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Unit 4 > Anticancer drug/transplant/toxicology > Flashcards

Anticancer drug/transplant/toxicology Flashcards

1
Q

Anticaner drugs follow zero or first order kinetics?

A

First order

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2
Q

Anticancer drugs target normal high growth fraction cells such as? and the resulting side effects?

A

Bone marrow/hair/GI

Bone marrow suppression/alopecia/nausea and vomiting

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3
Q

Non cell cycle specific and cell cycle specific anticancer drugs target high or low growth fraction tumors?

A

Cell cycle specific—>high growth fraction

Non cell cycle specific—>low or high growth fraction

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4
Q

Which anticancer drug is G2 phase specific?

A

Bleomycin

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5
Q

Which anticancer drugs are M phase specific?

A

Vincristine/Vinblastine/Paclitaxel

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6
Q

What are some anticancer drugs that are S phase specific?

A 
Anything that sounds like a DNA or RNA
6-MP
5-FU
Cytarabine
6-thioguanine 
Hydroxyurea
Irinotecan 
Etoposide
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7
Q

What are some anticancer drugs that are non cell cycle specific?

A

Alkylating agents
Doxorubicin
Daunorubicin
Nitrosoureas

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8
Q

What are the 3 anticancer drugs that are not bone marrow suppressive? and what are their toxicities?

A

Cisplatin (renal)
Bleomycin (pul fibrosis)
Vincristine (peripheral neuropathy)

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9
Q

What metabolite of cyclophosphamide does it cause hemorrhagic cystitis? and what helps to prevent it?

A

Acrolein/MESNA and hydration

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10
Q

What type of anticancer drugs are most likely to cause cancer later on?

A

Alkylating agents (mutagen)

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11
Q

What cancer might Procarbazine cause down the road?

A

Leukemia

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12
Q

How does doxorubicin cause cardiac toxicity and what can you use to counter that?

A

Free radical damage/dexrazoxane (iron chelating agent)

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13
Q

What drug can you use to protect cells from methotrexate? and is it protective against 5-FU as well?

A

Leucovorin/no it makes it worse

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14
Q

Pyramidine analog anticancer drugs (5-FU/cytarabine) inhibit which enzyme? and prevent the production of ?

A

Thymidylate synthetase/thymine

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15
Q

6-MP has to be activated by what enzyme and which enzyme inactivate 6-MP, which results in what drug interaction?

A

Activated by HGPRT
xanthine oxidase inactivate 6-MP
Drug interaction with allopurinol—>inhibit xanthine oxidase

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16
Q

5-FU is converted into ___ , which is the active form?

A

5-FdUMP

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17
Q

Which drug targets BCR-ABL of CML?

A

Imatinib

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18
Q

What do Cetuximab and Trastuzumab target and what cancers do they treat?

A

Cetuximab—>ErbB1—>head and neck cancer (wear TUX, head and neck stick out)
Trastuzumab—>ErbB2 (HER2)—>breast cancer

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19
Q

Which ‘mab is a VEGF inhibitor that treats solid tumors?

A

Bevacizumab

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20
Q

Tyrosine kinase inhibitor treat? and they all end in?

A

Cancer/nib

21
Q

What can we give cancer pts that are on anticaner drugs to reduce risk of infection and the need for antibiotics?

A

G-CSF (filgrastim)
GM-CSF (sargramastim)
EPO
Thrombopoietin

22
Q

What is the role of thymidylate synthetase?

A

Convert dUMP to dTMP

23
Q

What does cyclosporine and tacrolimus bind? what is their common mechanism?

A

Cyclosporine—>bind to cyclohilin
Tacrolimus—>bind to FK binding protein
They inhibit calcineurin—>inhibit activation of T cell

24
Q

What are the side effects of cyclosporine and tacrolimus?

A

Renal toxicity

Cyclosporine—>gingival hyperplasia

25
Q

What do azathioprine and mycophenolate inhibit?

A

Purine synthesis

26
Q

What does azathioprine convert to?

A

6-MP

27
Q

What do you give a Rh- mother to prevent Rh hemolytic disease of the new born?

A

Anti D immunoglobulin

28
Q

What does abciximab targets and where does it used?

A

Targets GP2b/3a—>used in angioplasty procedure

29
Q

What are the 2 common mab that are used to treat RA?

A

Infliximab (Crohn disease as well) and adalimumab

30
Q

What are interferon alpha/beta/gamma commonly used for?

A

Alpha—>hep B and C/leukemia/melanoma
Beta—>MS
Gamma—>chronic granulomatous disease

31
Q

What is DUMBBELSS and what is it from? and how do we counter it?

A

Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle, Lacrimation, Sweating, Salivation
AChE inhibitor overdose
Counter with atropine and pralidoxime

32
Q

What drug do we used to counter atropine overdose?

A

Physostigmine

33
Q

How to treat CO poisoning?

A

Hyperbaric O2

34
Q

Atropine and amphetamine overdose are similar except? and what to give for amphetamine overdose?

A

Atropine overdose has hot and dry skin

Amphetamine overdose has warm and sweaty skin/benzo

35
Q

What do you see with opioid overdose and what drug to counter it?

A

Lethargy/sedation/decrease HR and BP/respiratory failure

Naloxone (IV)

36
Q

What is the first sign of salicylate overdose? and how to treat it?

A

Tinnitus

Urine alkalization/hemodialysis

37
Q

What drug to give for benzo overdose?

A

Flumazenil

38
Q

SSRI combine with what can cause serotonin syndrome? and what drug is used for that?

A

TCA or MAOi/cyproheptadine (5-HT2 receptor blocker)

39
Q

Which opioid can cause serotonin syndrome?

A

Meperidine—>metabolized into norperidine—>block reuptake of serotonin

40
Q

What are the 3 Cs of TCA toxicity?

A

Convulsion/coma/cardiotoxicity

41
Q

What are some clinical presentation of chronic arsenic poisoning? what drugs to use for that?

A

Raindrop skin pigmentation/stock glove neuropathy

Dimercaprol/Penicillamine

42
Q

What do you see acute iron poisoning in children? and what is the antidote

A

Severe GI symptoms—>hematemesis and bloody diarrhea

Deferoxamine

43
Q

What drugs can be used for lead poisoning?

A

Dimercaprol/Succimer

44
Q

What does chronic mercury poisoning affect?

A

CNS affect—>ataxia/vision and hearing problem

45
Q

What is the antidote for acetaminophen/theophylline/methanol or ethylene glycol/copper or Wilson’s/heparin poisoning?

A 
Acetylcycsteine 
Esmolol 
Fomepizole
Penicillamine or trientine
Protamine
46
Q

What are Echinacea/garlic/gingko/ginseng/saw palmetto/St john’s wort used for? and what are their interactions with other drugs (real drugs)?

A

Echinacea—>cold
Garlic—>hyperlipidemia (antiplatelet action—>caution with pt on anticoagulant)
Gingko—>improve memory (antiplatelet)
Ginseng—>improve physical/mental performance
Saw palmetto—>inhibit 5 alpha reductase (BPH)
St John’s wort—>increase serotonin—>antidepressant (Serotonin syndrome with SSRI/P450 inducer—>decrease effect of other drugs)

47
Q

What are DHEA and melatonin used for?

A

DHEA—>for athlete to gain more muscle

Melatonin—>used for jet leg

48
Q

Acute gastroenteritis/HoTN/rice water diarrhea/torsades, think what metal poisoning?

A

Arsenic

Unit 4 (28 decks)

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