Alkylating Agents and Antimetabolites Flashcards
What is tumor lysis syndrome? (TLS)
tumor cells killed and cellular materials dumped into circulation. Adverse effects in kidney. Can cause gout. Often prophylactically treat with hydration, acid/base correction, and sodium bicarbonates.
What do alkylating agents do?
leave a chemical moiety bound to DNA to prevent cell division.
What do bis(chloroetyl)amine alkylating agents usually bind to on DNA?
N7 guanine. Messes Up DNA enough to trigger apoptosis and halt cell division.
What are the unique negative effects of bis(chloroethyl)amine alkylating agents?
IV administration causes vascular damage and irritation. Pulmonary fibrosis.Ifosfamide causes CNS toxicity.Acrolein production, which can cause renal failure and urotoxicity. Treat with MESNA
What is MESNA
prophylactic to treat the acrolein production from cyclophosphamide and alkylating agents.
What is busulfan?
and alkyl sulfonate.
What unique toxicities does busulfan have?
veno-occlusive disease of liver as well as pulmonary fibrosis.
What are nitrosoureas? What is unique about them?
BCNU and CCNU - both alkylators. They can penetrate the CNS and brain (unique).
What anticancer drug becomes active in hypoxic locations (such as necrotic tumor centers)?
Mitomycin C.
What is a unique toxicity of cisplatin?
ototoxicity from accumulation in ear. Also persistant peripheral neuropathy that can worsen even after cessation of treatment.
What is disulfiram-like effect?
disulfiram is a drug that makes alcoholic patients feel sick when they drink. Drugs like hprocarbazine can mimick this effect.
How does methotrexate work?
dihydrofolate reductase inhibition. Deny availability of DHF to provide carbon groups for DNA and RNA synthesis. It is polyglutamated so it becomes trapped inside cell and increases duration of function.
What is a unique side effect of 5-fluorouacil?
foot and hand neuropathy.
What drug can erase fingerprints over time?
capecitabine (very similar to 5-fluorouacil.)
What is the mechanism of cyclophoshamide and is there anything unique about it?
nitrogen mustard, alkylate DNA, intra or inter crosslinks.Creates acrolein so protect by using MESNA with it.Lung fibrosis