Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2-pharm Exam > Alkylating Agents > Flashcards

Alkylating Agents Flashcards

1
Q

the 4 most commonly used Nitrogen mustards are

A

mechlorethamine
cyclophosphamide
melphalan
chlorambucil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

This drug is a rapidly acting nitrogen mustard administered IV to minimize local tissue irritation- must be prepared fresh

A

mechlorethamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the IV dose of mechlorethamine

A

0.4mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

once mechlorethamine is administered what happens to the drug

A

it undergoes rapid chemical transformation - it is only active for a few minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what method can be used for mechlorethamine administration to prevent tissue toxicity

A

isolating blood supply to that tissue- to prevent tissue toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how is the action of mechlorethamine localized to a specific tissue

A

it is injected into the arterial blood supply to the desired tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the clinical uses of mechlorethamine

A

hodgkin disease and less predictably in other lymphomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

mechlorethamine is used in combination with what other three drugs called the MOPP regimen for the treatment of hodkins disease

A

vincristine
procarbazine
prednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the major side effects of mechlorethamine

A

nausea
vomiting
myelosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the principle limitations on the amount of mechlorethamine given

A

leukopenia

thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what skin lesion is frequently associated with nitrogen mustard therapy

A

herpes zoster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what conditions can mechlorethamine unmask?

A

latent viral infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what skin associations can occur with extraversion of mechlorethamine

A

several local tissue reactions such as brawny and tender indurations that may persist for prolonged periods of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

explain the chain of events that cyclophosamide goes through after oral administration

A

cyclophosphamide is activated by the liver to -aldophosphamide- for transport to target tissues- aldophosphamide is converted to highly cytotoxic metabolites - phosphoramide and acrolein- then alkylate DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the 4 clinical uses of cyclophosphamide

A

hodgkin disease
lymphosarcoma
burrito lymphoma
acute lymphoblastic leukemia of childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

cyclophosphamide is used in combination with what two other drugs after surgery for breast cancer

A

methotrexate

fluorouracil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

the potent immunosuppressive properties of cyclophosphamide make it useful for what two conditions

A

wegener granulomatosis

rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

less than 1% of patients treated with cyclophosphamide have what 2 conditions

A

hypersensitivity reactions
and
fibrosing pneumonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what 2 conditions are large doses of cyclophosphamide associated with

A

pericarditis
and
pericardial effusions (can progress to cardiac tamponade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what condition may not occur for as long as 2 weeks after the last dose of cyclophosphamide

A

hemorrhagic myocarditis with symptoms of CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the indications to discontinue cyclophosphamide

A

dysuria and hematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

doses greater than 50mg/kg of cyclophosphamide is associated with what occurance

A

inappropriate secretion of arginine vasopressin hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

water intoxication with cyclophosphamide is compounded by what two situations

A

avoidance of hematuria-hydration

and inappropriate secretion of vasopressin hormones

24
Q

if cyclophosphamide is extravated what will occur

A

nothing- no thrombophlebitis

25
Q

melphalan is what type of derivative of nitrogen mustard

A

phenylalanine derivative of nitrogen mustard

26
Q

what are NOT common side effects of melphalan

A

nausea
vomiting
alopecia
no changes of renal or hepatic

27
Q

what side effect of melphalan is possible

A

bone marrow suppression

pulmonary fibrosis

28
Q

what is the slowest acting nitrogen mustard in clinical use

A

chlorambucil

29
Q

chlorambucil is what type of derivative of mechlorethamine

A

aromatic!

30
Q

what is chlorambucil used in the treatment of

A

chronic lymphocytic leukemia and in primary waldenstrom macroglobulinemia

31
Q

when chlorambucil is used for polycythemia what is seen

A

increased incidence of leukemia and other tumors

32
Q

chlorambucil has CNS stimulation with large doses T/F

A

True

33
Q

side effects of chlorambucil

A 
myelosuppression -reversible
nausea 
vomiting
pulmonary fibrosis
hepatotoxicity-rarly
34
Q

busulfan produces remission in up to 90% of patients with “This”

A

chronic myelogenous leukemia

35
Q

this drug is a cell cycle nonspecific alkylating antienoplastic agent

A

busulfan

36
Q

busulfan has no value in the treatment of

A

acute leukemia

37
Q

4% of these patients experience -_____with busulfan

A

progressive pulmonary fibrosis

38
Q

what enhances the toxicity of busulfan

A

enhanced toxicity with administration of oxygen

39
Q

what are the two important side effects of busulfan

A

myelosuppression and thrombocytopenia

40
Q

why do we give allopurinol to busulfan

A

hyperuricemia

41
Q

explain the mechanism why nitrosoureas are good for the treatment of meningeal leukemias and brain tumors

A

their high lipid solubility results in passage across the blood brain barrier.

42
Q

what the exception of streptozocin what limits the clinical use of nitrosoureas

A

limited by profound drug induced myelosuppression

43
Q

what nitrosurea has the widest clinical use

A

carmustine

44
Q

what does carmustine inhibit the synthesis of

A

both RNA and DNA

45
Q

side effects of carmustine

A

interstitial pneumonitis and fibrosis (much like bleomycin)

46
Q

what is the delayed (6 weeks) side effect of carmustine

A

leukopenia and thrombocytopenia

47
Q

what nitrosurea is more effective than carmustine in the treatment of hodgkins disease

A

lomustine

48
Q

what is lomustine methylated analogue

A

semustine

49
Q

streptozocin has a unique affinity for …

A

beta cells of the islets of langerhans

50
Q

since streptozocin has unique affinity for B cells of the islets of langerhans it has proven useful in the treatment of

A

human pancreatic islet cell carcinoma and malignant carcinoid

51
Q

what is the prototypical alkylating agents

A

mitomycin

52
Q

what is a side effect of streptozocin

A

hyperglycemia

mylesuppression - not occcur

53
Q

what is the prominent side effect of mitomyocin

A

myelosuppression characterized by severe leukopenia and thrombocytopenia

54
Q

what else can mitomyocin side effect in 3-12% of patients

A

pulmonary fibrosis- limit exposure to hyperoxia.

55
Q

what is a rare, but well recognized side effect of mitomycin

A

glomerular damage resulting in renal failure

56
Q

mitomycin is used for the palliative treatment of gastric adenocarcinoma with what two other medications

A

fluorouracil and doxorubicin

2-pharm Exam (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions