Antimetabolites-cell-cycle specific

Question 1

How does an antimetabolite work?

Answer 1

interferes with DNA synthesis by acting as false metabolites. They are incorporated into the DNA strand or they block essential enzymes

Question 2

What are common side effects of all anti-metabolites?

Answer 2

myelosuppression, nausea, vomiting (methotrexate does not cause vomiting)

Question 3

Azacitidine (vidaza)

Answer 3

SC, IV

MDPS

side effects: M,N,V, diarrhea, fatigue, hypokalemia, renal tox

Question 4

Capecitabine (xeloda)

Answer 4

PO

breast, colon

Side effects: M,N,V, diarrhea, fatigue, increased bilirubin, Hand/foot syndrome

Interactions: Take with meal and full glass of water. B6 for hand/foot syndrome. Altered coagulation with warfarin

Question 5

Cytarabine (ARA-C) -think blood cancers

Answer 5

IV, SC, IT, IM

ALL, AML, CML, NHL

Side effects: M,N,V, mucositis, anorexia, acute pancreatitis, neurotoxicity, hepatic toxicity, pulmonary toxicity, conjunctivitis, keratitis

Question 6

Fludarabine (Fludara)- think bood cancers

Answer 6

IV

CLL, NHL, T-Cell lymphoma, Hairy cell leukemia

Side effects: M,N,V, diarrhea, neurotoxicity, rash

Question 7

Fluorouracil (5-FU)- female and GI

Answer 7

IV, topical

Breast, ovarian, HN, liver, colorectal, GI, pancreatic

side effects: M,N,V, diarrhea, mucositis, hand/foot syndrome, cardiac toxicity, photosensitivity

Interactions: Ice chips pre and post infusion to prevent mucositis, B6 for hand/foot syndrome

Question 8

gemcitabine (gemzar)

Answer 8

IV

Breast, ovarian, bladder, pancreatic, lung, NHL, sarcoma

Side effects: M,N,V, pulmonary tox, rash, flu-like symptoms

Question 9

mercaptopurine (6-MP) -blood cancers

Answer 9

PO

ALL, AML, CML, NHL

Side effects: M,N,V, mucositis, diarrhea, hepatic tox, hyperuricemia

Interactions: take on empty stomach, do not take with dairy-containing foods

Question 10

methotrexate (MTX)

Answer 10

IM, IV, IT, PO

bladder, breast, HN, sarcoma, NHL, CNS lymphoma, ALL

Side effects: M,N, mucositis, oral/GI ulcerations, renal tox, hepatic tox, photosensitivity

Interactions: take oral med on empty stomach, avoid folic acid with all forms of drug

Question 11

Pemetrexed (alimta)- think lung

Answer 11

IV

lung, mesothelioma

Side effects: M,N,V, diarrhea, fatigue, rash

Interactions: Folic acid and B12 supplementation to prevent anemias

Question 12

Thioguanine (6-TG)- think blood

Answer 12

PO

ALL, AML, CML

Side effects: M,N,V, mucositis, diarrhea, hepatic tox, renal tox, rash