Alkylating Agents/ DRUGS

Question 1

Attaches alkyl group to the GUANINE base of DNA @ the #7 N atom and creates inter/intra strand cross-links.

Answer 1

CYCLOPHOSHAMIDE

Question 2

Which alkylating agent is activated by cytochrome P450?

Answer 2

CYCLOPHOSPHAMIDE

Question 3

Which drug has the toxicity of hemorrhagic cystitis?

Answer 3

CYCLOPHOSPHAMIDE

Question 4

Hemorrhagic cystitis can be prevented by…???

Answer 4

hydration or MESNA (2-mercaptoethanesulfonate)

Question 5

Which drug causes myelosuppression,
along with
- nephrotic syndrome
-vasculitis
-hemolytic anemia

Answer 5

CYCLOPHOSPHAMIDE

Question 6

Cyclophosphamide causes __________________ in women and __________________ in men.

Answer 6

Infertility/pre-mature menopause in women and decreased sperm count (azoospermia) in men

Question 7

Cyclophosphamide can cause ________________ due to SIADH.

Answer 7

HYPONATREMIA

Question 8

Cyclophosphamide increases risk of ______________ cancer.

Answer 8

Bladder cancer (high grade transitional cell carcinoma)

Question 9

Which alkylating agent has the toxicity of an increased risk for bladder cancer?

Answer 9

CYCLOPHOSPHAMIDE

Question 10

What is the mechanism of nitrosoureas?

Answer 10

Forms DNA cross-links, which prevents DNA replication.

Question 11

Toxicities of nitrosoureas (carmustine, lomustine, and semustine) includes?

Answer 11

• DIZZINESS
• ATAXIA
  -CONVULSIONS

Question 12

Which alkylating agent causes dizziness, ataxia, and convulsions as their toxicities?

Answer 12

NITROSOUREAS

Question 13

Which alkylating agents are highly lipophilic → cross BBB → treat brain tumors (e.g. glioblastoma multiform)

Answer 13

NITROSOUREAS

Question 14

Which alkylating agent is useful in treatment of CNS cancers?

Answer 14

NITROSOUREAS

Question 15

Who are they in sketchy?

Answer 15

Question 16

Which alkylating agent has the mechanism of creating DNA intra-strand cross-links, which prevents DNA replication, and induces apoptosis of the cell?

Answer 16

BURSULFAN

Question 17

This alkylating agent is a conditioning agent used prior to bone marrow transplantation

Answer 17

BURSULFAN

Question 18

The toxicities of this alkylating agent includes:
- acute lung injury
- interstitial fibrosis
-alveolar hemorrhage

Answer 18

BURSULFAN

Question 19

Which alkylating agent can cause darkening of skin / hyperpigmentation reaction?

Answer 19

BURSULFAN (“busulfan tan”)

Question 20

Which alkylating agent penetrates the CNS and is used for treatment of anaplastic astrocytoma?

Answer 20

TEMOZOLOMIDE

Question 21

Which drug utilizes combination regimes (MOPP regimen - Mechlorethamine, Oncovin, Procarbazine, Prednisone) for Hodgkin’s and non-Hodgkin’s lymphoma as well as brain tumors?

Answer 21

PROCARBAZINE

Question 22

Which alkylating agent has increased risk for secondary cancers such as acute leukemia?

Answer 22

PROCARBAZINE

Question 23

Which alkylating agent methylates DNA and inhibits DNA function?
Toxicity includes:
- CNS depression
-myelosuppression

Answer 23

PROCARBAZINE

Question 24

Which alkylating agent methylates DNA and inhibits DNA function?
Toxicity includes:
-CNS depression
-myelosuppression
-ataxia
-lethargy
-confusion

Answer 24

DACARBAZINE

Question 25

Which alkylating agent has the toxicity of bone marrow depression with leukopenia, thrombocytopenia, and bleeding?

Answer 25

MECHLORETHAMINE