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Pharmacology > Anticancer > Flashcards

Anticancer Flashcards

1
Q

What are the classes of chemotherapy drugs?

A 
antimetabolites 
alkylating agents 
plants alkaloids 
antibiotics 
hormones 
immunotherapy 
miscellaneous
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2
Q

Antimetabolites

A

target S phase of the cell cycle by interfering with replication

SE: bone marrow suppression

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3
Q

What are the types of antimetabolites?

A

folate antagonists
pyrimidine analogs
purine analogs

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4
Q

Methotrexate
pemetrexed
pralatrexate

A

inhibit DHF reductase

decrease T, A, G

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5
Q

What are the side effects of antifolate dx?

A

BMS, diarrhea, N+V
pneumonitis , hepatic fibrosis
puritic rash
NSAID, penicillin toxicity

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6
Q

What treats antifolate toxicity?

A

leucovorin

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7
Q

What are the pyramid analogs

A

5 flurouracil
capecitabine
cytarabine
gemcitabine

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8
Q

5 fluoruacil & capecitabine

A

inhibit thymidylate synthase

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9
Q

What are the side effects of 5 fluoruacil & capecitabine

A

BMS, N+V. diarrhea
hand foot syndrome
neurotoxicity

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10
Q

Cytarabine (ARa-C)

A

inhibit DNA polymerase after phosphorylation and incorporation in DNA

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11
Q

What are the side effects of Cytarabine (ARa-C)

A

BMS, N+V, diarrhea
neurotoxicity
heaptotoxicity

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12
Q

Gemcitabine

A

inhibit DNA polymerase

inhibit ribonucleotide reductase

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13
Q

What are the side effects of Gemcitabine

A

BMS , N+V, diarrhea, mucosistis
interstitial pneumonitis
progressive HUS

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14
Q

Pruine analogs

A

mecaptopurine

6- thiofuanine

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15
Q

mecaptopurine

6- thiofuanine

A

activated by HGPRTase to monphosphate

inhibit PRPP amidotransferase

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16
Q

What are the side effects of mecaptopurine

6- thiofuanine

A

BMS, N+V, mucositis , diarrhoea
hyperpigmentation of skin
immunosuppression

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17
Q

Alkylating agents types

A 
non cell cycle specific 
nitrogen mustards
platinum analog
methylhydrazine 
nitrosoureas
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18
Q

What are the nitrogen mustards?

A

cyclophosphamide
ifosfamide
Mechlorethamine

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19
Q

cyclophosphamide

ifosfamide side effects

A

BMS< N+V
hemorrhagic cystitis d/t acrolein

MENSA is protective

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20
Q

Mechlorethamine side effects?

A

severe N+V

BMS

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21
Q

What are the platinum analogs

A

Cisplatin
carboplatin
oxaliplatin

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22
Q

Cisplatin
carboplatin
oxaliplatin side effects

A 
nephrotoxicity - tx amifostine 
severe N+V -tx ondansetron
otoxicity 
peripheral neuropathies 
BMS
hypersensitivity to platinum 
carboplatin less toxic 
oxaliplatin less nephrology/ototoxic
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23
Q

Methylhydrazine

A

procarbazine

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24
Q

procarbazine side effets

A

BMS
disulfram life reaction
metabolite of MAO inhibitor

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25
Q

Nitrosurea

A

carmustine

lomustine -crosses BBB

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26
Q

carmustine

lomustine side effects

A

BMS, N+V

interstitial nephritis

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27
Q

Vunblastine
vincristine
vinorelbine

A

vinca alkaloids
M phase specific - inhibit microtubules polymerization

arrest in metaphase

28
Q

Side effects of Vunblastine
vincristine
vinorelbine

A

BMS,peripheral neuropathies

constipation, SIADH

29
Q

Paclitacel
docetaxel
cabazitaxel

A

taxanes
m phase specific- inhibit microtubule depolymerization
arrest in prophase

30
Q

What are the side effects of Paclitacel
docetaxel
cabazitaxel ?

A

hypersensitivity
BMS , N+V , diarrhea
peripheral neuropathies

31
Q

irinotecan

toptecan

A

camptothecin analogs
S phase specific
inhibition of topoisomerase I

32
Q

What are the side effects of irinotecan

toptecan ?

A

BMS, N+V

astenia

33
Q

etoposide

teniposide

A

s phase specific

inhibition of topoisomerase II

34
Q

What are the side effects of etoposide

teniposide ?

A

BMS, N+V
hypersensitivity
hypotension

35
Q

Antinomycin D

A

antibiotics used in cancer

inhibit RNA polymerase - between G-C base pairs

36
Q

What are the side effect of antinomycin D?

A

BMS. N+V, diarrhea
hyperpigmentaiton
hepatotoxic

37
Q

Daunorubicin
doxorubicin
epirubicin
idarubicin

A

intercalate in DNA
free radical formation
block topoisomerase II

38
Q

What are the side effects of Daunorubicin
doxorubicin
epirubicin
idarubicin ?

A

BMS, N+V\red orange urine
dose dependent cardio toxicity
cardiomyopathy

Tx: Dexrazoxane

39
Q

Bleomycin

A

G2 phase specific
antibiotic used in cancer
binds to iron , forms free radicals –> strand scission

40
Q

What are the side effects of bleomycin?

A

pulmonary fibrosis
skin reaction
hypersensitivity

41
Q

Tamoxifen

toremifene

A

competitive inhibitor of estradiol binding to ER in breast tissue

42
Q

What are the side effects of Tamoxifen

toremifene

A 
hot flashes 
vaginal mucosal atrophy 
vaginal bleeding 
endometrial hyperplasia 
slow development of osteoporosis 
lowers total cholesterol , LDL
43
Q

fulvestrant

A

SERDs
pure ER antagonist
prevent dimerization
enhances degradation of receptor

44
Q

What are the side effects of fulvestrant?

A

nausea, headache

hot flashes

45
Q

Anastrozole
letrozole
exemestane

A

aromatase inhibitors
bind to heme of CYP19 aromatase
competitive & irreversible inhibition

46
Q

What are the side effects of Anastrozole
letrozole
exemestane ?

A

hot flashes
hypercholesterolemia
osteoporosis
joint muscle pain

47
Q

Leuprolide
goserelin
triptorelin

A

GnRH analogs
initial surge in LH, FSH
increase testosterone

48
Q

degarelix

A

GnRH antagonist

no surge in Lh, FSH

49
Q

Flutamide
nilutamide
bicalutamide
enzalutamide

A

competitive androgen receptor antagonist

50
Q

What are the side effects to anti androgen therapy ?

A 
hot flashes 
decreased libido 
erectile dysfunction 
gynecomastia 
osteoperosis
51
Q

Rituximab

A

MOA: CD20 , sensitizes B cell to chemotherapy

used: NHL. CLL , weaner granulomatosis, microscopic polyangitis

52
Q

Alemtuzumab

A

MOA: CD52, PMNs & lymphocyte

SE: meylo /immuno suppression

used :CLL

53
Q

Trastuzumab

A

MOA: Erb2 / Her 2/neu , elf receptor

used :metastatic erb2 breast cancer, erb2 gastric or gastroesophageal adenocarcinoma

54
Q

Cetuximab

A

MOA: erb1/ Her1/neu , elf receptor

USED: EGFR metatstatic colorectal cancer

55
Q

Bevacizumab

A

MOA: VEGF

SE: hypertensioin , proteinuria,
GI perforation and hemorrhage

USED: metastatic colorectal cacer, non small cell lung cancer, erb2 - breast cancer
metastatic renal cell carcinoma
glioblastoma

56
Q

Imatinib

A

TKIs

target: bar-abl, c-kit, PDGFR
used: CML, gastrointestinal stroma tuner, hypereosinophillc syndrome

57
Q

Getinib

Erlotinib

A

TKIs
target: erbB1
used : non small cell lung cancer , pancreatic cancer

58
Q

sorafenib

A

TKIs

target: multiple tyrosine kinases
used: RCC, HCC, thyroid cancer

59
Q

Sunitibib

A

TKIs

target: multiple TK receptors
used: metastatic RCC, GISTs, pancreatic neuroendocrine tumors

60
Q

Rapamycin

A

mTOR inhibitor
decreases cell growth, proliferation and motility

used in transplant rejection

61
Q

L-Asparaginase

A

hydrolysis to aspartate and ammonia decrease asparagine for tumor survival

62
Q

What is the side effect of L-asparginase

A

decreased protein synthesis , hyperglycaemia, pancreatitis , hemorrhagic events

63
Q

ATRA

A

all trans retinoid acid

cause differentiation of promyelocytes

64
Q

Retinoid acid syndrome

A

fever, dyspnea, weight gain
pulmonary , pleural, pericarditis
mental confusion , death

65
Q

Inflicimab

A

inhibit tumor necrosis factor-alpha

66
Q

Rituximab

A

inhibit CD20 - b cell lymphomas

67
Q

Cyclosporine

A

decrease T lymphocytes

SE: nephrotoxicity
neuropathy
gingival hyperplasia

Pharmacology (15 decks)

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