Anti-cancer drugs, GI, toxicology Flashcards by Christel Mendoza

anticancer drugs kill a fixed proportion of tumor cell population

log-kill hypothesis

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cell-cycle specific drugs: M phase

MVVP: vinblastine, vincristine, paclitaxel

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cell-cycle specific drugs: S phase

CHEM 66: cytaribine, hydroxyurea, etoposide, mtx, 6-mercaptopurine, 6-thioguanine

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cell-cycle specific drugs: G2 phase; SE

bleomycin; pulmonary fibrosis

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rescue therapy: methotrexate

leucovorin

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rescue therapy: cyclophosphamide

mesna

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rescue therapy: doxorubicin

doxrazoxane

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rescue therapy: cisplatin

amifostine (amy at faustine)

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decrease nephrotoxicity of cisplatin by administering _____ with _____

mannitol; forced hydration

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alkylating agent with disulfiram-like reaction, leukemogenic

procarbazine

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alkylating agent which exhibits phototoxicity, not leukemogenic

dacarbazine

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marrow-sparing alkylating agent

busulfan

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highly lipophilic alkylating agent, can cross BBB and cause CNS toxicity, used for brain tumors

carmustine or lomustine

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inhibits de novo purine nucleotide synthesis, activated by HGPRT, cell cycle specific; metabolism is inhibited by ___ and ____

6-mercaptopurine; allopurinol and febuxostat

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cause thymine-less cell death; inhibits thymidylate synthase, cell cycle specific, causes alopecia

5-FU

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inhibits ribonucleotide reductase, cell cycle specific

cytaribine, gemcitabine

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prevents microtubule assembly, causing cell arrest at metaphase

vincristine and vinblastine

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vinca alkaloid which causes myelosuppression

vinblastine

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inhibits DNA topoisomerase II (gyrase), cell cycle specific

etoposide, teniposide

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inhibits DNA topoisomerase I (swivelase)

topotecan (2nd line for ovarian CA, small cell lung CA), irinotecan (metastatic colorectal CA)

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prevents microtubule disassembly

paclitaxel, docetaxel

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inhibits DNA topoisomerase II (gyrase), cell cycle nonspecific, can cause reversible dilated CM

doxorubicin

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anti-tumor antibiotic which inhibits DNA-dependent RNA synthesis, cell cycle nonspecific, used for melanoma, wilms, rhabdomyosarcoma, kaposi sarcoma, GTN

actinomycin D

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tyrosine kinase inhibitors

imatinib, dasatinib, nilotinib

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uses of imatinib

CML (via bcr-abl), GIST (via c-kit)

MAB used for metastatic breast CA via Her2neu receptor

trastuzumab

MAB inhibiting binding of BEGF, inhibits tumor vascular permeability

bevacizumab

MAB used for NHL

rituximab

chemotherapeutic drugs causing myelosuppression

MTX, 5-FU, 6-MP, vinblastine

DOC for ALL but may cause ____

asparaginase; acute pancreatitis

DOC for APML; only vitamine that can cure CA; SE and treatment for it

all-trans retinoic acid; retinoic acid syndrome (dyspnea, fever, wt gain, peripheral edema), dexamethasone

antacid may cause milk-alkali syndrome

ca carbonate

suppresses nocturnal acid secretion, modest effect on meal stimulated secretion

H2 blockers (cimetidine, ranitidine)

suppresses nocturnal and meal stimulated acid secretion

PPI (omeprazole)

PPIs act on ___ channel in active ______

H/K ATPase; parietal cells

forms protective coating on ulcerated tissue; used in infectious diarrhea; can cause black stools, darkening of the tongue, enceph

bismuth salicylate

DOC for diabetic gastroparesis

metoclopromide

macrolide which is also a prokinetic agent, stimulates motilin receptorsq

erythromycin

bulk-forming laxative

psyllium

stool-softening laxative; may cause lipid pneumonitis and ADEK malabsorption

docusate

osmotic laxative used for endoscopy

polyethylene glycol

anthraquinone containing laxative which may cause melanosis coli

senna

activates opioid receptors in enteric nervous system, slows down motility, CI in ______, reverse ileus by _____

diphenoxylate; children <4 yo; betanechol

immunomodulator used for inflammatory bowel disease

mesalamine, sulfasalazine

herbicide which causes increased risk of NHL on long-term exposure

chlorophenoxyacids (e.g. agent orange)

most widely used herbicide in the world, causes eye and skin irritation, no specific tx

glyphosate

bipyridyl herbicide used to kill weeds, cause GI irritation and pulmonary fibrosis

paraquat

used in manufacturing electrical equipment, MC effect is dermatotoxicity

polychlorinated biphenyls

by-products of chemicals, cause dermatitis, chloracne, carcinogenic and teratogenic

dioxins

inc risk of mesothelioma

asbestos

tx for chronic inorganic lead poisoning (plumbism) - OPD and severe cases; dietary modification

oral succimer; EDTA + dimercaprol; high ca diet

tx for organic lead poisoning (gasoline additives)

decontamination, seizure control

rice-water stools, garlicky odor in breath and stools; tx

acute arsenic poisoning; dimercaprol

Mee's lines, milk and roses complexion, raindrop hyperpigmentation; tx

chronic arsenic poisoning; dimercaprol

massive hemolysis leading to pigment overload and renal failure; associated with semiconductor manufacturing, tx

arsine gas; exchange transfusion, hydration, dialysis, chelators have no value

hemorrhagic gastroenteritis followed by renal failure; tx

acute inorganic mercury poisoning; oral succimer or IM dimercaprol

loosening of gums and teeth, GI disturbances, neurologic and behavioral changes (erethism), tx

chronic inorganic mercury poisoning; oral succimer, unithiol (dimercaprol may redistribute mercury to CNS)

minamata disease

organic mercury poisoning

chelator which causes transient hypertension, tachycardia, increased prothrombin time

dimercaprol

cut-off lead concentration for administering succimer

45 mcg/dL

Keiser-Flecher rings, Wilson's disease; tx; SE

copper poisoning; penicillamine; nephrotoxicity with proteinuria, drug-induced lupus

aspirin poisoning mnemonic; tx

CHAFS: coma, hyperventilation, hyperthermia, hypokalemia, acidosis (HAGMA), fever, seizure; alkaline diuresis, supportive

mnemonic for utility of activated charcoal

ABCDPPTTV: amitriptyline, barbiturates, carbamezapine, digitalis, phenycyclidine, propoxyphene, theophylline, TCA, valproic acid

antidote for caffeine, theophylline, sympathomimetics

esmolol

antidote for methanol, ethylene glycol

ethanol, fomepizole

antidote for cyanide poisoning

inhaled amyl nitrite + IV sodium nitrite + IV sodium thiosulfate

herbal supplement which decreases duration of cold symptoms

echinacea

herbal supplement for asthma, bronchitis, CNS stimulation

ephedra (ma huang)

herbal supplement for intermittent claudication, dementia

ginkgo

herbal supplement which can be used as antidote for amanita mushroom poisoning

milk thistle

herbal supplement for BPH

saw palmetto

herbal supplement for tx of mild to moderate depression

St. John's wort

herbal supplement for improvement of IHD and Parkinson's

Coenzyme Q10

herbal supplement for reduction of pain w/ OA

glucosamine

Anti-cancer drugs, GI, toxicology Flashcards

(74 cards)