Metabolised by CYP3A4
87
Adverse effects of erlotinib
Skin rash Diarrhoea Anorexia Fatigue
88
Erlotinib is effective in
``` Women Non smokers Asians Non small cell lung Ca Adenocarcinoma Bronchioalveolar Ca ```
89
Use of erlotinib
Non small cell lung cancer with EGFR receptor mutation KRAS mutation cancers don't respond to it Pancreatic Ca
90
Use of sorafenib and sunitinib
Sunitinib- RCC,GIST | sorafenib-RCC,HCC
91
Adverse effects of sorafenib and sunitinib
Hypertension
92
Route of administration of tyrosine kinase inhibitors
Oral
93
Use of lapatinib
Ca breast | Inhibits TK associated with her2/neu
94
Use of pazopanib
Advanced RCC | Multi targeted TK inhibitor against VEGF,PDGF,c kit
95
Drug that inhibits TK activated by JAK
Tofacitinib
96
Tofacitinib is used against
rheumatoid arthritis
97
Tyrosine kinase inhibitors used in medullary Ca of thyroid
Vandetanib(VEGFR,EGFR) | Cabozantinib(c-MET,VEGFR-2)
98
TK inhibitor used in Rx of malignant melanoma
Vemurafenib(BRAF)
99
TK inhibitor used in myelofibrosis
Ruxolitinib(JAK1,2)
100
TK inhibitors used in CML
``` Bosutinib Dasatinib Imatinib Nilotinib Ponatinib ```
101
TK inhibitor used in colorectal cancer
Regorafenib(VEGFR2,TIE2)
102
TK inhibitors used in non small cell carcinoma of lung
Crizotinib(cMET,ALK) Erlotinib(EGFR) Gefitinib(EGFR)
103
TK inhibitors used in advanced RCC
Axitinib(VEGFR1,2,3) Pazopanib(VEGFR1,2,3;PDGFR A,B;cKIT) Sorafenib Sunitinib
104
TK inhibitors used in pancreatic Ca
Sunitinib | Erlotinib
105
Dose limiting toxicity of transtuzumab
Cardiotoxicity
106
CD52 antagonist
Alemtuzumab(low grade lymphomas and CLL)
107
Monoclonal Ab against EGFR
Cetuximab Panitumumab EGFR positive metastatic colorectal Ca
108
CD33 Antagonist
Gemtuzumab ozogamycin | CD33 positive AML
109
CD 20 antagonists conjugated with radioisotopes
I131-tositumomab Y90-ibritumomab tiuxetan Used for relapsed lymphomas
110
Recombinant IL-2 with diphtheria toxin
Denileukin diftitox | Used for recurrent cutaneous T cell lymphoma
111
Adverse effects of cetuximab
Rash Hypomagnesimia ILD
112
Rituximab is used against
``` CLL AIHA ITP NHL RA ``` CHINA
113
Use of cetuximab
Colorectal Ca | Head and neck cancer
114
Advantage of panitumumab
Fully human Mab | No rash
115
Adverse effects of bevacizumab
Hypertension Thromboembolism Impaired wound healing GIT perforation
116
Use of bevacizumab
``` Colorectal Breast Glioblastoma Metastatic RCC non small cell lung Ca ```
117
Adverse effects of flutamide
Hot flushes Gynacomastia Hepatic dysfunction
118
Complete androgen blockade
AR blockers | GnRH agonists
119
MOA of abiraterone
17 A hydroxylase inhibitor | Prostate Ca
120
Drugs that inhibit 17 A hydroxylase
Etomidate | Abiraterone
121
Drugs that inhibit 11 B hydroxylase
Metyrapone | Etomidate
122
SERD
Selective estrogen receptor downregulator | Fulvestrant
123
Aromatase inhibitors
``` 1G-Aminoglutethimide 2G Formestane Fadrozole Rogletimide 3G Exemestane Anastrazole Letrozole Vorozole ```
124
Adverse effects of aminoglutethemide
Adrenal insufficiency Myelosupression Rash
125
Adverse effects of L asparaginase
Severe hypersensitivity reactions Acute pancreatitis CVT
126
Asparaginase is used in treatment of
Leukemias | Lymphomas
127
MOA of pentostatin
Inhibits ADA
128
Use of Plicamycin
Hypercalcemia of malignancy | Metastatic testicular Ca
129
Hydroxy urea is DOC for
Sickle cell anemia Essential thrombocytosis Polycythemia Vera
130
Second drug of choice in essential thrombocytosis
Anagrelide
131
Route of administration of hydroxy urea
Oral
132
Adverse effects of tretinoin
Vit A toxicity- headache,dryness,rash,pruritis,conjunctivitis Retinoic acid syndrome- pleural or pericardial effusion,pulmonary infiltrates,fever Hypercholesterolemia Hypertriglyceridemia Abdominal pain and diarrhoea
133
Adverse effects of arsenic trioxide
Hyperglycaemia | Prolonged QT interval
134
Adverse effects of thalidomide
``` Teratogenicity Constipation Peripheral neuropathy Rash Hypothyroidism Increased risk of DVT ```
135
IMiD and selCID
Immunomodulatory derivatives of thalidomide | Selective cytokine inhibitory drugs
136
MOA of thalidomide
``` Inhibition of angiogenesis Inhibition of TNF A Increased production of IL-10 Reduces phagocytosis Alteration of adhesion molecule expression ```
137
Use of thalidomide
``` MM ENL skin manifestations of SLE HIV associated wasting Crohn Conditioning before stem cell transplantation MDS kaposi sarcoma Primary brain malignancies Recurrent aphthous ulcers TB GVHD ```
138
Histone deacetylase inhibitors
Vorinostat | Romidepsin
139
Use of histone deacetylase inhibitors
Cutaneous T cell lymphoma
140
Recombinant IL-2
Aldesleukin
141
Use of aldesleukin
RCC | malignant melanoma
142
Use of neoadjuvant chemotherapy
``` Bladder Breast Colorectal Stomach Esophagus Lung ```
143
Recombinant IL-11
Oprelevkin | Used to prevent thrombocytopenia
144
Rx for radiation induced xerostomia
Pilocarpine | Palifermin
145
Induction Rx for ALL
``` Intrathecal MTX asparaginase Daunorubicin Prednisolone Vincristine ``` MAD PV
146
Drugs used during consolidation phase of ALL
``` Hyper CVAD alternated with cytarabine+MTX cyclophosphamide Vincristine Adriamycin Dexamethasone ```
147
Rx of choice for AML
Cytarabine+Daunorubicin/idarubicin
148
Rx of choice for CLL
Fludarabine Cyclophosphamide Rituximab FCR
149
Rx of choice for Hodgkin
``` ABVD adriamycin Bleomycin Vinblastine Dacarbazine ```
150
Rx of choice for non hodgkin lymphoma
``` R-CHOP Rituximab Cyclophosphamide Hydroxydaunorubicin(doxorubicin) Oncovin(vincristine) Prednisone ```
151
Rx of choice for multiple myeloma
Bortezomib Dexamethasone Lenalidomide
152
Rx of choice for waldenstrom macroblobinemia
FCR
153
Rx of choice for non small cell lung Ca
Cisplatin | Vinorelbine+/- bevacizumab
154
Rx of choice of small cell lung Ca
Cisplatin+etoposide
155
Rx of choice of mesothelioma
Cisplatin+pemetrexed
156
Rx of choice for head and neck cancer
Cisplatin+5FU
157
Rx of choice for esophageal Ca
Cisplatin+5FU
158
Rx of choice of ovarian cancer
Paclitaxel+carboplatin
159
Rx of choice cervical Ca
Paclitaxel+cisplatin
160
Adjuvant chemotherapy for Ca breast
Doxorubicin Cyclophosphamide Docetaxel
161
Rx of choice of uterine cancer
Progestin/tamoxifen/Aromatase inhibitors | Cisplatin+doxorubicin+paclitaxel
162
Rx of choice for choriocarcinoma
MTX/dactinomycin
163
Rx of choice of testicular Ca
BEP | Bleomycin+etoposide+cisplatin
164
Rx of choice for kidney cancer
Sunitinib
165
Rx of choice for bladder cancer
Gemcitabine+cisplatin
166
Rx of choice for astrocytoma/GBM
Temozolamide
167
Rx of choice for neuroblastoma
Cyclophosphamide Doxorubicin Cisplatin Etoposide
168
Rx of choice for thyroid Ca
I131 | Sorafenib
169
Rx of choice for stomach cancer
Epirubicin Cisplatin 5FU
170
Rx of choice for pancreatic Ca
Gemcitabine | Gemcitabine+cisplatin/erlotinib
171
Rx of choice for colon cancer
FOLFOX6+/- bevacizumab FOLFIRI+/- bevacizumab FOLinic acid+5FU+OXaliplatin FOLinic acid+5FU+IRInotecan
172
Rx of choice for rectal cancer
Radiotherapy | 5FU
173
Rx of choice for anal Ca
RT+5FU+mitomycin C
174
Rx of choice for insulinoma
Interferon/Streptozocin
175
Rx of choice for osteosarcoma
Doxorubicin Cisplatin Ifosfamide High dose MTX Any two of above drugs
176
Rx of choice for soft tissue sarcoma
``` MAID Mesna Adriamycin Ifosfamide Dacarbazine ```
177
Rx of choice for melanoma
Dacarbazine/temozolamide/IL2
178
Rx of choice for HCC
Sorafenib
179
Rx of choice for kaposi sarcoma
Liposomal doxorubicin/Daunorubicin
180
Rx of choice for adrenal Ca
Mitotane
181
Rx of choice for carcinoid
Streptozocin+5FU
182
Other name for Amifostine
Ethyol
183
Dose limiting side effect of Amifostine
Hypotension
184
Route of administration of Amifostine
SC
185
OER
Oxygen enhancement ratio | Amount of radiation dose required before and after radiation

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