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Pharm Test 3 > Anti-cancer > Flashcards

Anti-cancer Flashcards

1
Q

Chlorambucil

A

Alkylating agent

Less effective and less side effects than cyclophosphamide

Excreted through kidneys

Used for chronic lymphocytic leukemia, feline GI lymphoma

Mild myelosuppression

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2
Q

Cytosine arabinoside

A

Most commonly used in renal lymphoma, lymphoma rescue, CNS tumors

Crosses BBB

S phase

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3
Q

Cisplatin

A

Causes fatal pulmonary edema in cats

Used for osteosarcoma and squamous cell carcinoma

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4
Q

Doxorubicin

A

Cant get it outside of vein

Can cause anaphylaxis and cardiotoxicity

Used for lymphoma osteosarcoma and hemangiosarcoma

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5
Q

Methotrexate

A

S phase

Crosses BBB

Hepatic toxicity

GI and myelosuppression

Used for lymphoma, CNS tumors, and osteosarcoma

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6
Q

Procarbazine

A

Alkylating agent

Rescue protocol

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7
Q

Carboplatin

A

Cell phase- non specific

Renal excretion

Safe for cats

Myelosuppression

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8
Q

Cyclophosphamide

A

Alkylating agent

Hepatic activation and renal excretion

Can cause myelosuppression, sterile hemorrhagic cystitis, and transitional cell carcinomas

Can have syndrome of inappropriate ADH secretion (hyponatremia)

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9
Q

Lomustine

A

Alkylating agent

Completely absorbed

Crosses BBB

Can cause hepatic toxicity and myelosuppression

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10
Q

Mitoxantrone

A

Very expensive

May turn urine blue green

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11
Q

Melphalan

A

Alkylating agent

Most commonly used for multiple myeloma
And lymphoma rescue

Causes myelosuppression (thrombocytopenia)

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12
Q

What do cancer drugs affect the most

A

DNA
“Genotoxic”

Will have affects on unborn fetuses

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12
Q

What must happen for chemotherapy to work

A

Cancer cells must be more sensitive to the drugs than the normal tissues

Otherwise there are major issues

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12
Q

Indications for chemotherapy

A

Systemic neoplasia (lymphoma)

Palliative for gross metastatic disease

Adjuvant to eradication of metastatic disease

Radio-sensitization

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12
Q

What is the most sensitive cell type to chemo

A

Bone marrow

Then epithelial tissue then mesenchymal cells

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12
Q

Two biggest types of chemo drugs

A

Phase specific- vincristine, vinblastine (affect mitosis) cytosine arabinoside, methotrexate (affect DNA synthesis)

Phase non-specific- alkylating drugs

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13
Q

Drug classification groups

A

Alkylating agents- biggest and most commonly used group

Antimetabolites- methotrexate

Tumor antibiotics

Vinca alkaloids

Platinum derived (synthetic)

Hormones

Miscellaneous

Targeted therapy

13
Q

Alkylating agents:

How do alkylating agents hurt cells?

what cell phase are they?

What/how side effects

What drugs fall into this category?

A

DNA damage- cross link DNA and inhibit protein synthesis

Cell cycle nonspecific

Activates chemotrigger center to induce vomiting

Cyclophosphamide, chlorambucil, melphalan, procarbazine, lomustine

14
Q

Cyclophosphamide:

How is it activated? Excreted? Toxic effects?

A

Hepatic activation

Renal excretion

Myelosuppression, GI, sterile hemorrhagic cystitis (main side effect)(caused by acrolein)
Avoid by taking out to pee immediately

15
Q

How to prevent sterile hemorrhagic cystitis?

A

Predisolone

Give antidote- MESNA

Stop if you see SHC

16
Q

SIADHS

A

Caused by cyclophosphamide toxicity

Rare

Syndrome of inappropriate ADH secretion

17
Q

Chlorambucil:

A

Doesn’t require hepatic activation

Substitute for cyclophosphamide

NO SHC

Needs to be kept cold

18
Q

Melphalan

A

Used for multiple myeloma

Will see thrombocytopenia as die effect as well as myelosuppression and GI upset

19
Q

Lomustine

What is it?
What two things do I need to know about it?

A

Alkylating agent (part 2); forms double stranded DNA breaks

Crosses BBB
Causes hepatotoxicity- protect with denamarin or alpha lipoic acid

20
Q

What do i need to know about procarbazine

A

Its used as a rescue agent and is alkylating agent part 3

21
Q

Cisplatin

Whats can it not be used in? Whats bad about it?

A

Platinum

KILLS cats!

Significant nephrotoxicity- pee is toxic

22
Q

Carboplatin

A

Platinum

More used than cisplatin

Safe for cats

23
Q

Antimetabolite agents

What cell phase?

Which drugs?

A

Cell phase specific- S phase

Methotrexate, cytosine arabinoside

24
Q

Methotrexate:

What do I need to know about it- how do you reverse it?

A

Give folate

Crosses BBB

25
Q

Cytosine arabinoside- how to use it?

A

Through CRI

Crosses BBB

26
Q

Antibiotics

What cell phase?

Which drugs?

How they work?

A

Non specific

Doxorubicin
Actinomycin D
Mitoxoantrone

Free radical damage and/or inhibition of topoisomerase II

27
Q

Doxorubicin- side effects? Antidote?

A

Cardiotoxicity that looks like DCM

Anaphylaxis esp SEVERE if given outside the vein

Zinecard!

28
Q

Mitoxantrone

A

Expensive

Used when doxrubicin can’t be used anymore

Also don’t want to get outside of vein

29
Q

Actinomycin D

A

True sub for doxorubicin- not cardiotoxic

30
Q

Plant alkaloids

Which phase?

Cross resistance?

How does it work and which drugs?

A

Cell cycle phase specific- M phase

No class cross resistance

Prevent assembly of spindles- vincristine, vinblastine

31
Q

Vincristine- whats important? (Side effects)

A

Its a vesicant and causes peripheral neuropathy and myelosuppression

32
Q

Vinblastine- what’s it used for?

A

Mast cell tumors

33
Q

Hormones- how does it work?

Which drugs?

A

Inhibit DNA synthesis

Prednisone- used for lymphomas (think how it decreases with stress leukograms)

34
Q

L-aspariginase- how does it work?

What cell phase?

Effectiveness?

What’s nice about this? Think side effecs\ts

A

Targets asparagine so cancer cells cant make DNA but healthy cells are fine

Nonspecific

Veryy effective but can get anaphylaxis if used too much

Doesn’t cause myelosuppression by itself

35
Q

Targeted therapy- what are they? What are they used for?

Which drugs?

A

Receptor tyrosine kinase inhibitors

Used for mast cell tumors

Toceranib (palladia) (targets KIT)

36
Q

Masitinib

A

Not available and not FDA approved but same as toceranib

37
Q

Tanovea- what is it

What can you use it for?

How does it work?

Unique side effect?

A

Targeted drug therapy

Only lymphomas

Inhibits DNA polymerase

Pulmonary fibrosis and skin issues

Pharm Test 3 (7 decks)

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