Anti Cancer Drugs

Question 1

Cyclophosphamide activation, excretion, toxicity

Answer 1

• hepatic activation
• renal exertion
• myelosuppression, sterile hemorrhagic cystitis, transitional cell carcinomas

Question 2

Cyclophosphamide therapy (bladder toxicity)

Answer 2

• prednisolone: increases dieresis an inhibits microsomes activation of CTX
• replace with chlorambucil
• give N-acetycystine
• antibiotics
• MESNA
• DMSO

Question 3

SIADHS

Answer 3

• syndrome of inappropriate ADH secretion
• associated with cyclophosphamide
• used for tumors

Question 4

Chlorambucil: excretion and uses

Answer 4

-renal excretion
- substitute for cytoxin
Chronic lymphocytic leukemia
Feline GI (small cell) lymphoma

Question 5

Lomustine

Answer 5

• completely absorbed after oral intake
• 1st pass hepatic degradation -metabolites active
• highly lipid soluble (cross BBB)
• renal exertion: partial hepatic excretion- enterohepatic cycle

Question 6

Lomustine toxicity

Answer 6

Myelosuppresive and hepatic toxic

• liver protectant alpha lipoid acid may help
• neurtopenia nadir variable
• LOPP protocol

Question 7

Procarbazine

Answer 7

• matulane: alkalating agent

- LOPP/MOPP rescue protocol

Question 8

Cisplatin toxicity

Answer 8

• nephtotoxic: diurese
• nausea: treat with antimetics
• fatal pulmonary edema in cats!*

Question 9

Cisplatin primary use

Answer 9

Osteosarcoma, squamous cell carcinoma

Question 10

Carboplatin: excretion and toxicity

Answer 10

• renal excretion
• myelosuppression, monitor platelets
• safe in cats!

Question 11

What cell cycle phase are antimetabolites specific to?

Answer 11

S phase

- inserted into DNA and non-functional

Question 12

Methotrexate: metabolism, exertion,

Answer 12

• hepatic metabolism
• renal excretion (tubular)
• crosses BBB

Question 13

methotrexate toxicity and sues

Answer 13

• GI and myelosuppressoin

- lymphoma, CNS tumors, osteosarcoma

Question 14

Cytosine arabinoside: exertion, given by, solubility

Answer 14

• removed by circulation by kidneys
• continuous infusion
• cross BBB

Question 15

Doxorubicin: metabolism, excretion

Answer 15

• meta by liver:dose reduction if bilirubin >2mg/dl

- renal excretion: primary route of excretion in the cat

Question 16

Doxorubicin toxicity

Answer 16

• anaphylaxis
• vesicant
• cardiotoxiciy

Question 17

Mitoxantrone toxicity, facts

Answer 17

Myelosuppressoin

• very expensive but not per dose
• may turn urine blue-green

Question 18

Dactinomycin

Answer 18

• excretion: urine, feces
• Toxicity: myelosuppression
• non-cardiotoxic substitute for doxorubicin

Question 19

Vincristine

Answer 19

• hepatic excretion (dose reduction when bilibruin >2mg/dl)

- toxicity: vesicant, myelosuppression, peripheral neuropathy

Question 20

Vinblastine

Answer 20

Excretion: hepatic

• vesicant
• primary use: mast cell tumor

Question 21

L-asparaginase

Answer 21

Toxicity: anaphylaxis, potentiate vincrinstine induced myelosuppressoin
-alone not myelosuppressive

Question 22

Enzyme cell cycle specificity

Answer 22

Cell cycle phase non specific

Question 23

Plant alkaloids cell cycle specificity

Answer 23

M phase

Question 24

Antibiotics cell cycle specificity

Answer 24

Cell cycle phase nonspecific