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farmakoloji 300 > anti kanser drugs > Flashcards

anti kanser drugs Flashcards

1
Q

Hücre siklüsünden bağımsız etki gösteren antikanser ilaç hangisidir:

A

Antimetobolitler S phase : Bine + 5FU+ 6(MP+TG) + MTX+ Pralaraxate ​

Topoisomerase 2 inhibitorleri g1s: Etopside​

Topoisomerase 1 g2m: Camptotecins: Tecan’lar​

Taxanes: Mphase: taxelle bitenler​

Vinca alkolaids: vin ile baslayanlar​

Antimicritubuller: ixabepillon Eribulin​

Antitumors g2m: Bleomycin​

​

​

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2
Q

Mercatopurine ve Thioguanin nasil çalışır?

A

inhibits denovo synthesis of purine ring and nucleotide interconversion

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3
Q

Methotrexate, pemetrexed, and pralatrexate​ nasıl çalışır?

A

Methotrexate (MTX), pemetrexed, and pralatrexate are antifolate agents.

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4
Q

Mechanism of MTX

A

inhibiting mammalian dihydrofolate reductase (DHFR), the enzyme that converts folic acid to its active, coenzyme form, tetrahydrofolic acid (FH4). The inhibition of DHFR can only be reversed by administration of leucovorin

Note: Leucovorin, or folinic acid, is the N5-formyl group–carrying form of FH4.]​

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5
Q

Pemetrexed ve MTXin farkı nedir?

A

in addition to inhibiting DHFR, it also inhibits thymidylate synthase and other enzymes involved in folate metabolism

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6
Q

Mtx Neye karşı kulanılır?

A

acute lymphocytic leukemia, Burkitt lymphoma​ in children, breast cancer, bladder cancer, and head and neck carcinomas

Low-dose MTX is effective as a single agent against certain inflammatory diseases, such as severe psoriasis and rheumatoid arthritis, as well as Crohn disease

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7
Q

Pemetrexed Neye karşı kulanılır?

A

non–small cell lung cancer

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8
Q

Pralatrexate neye karşı kulanılır?

A

relapsed or refractory T-cell lymphoma.​

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9
Q

İmmünosupresif etkisi nedeni ile romatoid artrit ve ankilozan spondilit tedavisinde ​ Kullanılan antineoplastik ajan hangisidir:

A

metotreksat MTX

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10
Q

Aşağıdaki hastalıkların hangisinde metotreksat kullanılmaz:
akut lenfoblastik lösemi,​
Romatoid artrit,
psöriazis,
küçük hücreli akciğer kanseri, ​

A

küçük hücreli akciğer kanseri,

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11
Q

MTX’ın pharmacokinetik ozellikleri

A

absorbed at low doses from the GI tract
but it can also be administered by intramuscular, intravenous (IV), and intrathecal routes. Because MTX does not easily penetrate the blood-brain​-barrier
intrathecally to destroy neoplastic cells that thrive in the sanctuary of the CNS

Small amounts of MTX undergo hydroxylation at the 7th position to form 7-hydroxymethotrexate. This derivative is less water soluble than MTX and may lead to crystalluria. Therefore, it is important to keep the urine alkaline and the patient well hydrated to avoid renal toxicity. Excretion of the parent drug and the 7-OH metabolite occurs primarily via urine.​

Renal excretion is the main route of elimination

Care must also be taken when MTX is used in the presence of drugs such as aspirin, nonsteroidal anti-inflammatory agents, penicillin, and cephalosporins, as these agents inhibit the renal excretion of MTX.

MTX can be reversed by administration of the reduced folate leucovorin (5-formyltetrahydrofolate) or by L-leucovorin

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12
Q

Folinik asit aşağıdaki ilaçlardan hangisinin toksisitesini önlemek için kullanılır?
kaptopril, ​
Metotreksat,
fenitoin,
fenasetin,
vinkristin ​

A

Metotreksat

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13
Q

Metotreksatın toksik etkisini önleyen hangisidir:

A

folinik asit,

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14
Q

6-Mercaptopurine is good for threating?

A

beneficial for treating neoplastic disease. 6-MP is used principally in the maintenance of remission in acute lymphoblastic leukemia. ​

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15
Q

Aşağıdaki antineoplastik ajanlardan hangisi immünsupresif olarak da kullanılır: ​ aminopterin, azatiopürin, bortezomib, daktinomisin, vinkristin

A

Bir immün baskılayıcı olan azatiyoprin, sitotoksik etkilerini 6-MP’ye dönüştükten sonra gösterir.

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16
Q

Aşağıdaki antineoplastik ilaçlardan hangisi ksantin oksidaz tarafından tiyoürik asite Dönüştürülerek böbrekten atılır:

aminopterin, karmustin, busulfan, 6-merkaptopurin,​5-fluorourasil ​

A

6-merkaptopurin,​

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17
Q

Merkaptopurini yıkan enzimi inhibe ederek etkisini artıran ilaç hangisidir: ​

Kolşisin, aspirin, parasetamol, N-asetil sistein, allopurinol

A

allopurinol

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18
Q

Fludarabine ne için kulanılır?

A

hronic lymphocytic leukemia, hairy cell leukemia, and indolent non-Hodgkin lymphoma.

Fludarabine is a prodrug, and the phosphate is removed in the plasma to form 2-F-araA, which is taken up into cells and again phosphorylated (initially by deoxycytidine kinase). Although the exact cytotoxic mechanism is uncertain, the triphosphate is incorporated into both DNA and RNA.

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19
Q

5-Fluorouracil ne işe yarar

A

employed primarily in the treatment of slow-growing solid tumors (for example, colorectal, breast, ovarian, pancreatic, and gastric carcinomas). When applied topically, 5-FU is also effective for the treatment of superficial basal cell carcinomas.​

Timin oluşumunu engeller

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20
Q

Pirimidin antimetaboliti olan ilaç hangisidir:
metotreksat,
vinkristin,
6-merkaptopurin,
​ 5-flourourasil,
klorambusil

A

​ 5-flourourasil,

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21
Q

Folinik asit aşağıdaki ilaçlardan hangisinin toksisitesini önlemek için kullanılır:
kaptopril,
​Metotreksat,
fenitoin,
fenasetin,
vinkristin ​

A

Metotreksat

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22
Q

Metotreksatın toksik etkisini önleyen hangisidir:
folinik asit,
C vitamini,
Vit B12,
pridoksal ​ Fosfat,
pantotenik asit

A

folinik asit,

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23
Q

Pemetrexed and pralatrexate should be given with?

A

folic acid and vitamin B12 supplements

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24
Q

Pretreatment with …………….. to prevent​

cutaneous reactions is recommended with pemetrexed.​

A

corticosteroids

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25
Q

5-FU enters cell via?

A

deoxynucleotide (5-fluorodeoxyuridine monophosphate
[5-FdUMP];
which competes with deoxyuridine monophosphate for thymidylate synthase, thus inhibiting its action. ​

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26
Q

…… is administered with 5-FU

A

Leucovorin

because the reduced folate coenzyme is required in the thymidylate synthase inhibition. For example, a standard regimen for advanced colorectal cancer is irinotecan plus 5-FU/leucovorin.] ​

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27
Q

(5-FdUMP), which competes with deoxyuridine monophosphate (dUMP) for the enzyme ……. synthase

A

thymidylate

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28
Q

5-FU is administered?

A

IV or, in the case of skin cancer, topically

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29
Q

Elevated levels of …………………………………………………………………… can increase the rate of 5-FU catabolism and decrease its bioavailability. ​

A

dihydropyrimidine dehydrogenase (DPD)

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30
Q

Capecitabine used for?

A

treatment of colorectal and metastatic breast cancer

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31
Q

cytotoxic activity of capecitabine is the same as that of ….

A

5-FU

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32
Q

cytarabine used for?

A

in acute nonlymphocytic (myelogenous) leukemia (AML)

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33
Q

Cytarabine is given?

A

Given IV, it distributes throughout the body but does not penetrate the CNS in sufficient amounts.
also be injected intrathecally.

are excreted in urine.​

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34
Q

Azacitidine​ pyrimidine nucleoside analog of ?.

A

cytidine

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35
Q

Azacitidine used for the treatment of ?

A

myelodysplastic syndromes and AML. Azacitidine

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36
Q

Gemcitabine is an analog of the nucleoside ?

A

deoxycytidine

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37
Q

Gemcitabine used most commonly for ?

A

pancreatic cancer and non–small cell lung cancer.

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37
Q

Gemcitabine is administered by ?

A

IV
excreted in urine.​

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37
Q

The anthracyclines exert their cytotoxic action through four major mechanisms: (1) ………. 2……… 3…….. (4) ……

A

1 inhibition of topoisomerase II
2 generation of semiquinone free radicals and oxygen free radicals through an iron-dependent, enzyme-mediated reductive process
3 high-affinity binding to DNA
4 binding to cellular membranes

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37
Q

Antrasiklin ile ilgili yukarıdakilerden hangisi yanlıştır; ​

1 Topoizomeraz 2 enzimini inhibe ederek etki gösterir.
2. aritmi, perikardit, myokardit gibi ​ yan etkileri vardır.
3. mitoksantrone bu grubun üyesidir
4. ön ilaçtır ve etki gösterebilmek ​İçin karbonyum iyonunu oluşturur. ​

A

Yalnızca 4​

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38
Q

Doxorubicin usded for

A

treatment of sarcomas and a variety of carcinomas, including breast cancer, as well as for treatment of acute lymphocytic leukemia and lymphomas.​

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39
Q

Daunorubicin and idarubicin are used in?

A

acute leukemias,

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40
Q

mitoxantrone is used in?

A

prostate cancer.​

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41
Q

Extravasation is a serious problem that can lead to?

A

tissue necrosis

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42
Q

cardiotoxicity is the most serious adverse reaction and is more common with …… and ……..

A

daunorubicin and doxorubicin

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43
Q

…….. in protecting against the cardiotoxicity of doxorubicin

A

dexrazoxane

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44
Q

Aşağıdakilerden hangisi antrasiklin türevi kemoterapötiklerin oluşturdukları radikallere ​ Bağlı organotoksik etkileri azaltmak için kullanılır:
deksrazoksan,
lökovorin,
sugammadeks,​
Metotreksat,
amifostin​

A

deksrazoksan

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45
Q

Bleomycin cause …. of DNA in G2 phase

A

scission

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46
Q

Bleomycin is primarily used in the treatment of …… and ……

A

testicular cancers and Hodgkin lymphoma

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47
Q

The pulmonary fibrosis that is caused by bleomycin is often referred as ?

A

bleomycin lung.

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48
Q

bleomycin lung. is caused by

A

bleomycin

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49
Q

Alkylating Agents​ binding to …… groups on various cell constituents. theya are used to treat a wide variety of lymphatic and solid cancers

A

nucleophilic

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50
Q

Alkilleyici antineoplastikler ile ilgili yukarda yazılanlardan hangisi doğrudur:​

  1. DNA da zincirler arası ya da zincir içi çapraz köprüler oluşturur, 2. non hodging lenfoma , ​ burkit lenfoma ve meme kanserinde kullanılır,
  2. melfelan ve karmustin bu gruba ait ilaçlardır.​
    ​
A

hepsi

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51
Q

Aşağıdakilerden hangisi kanser kemoterapisinde kullanılan alkilleyici ajanlardan biri değildir​

Karmustin, siklofosfamid, lomustin, mekloretamin, bleomisin

A

bleomisin

52
Q

Cyclophosphamide and ifosfamide​ are produced through hydroxylation by ……

A

in the liver by cytochrome P450 (CYP450) . 3A4 and 2B6

53
Q

Cyclophosphamide is available in …. and …. preparations, whereas ifosfamide is …. only.

A

oral IV IV

54
Q

A unique toxicity of Cyclophosphamide and ifosfamide is ?

A

hemorrhagic cystitis, which can lead to fibrosis of the bladder.

55
Q

Aşağıdaki alkileyici antineoplastik ilaçlardan hangisinin miyelosupresif etkisi en kısa sürer;​

Melfalan,klorambusil, lomustin, siklofosfamid, karmustin

A

siklofosfamid

56
Q

Siklofosfamid ürotoksisitesinin antidotu hangisidir:
mitotan, formestan, aloe, mesna,​ Senna

A

mesna

57
Q

Yan etki olarak steril hemorajik sistit yapan antineoplastik ajan hangisidir:
vinkristin, ​ Adriamisin, bleomisin, 5-florourasil, siklofosfamid

A

siklofosfamid

58
Q

nitrosoureas are primarily employed in the treatment of ….

A

brain tumors.​

59
Q

, is interesting because it has minimal bone marrow toxicity. This agent has activity in the treatment of insulin-secreting islet cell carcinoma of the pancreas.

A

streptozocin

60
Q

Aşağıdaki antineoplastik ilaçlardan hangisi pankreas langerhans hücreleri tarafından​ Selektif olarak alınır:
melfalan, streptozosin, karmustin, ıfosfamid, klorambusil​

A

streptozosin

61
Q

nitrosoureas cytotoxicity is expressed primarily in cells that are actively dividing. Therefore, nondividing cells can escape death

A

İMP

62
Q

Carmustine İS GİVEN?

A

administered IV

63
Q

lomustine is given ?

A

orally

64
Q

the ….is the major excretory route for the nitrosoureas.​

A

kidney

65
Q

Dacarbazine (MTIC=) has found use in the treatment of

A

melanoma and Hodgkin lymphoma.​

66
Q

Temozolomide does not require the…. system for metabolic transformation, and it undergoes chemical transformation at normal physiological pH

A

CYP450

67
Q

Temozolomide also inhibits the ….

A

repair enzyme

68
Q

Temozolomide differs from dacarbazine in that it crosses the ….. …………….and, therefore, is used in the treatment of ………..

It is also used in ……..

A

blood–brain barrier
brain tumors
metastatic melanoma

69
Q

Mechlorethamine cause ….

A

lymphocytopenia led to its use in lymphatic cancers

70
Q

Melphalan is used for

A

multiple myeloma

71
Q

The dose of melphalan is carefully adjusted by monitoring the ……. and …….

A

platelet and white blood cell counts

72
Q

Hangisi alkilleyici ajandır: azatioprin, melfalan, metotreksat, sisplatin, flusitozin​

A

melfalan

73
Q

Chlorambucil is bifunctional alkylating that is used in the treatment of ….

A

chronic lymphocytic leukemia

74
Q

Kemoterapide kullanılan ilaçlardan hangisi akciğer toksisistesi yapar:
adriyamisin, melfalan, Vinkristin, busulfan, karboplatin

A

busulfan

75
Q

Vincristine VX is used in the treatment of

A

acute lymphoblastic leukemia in children, Wilms tumor, Ewing soft tissue sarcoma, and Hodgkin and non-Hodgkin lymphomas, as well as some other rapidly proliferating neoplasms. ​

76
Q

VBL (vinblastine) is administered with bleomycin and cisplatin for the treatment of

A

metastatic testicular carcinoma.

It is also used in the treatment of systemic Hodgkin and non-Hodgkin lymphomas

77
Q

VRB(vinorelbine) used for

A

advanced non–small cell lung cancer, either as a single agent or with cisplatin.​

78
Q

Aşağıdakilerden hangisi vinblastin, vinkristin ve vinorelbinin gibi bitki alkaloidlerinin ​antikanserojen etkinliğini en iyi açıklar:

A

hücre iskeletindeki mikrotübüllerin inhibisyonu​İle mitozun engellenmesi ​

79
Q

Mikrotubul formasyonunu bozan mitoz zehiri olarak da bilinen antineoplastik ​Aşağıdakilerden hangisidir:
metotreksat,
6-merkaptopurin,
sitarabin,
aktinomisin D,
​vinblastin

A

vinblastin

80
Q

he Vinca alkaloids are concentrated and metabolized in the liver by the …… pathway and eliminated in bile and feces. Dosage adjustment is required in patients with …… or biliary obstruction.​

A

CYP450
impaired hepatic function

81
Q

VX and VBL are both associated with ………………. if extravasation occurs during injection

A

phlebitis or cellulitis

82
Q

Paclitaxel used for

A

advanced ovarian cancer​

and metastatic breast cancer

non–small cell lung cancer when administered with cisplatin

82
Q

Hodgin hastalığı için kemoterapi alan bir hastanın 4. kürü sırasında el ve ayaklarda uyuşma,​
Yanma, karıncalanma meydana geliyor. Bu semptomlara yol açan ilaç hangidir:

A

vinkristin

82
Q

Docetaxel commonly used in

A

prostate, breast, GI, and non–small cell lung cancers.​

83
Q

Paclitaxel and docetaxel​ are active in the …… phase of the cell cycle,

A

G2/M

84
Q

Paclitaxel and docetaxe metabolism by the CYP450 system and are excreted via the biliary system. Dosages should be reduced in patients with ………. .​

A

hepatik dysfunction

85
Q

The dose-limiting toxicities of paclitaxel and docetaxel are neutropenia and leukopenia. Peripheral neuropathy is also a common adverse effect with the ?

A

taxanes.​

86
Q

dyspnea, urticaria, and hypotension), patients who are treated with paclitaxel should be premedicated with ….. and ….. , as well as with an H2 receptor

A

dexamethasone
diphenhydramine

87
Q

antiestrogen tamoxifen prevents estrogen stimulation of ……

A

breast cancer cells)

88
Q

Aşağıdaki ajanlardan hangisi meme kanser tedavisinde kullanılan ve östrojen reseptör ​ Antagonisti olan bir ajandır:
flutamid, leuprolid, aminoglutetimid, tamoksifen, androjen​

A

tamoksifen

89
Q

Tamoxifen is (). It is an …………………………….

A

SERM
estrogen antagonist in breast tissue

90
Q

Tamoxifen is an inhibitor of …. and ……

A

CYP3A4
P-glycoprotein.​

91
Q

Adverse effects caused by tamoxifen include ……………………. , nausea, vomiting, skin rash, and vaginal bleeding and discharge
……………………

A

hot flashes
thromboembolism and effects on vision.​

92
Q

Tamoxifen has the potential to cause …….. cancer

A

endometrial

93
Q

Fulvestrant is an ….. receptor antagonist

A

estrogen

cause hot flashes, arthralgias, and myalgias.​

94
Q

Raloxifene is an ….. receptor antagonist

A

estrogen

cause hot flashes, arthralgias, and myalgias.​

95
Q

The aromatase reaction is responsible for extra-adrenal synthesis of

A

estrogen

96
Q

Anastrozole and letrozole are nonsteroidal …… inhibitors.

A

aromatase

97
Q

Anastrozole and letrozole ARE first-line drugs for the treatment of …….

They are orally active and cause almost a total suppression of estrogen synthesis

excreted primarily in the urine.​

A

breast cancer in postmenopausal women

98
Q

Exemestane is a
Hepatic metabolism occurs via the
excreted in urine, doses of the drug must be adjusted in patients with renal failure.

A

irreversible inhibitor of aromatase

CYP3A4

99
Q

Major toxicities of Exemestane are nausea, fatigue, and have also ……………………………………………………………………….. been noted.

A

hot flashes. Alopecia and dermatitis

100
Q

Leuprolide, goserelin, and triptorelin are synthetic analogs of ……

A

GnRH
inhibition of release of FSH and LH
both androgen and estrogen synthesis are reduced. ​

101
Q

Leuprolide is available as 1) a subcutaneous daily injection, 2) a subcutaneous depot injection, or 3) an intramuscular depot injection to treat ……………………..

A

metastatic carcinoma of the prostate. ​

102
Q

Goserelin acetate is a

A

subcutaneous implant

103
Q

riptorelin pamoate is

A

injected intramuscularly. ​

104
Q

Flutamide, nilutamide, bicalutamide, and enzalutamide are oral …..

A

antiandrogens

105
Q

antiandrogens used in …..
Adverse effects include …………,

A

the treatment of prostate cancer
gynecomastia

106
Q

isplatin has synergistic cytotoxicity with radiation and other chemotherapeutic agents. It has found wide application in the treatment of …….

A

solid tumors

metastatic testicular carcinoma in combination with VBL and bleomycin, ovarian carcinoma in combination with cyclophosphamide, or alone for bladder carcinoma. ​

107
Q

Carboplatin used when patients cannot be ……. , as is required for cisplatin treatment, or if they suffer from kidney dysfunction or are prone to neuro- or ototoxicity. ​

​

A

vigorously hydrated

108
Q

Oxaliplatin is a closely related analog of carboplatin used in the setting of …….

A

colorectal cancer.

109
Q

ntineoplastik ilaçların neden olabileceği toksisisteyi azaltmak için kullanılan ajan ile ilgili ​Antineoplastik ilaç eşleştirmesini yapınız:

A: sisplatin-öncesinde hidrasyon ve furosemid,

B: 5 fluorasil-​ Öncesinde pentostatin,

C: daunorubisin-eş zamanlı mesna,

D: siklofosfamid-öncesinde hidrasyon ve​ İdrarın alkalileştirilmesi,

E: metotreksat- eş zamanlı dekstrazoksan​

A

sisplatin-öncesinde hidrasyon ve furosemid,

110
Q

Irinotecan and topotecan are semisynthetic derivatives of …….​

A

camptothecin

111
Q

Topotecan is used in …..

A

metastatic ovarian cancer

112
Q

Irinotecan used with …. and leucovorin for the treatment of ……..

A

5-FU
colorectal carcinoma.​

113
Q

Camptothecins are ……… specific and inhibit topoisomerase ….

A

S-phase
1

114
Q

İrinotekan ile ilgili aşağıdakilerden hangisi yanlıştır:

topoizomeraz 2 enzimini inhibe eder, ​

Metastatik kolorektal kanser tedavisinde kullanılır,

diare ve salya artışı gibi kolinerjik yan​ Etkiler oluşturabilir,

kemik iliği depresyonu yapabilir

A

topoizomeraz 1 enzimini inhibe eder, ​

115
Q

Bone marrow suppression, particularly neutropenia, is the dose-limiting toxicity for ………. Myelosuppression is also seen with irinotecan. Acute and delayed diarrhea with irinotecan may be severe and require treatment with atropine during the infusion or high doses of loperamide in the days following the infusion.​

A

topotecan

116
Q

Etoposide blocks cells in the ………………….
Results in …………………………

A

late S to G2 phase of the cell cycle
irreversible double-strand breaks

117
Q

Etoposide’s clinical use is against …….. and with bleomycin and cisplatin for …………. .

A

lung cancer
testicular carcinoma

118
Q

Pertuzumab is a recombinant humanized ….. monoclonal​
antibody

suppresses tumor growth

It is approved for the treatment of metastatic or locally advanced …… (Erb0B2)/neu-positive ………..

MAP kinase (mitogen-activated protein kinase) and PI3 kinase pathways

Pertuzumab also mediates antibody-dependent cell-mediated cytotoxicity on HER-2/neu-positive tumor cells.​

A

IgG1
HER-2
breast cancer

119
Q

Kanser tedavisinde kullanılan insan monoklonal antikorlardan hangisi ErbB2 adlı glikoproteinin ​ dış parçasını hedef alarak tümör apoptozisini engelleyen sinyalleri baskılar:

Natalizumab,​
Etanercept,
alemtuzumab,
pertuzumab,
infiksimab ​

A

pertuzumab

120
Q

Aşağıdaki kanser ilaçlarından hangisi bcr-abl kinazı inhibe ederek etki gösterir:

A

dasatinib,

121
Q

Aşağıdakilerden hangisi anti-kanser etkinliğini tirozin kinaz enzimini inhibe ederek göstermez:
İmatinib, gefitinib, erlotinib, bortezomib, dasatinib ​

A

bortezomib

122
Q

The two most commonly used checkpoint inhibitors are …………… and ………

A

pembrolizumab and nivolumab. ​

123
Q

Abiraterone acetate is an oral agent used in the treatment of metastatic castration–resistant prostate cancer
inhibit the ……. enzyme

Coadministration with …………… is for effects of CYP17 inhibition.​

A

CYP17 an enzyme required for androgen synthesis

prednisone

124
Q

Thalidomide, lenalidomide, and pomalidomide are oral agents used in the treatment of ………..

A

multiple myeloma

125
Q

thalidomide, lenalidomide and pomalidomide are contraindicated in pregnancy.​

A

severe birth defects

126
Q

Bortezomib , ixazomib, and carfilzomib are proteasome inhibitors commonly used as the backbone therapy in the treatment of ……..

A

multiple myeloma

127
Q

Aşağıdaki kanser ilaçlarından hangisi histondeasetil enzimini inhibe ederek etki gösterir:​

Vorinostat, bortezomib, irinotekan, etopozid, doksorubisin

A

Vorinostat and romidepsin​

128
Q

what can be given aginst Acute lymphoblastic leukemia

A

Subsequently, corticosteroids, 6-mercaptopurine, cyclophosphamide, vincristine, daunorubicin, and asparaginase all have been found to be active against this disease. ​

129
Q

Aşağıdakilerden hangisi akut lenfoblastik lösemi tedavisinde intravenöz olarak kullanılır:​

Busulfan, flurourasil, klorambusil, mekloretamin, asparajinaz

A

asparajinaz

farmakoloji 300 (1 decks)

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