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HemeOnc 2 > Anti-CA Pharm > Flashcards

Anti-CA Pharm Flashcards

1
Q

antimetabolites

A
  • bone marrow cell replication PROFOUNDLY inhibited

- highly cell cycle specific

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2
Q

MTX (methotrexate)

A
  • folic acid analog
  • binds DHFR = inhibits formation of MTHF which is needed for dTMP synthesis
  • works on cells in S phase mostly
  • result = decrease in nucleic acid synthesis
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3
Q

what step of DNA synthesis is inhibited by 5-FU? hydroxyurea?

A
  • 5-FU = step taking dUMP –> dTMP

- hydroxyurea = UMD –> dUMP & CTP –> dCTP

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4
Q

taxanes carry the risk of what s/e? why?

A

risk of hypersensitivity rxn b/c they are natural agents

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5
Q

what are paclitaxel and docetaxel made from?

A
  • paclitaxel = PACIFIC yew tree bark

- docetaxel = ENGLISH yew tree bark

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6
Q

taxane MOA

A
  • interfere w/ mitosis

- bind to microtubules = inhibits microtubule disassembly to tubulin = cell prevented from finishing mitosis

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7
Q

how is the MOA of taxanes different from colchicine?

A
  • colchicine blocks mitosis by preventing the formation of the spindles in the first place
  • taxanes prevent the spindles from being broken down
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8
Q

paclitaxel

A
  • used for solid tumors
  • given IV
  • irritates skin and mucous membranes on contact
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9
Q

docetaxel

A
  • first line tx for breast CA
  • 2nd line for non-small cell lung CA
  • 1st line for prostate CA when combined w/ prednisone
  • skin and mucous memb irritant; given IV
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10
Q

s/e of taxanes

A
  • myelosupression & hypersensitivity rxns
  • paclitaxel = neurotoxicity; can reduce dose but that also lowers chance of curing the CA; usually reversible so can consider switching meds
  • docetaxel = fluid retention –> usually can be minimized by taking steroids night before and morning of tx
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11
Q

vinca alkaloid MOA/effect on mitosis

A
  • binds tubulin = prevents spindles from forming
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12
Q

vinca alkaloid - route of administration; why is it so important?

A
  • only given IV
  • FATAL if given intrathecally
  • the pt won’t die immediately; they will have progressive neurotoxicity and die in a few weeks/months
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13
Q

vinca alkaloid s/e

A
  • vincristine = neurotoxicity

- vinblastine & vinorelbine = myelosuppression

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14
Q

podophyllotoxin MOA & effect on mitosis

A
  • blocks cell cycle in 2 places = G1 phase & S-phase (DNA replication)
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15
Q

podophyllotoxin s/e & admin routes

A
  • s/e = hypotension, alopecia, n/v, myelosuppression
  • admin = IV (more common) or orally as liquid capsule
  • have to give IV over 60 minutes b/c any longer than that will cause more hypotension
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16
Q

indications for podophyllotoxin

A
  • genital warts assoc w/ squamous cell carcinomas (when in the cream form)
  • testicular CA that didn’t respond to other tx plans (etoposide form)
17
Q

antitumor antibiotics

A
  • from Streptomyces spp.
  • interact w/ DNA and/or RNA usually
  • less phase specific
  • s/e = tissue necrosis
  • all given IV
18
Q

what is the only antitumor antibiotic that can be given in other forms besides IV?

A
  • bleomycin

- can be given IV, IM, subQ, intrapleural

19
Q

alkylating agents: take home points

A
  • directly damages DNA
  • broad spectrum of antitumor activity & immunosuppression
  • active vs. proliferating & nonproliferating cells
  • cause dose-limiting myelosuppression
  • genotoxic & assoc w/ increased risk of leukomogenesis
20
Q

MOA of doxorubicin; what is the effect on cell membranes?

A
  • MOA = DNA topoisomerase II inhibitor (blocks DNA replication and transcription)
  • leads to generation of free radicals = membrane damage = DNA strand breaks
21
Q

s/e of antracyclines (including doxorubicin)

A
  • dose cumulative cardiotoxicity
  • red discoloration of urine
  • myelosuppression
  • amenorrhea
  • n/v
22
Q

MOA of cisplatin

A
  • C1-moieties react w/ N7 of guanine causing intrastrand & interstrand crosslinks in DNA
  • cell cycle non-specific but may be most active in G phase
23
Q

s/e of cisplatin

A
  • platinum analogs overall cause myelosuppresion, n/v, neurotoxicity
  • cisplatin specifically = NEPHROtoxicity
24
Q

what platinum analog has less nephrotoxicity than cisplatin? how is it dosed?

A
  • carboplatin

- dosed based on area under curve (AUC)

HemeOnc 2 (4 decks)

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