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pharma > Antineoplastic Drugs > Flashcards

Antineoplastic Drugs Flashcards

1
Q

Methotrexate MOA

A

-inhibition of DHF reductase
(“meat sticks chef trying to replace the folate leafs”)

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2
Q

Methotroxate is useful in treating ...

A

-cancers
(“Cracked crab”)

-MTX with misoprostol used as abortifacient and ectopic pregnancy

(“Empty uterus backpack”)
(“baby keychain on the side”)

-invasive molar pregnancy, trophoblastic tumors and choriocarcinoma
(“Mole keychain”)

-Methotrexate treats psoriasis
(“Silver knee/elbow pads”)

-Methotrexate is first line treatment for rheumatoid arthritis or DMARD
(“Joint lantern with flame”)

-used for immunosuppressive therapy such as IBD, SLE, vasculitis, dematomyositis
(“Torn antibody latern”)

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3
Q

Methotrexate Side Effects

A

-folate deficiency
(“Foliage falling”)

-megaloblastic anemia
(“Blasting firework lantern”)

-pancytopenia, myelosuppression
(“Falling pan of sushi:”)

-immunosuppressed have increased risk for infection
(“Cane”)

-lung fibrosis (restrictive lung dz)
(“Fibrotic lung bonsai”)

  • hepatotoxicity, monitor LFTs
    (“Liver spot on apron”)

-causes baldness
(“Bald guy”)

  • mucositis
    (“Guy eating hot meat stick”)
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4
Q

what is the antidote for Methotroxate toxcity ?

A

folinic acid

(“Lucky feline”)

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5
Q

5’-Fluorouracil MOA

A

inhibits thymidylate synthase to block thymidine production

  • increase dUMP via inhibition of thymidylate synthase
    (“Buildup of dumpling plates”)

(“Full guy”)

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6
Q

5’-Fluorouracil Side Effects

A

-diarrhea
(“Stained pants”)

-photosensitivity and rash
(“Sensitive photos”)

-increases myelosuppression and infection
(“Falling pan of sushi”)

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7
Q

5 -Fluorouracil Antidote

A

NO ANTIDOTE! MUAHAHAHAHA!!!!!!!

(“Knocked over cat”)

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8
Q

Hydroxyurea MOA

(“Hydro rock area”)

A

ribonucleotide reductase inhibitor, blocks thymidine synthesis

  • ribonucleotide reductase converts UDP to deoxy-UDP
    (“Crossed out OXY”)
  • UDP (uridine diphosphate) is precursor to pyrimidine nucleosides
    (“UDP sign”)

(“inhibited wait list waitress”)

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9
Q

Hydroxyurea can treat …

A

sickle cell anemia

  • increase HbF, protection against HbS
    (“Raised baby with Hb coin”)

(“Zen sickle”)

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10
Q

Hydroxyurea Side Effect

A

myelosuppression and increased infection side effect
(“Falling pan of sushi”)

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11
Q

6 Mercaptopurine MOA

(“CAPTured gypsy”)

A

Azathioprine is prodrug
(“AZmeralda”)
——————————————————————————–
-cytotoxic purine analog

  • need HGPRT (enzyme) to activate 6-MP

(“HiGh Priest”)

​-block synthesis of IMP
(“captive toppling imp”)

-inhibits DNA synthesis, blocks S phase
(“broken stair way”)

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12
Q

6-Mercaptopurine can treat …

A

hematogenous malignancies

  • ALL
    (“stained glass window with crabs, antibody archers and T knights”)

​​-used for immunosuppressive therapies

  • SLE
  • ​grafts
  • ​ inflammations

(“torn lanterns with antibodies and bone”)

-rheumatoid arthritis, DMARD
(“bone lantern”)

-Inflammatory Bowel Disease
(“inflamed colonic lanterns”)

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13
Q

6-Mercaptopurine Side Effects

A

-bone marrow suppression
(“nun with bone tray feeding bird”)

-immunosuppression and increased risk for infection monitor pt with CBCs
(“statue with cane”)

-pancreatitis
(“pancreas sponge”)

-hepatotoxicity or hepatitis
(“liver stain on apron”)

-allopurinol inhibits breakdown of 6 mercaptopurine and azathioprine increasing risk of toxicity

  • may cause a mild rash
    (“purine bead necklace”)
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14
Q

Mycophenolate Mofetil MOA

(“quasimoto”)

A

-IMP dehydrogenase inhibitor

  • decrease GMP synthesis, decreased lymphocyte production
    (“knocking over GruMPy statue”)
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15
Q

Mycophenolate Mofetil is used to treat …

(“Quasimoto”)

A

-for immunosuppressive therapy

  • grafts
  • SLE
  • MG
  • rheumatoid arthritis (DMARD)

(“swinging on lanterns”)

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16
Q

Mycophenolate Mofetil Side Effects

(“Quasimoto”)

A

-GI effects
(“nauseated quasi-mofetil”)

-immunosuppressive side effects
(“nuns”)

-increased infection in immunosuppressed
(“cane”)

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17
Q

Cladribine, Cytarabine, Gemcitabine MOA

A

-inhibit DNA polymerase → inhibit the S phase of the cell cycle

(“Cracked replication fork”)
(“Stone Phase”)

  • cytarabine and gemcitabine are pyrimidine analogs
    (“Pyrimidine shapes”)
  • ​cladribine is a purine analog
    (“Purine shaped hammer”)
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18
Q

Cladribine can treat …

A

hairy cell leukemia

(“Hairy caveman”)

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19
Q

Cytarabine can treat …

A

only active against hematologic malignancies

(“Scratched out antibody archers and T-cell swordsman”)

  • AML
  • ​ non-Hodgkin lymphoma
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20
Q

Gemcitabine can treat…

(“gems inside geode”)

A
  • active against both hematologic malignancies and
  • *solid** tumors

(“Cracked crab fossil on solid rocks”)

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21
Q

Cladribine, Cytarabine, Gemcitabine Side Effects

A

-can cause immunosuppression and increased risk of infection
(“Immunosuppressed cane”)

-can cause myelosuppression
(“Broken marrow”)

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22
Q

Name the Alkylating agents

A

Cyclophosphamide
(“Cyclops Polyphemus”)

Busulfan
(“Beautiful sirens”)

Nitrosureas
(“Mustang”)

  • Carmustine
  • ​Lomustine

​Ifosfamide

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23
Q

Cyclophosphamide
Busulfan
Nitroureas
MOA

A

alkylating agents donate an alkyl group → DNA cross-links

  • cell cycle NON-specific

**Cyclophosphamide is activated by CYP450**

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24
Q

Cyclophosphamide can be used to treat …

A

treats many hematologic and solid malignancies

  • leukemias and lymphomas,
  • breast cancer,
  • ​ ovarian cancer
    (“Torn cancer crab”)

potent immunosuppressive therapy
treatment of

  • nephrotic syndrome,
  • nephritic syndrome,
  • vasculitis,
  • ​autoimmune hemolytic anemia
    (“Torn antibody”)
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25
Q

Cyclophosphamide Side Effects

A

can cause myelosuppression
(“Broken marrow”)

-can cause hemorrhagic cystitis
(“Red urine kid fountain”)

  • co-administration of 2-mercaptoethanesulfonate (MESNA) prevents hemorrhagic cystitis
    (“Protective maze surrounding red urine fountain”)

-increases risk of bladder cancer
(“Cancer crab belt buckle”)

  • high grade transitional cell carcinoma

can cause hyponatremia due to SIADH
(“Inappropriately wet head”)

-cause infertility and premature menopause
(“Dried up fruit tree”)

​

​

27
Q

Busulfan can be used to treat …

(“beautiful sirens”)

A

useful as a conditioning agent prior to bone marrow transplantation
(“Severely depleted marrow”)

28
Q

Nitrosoureas

Carmustine
Lomustine
(“Mustang Centaurs”)

Streptozotocin
(“Striped zebra centaur”)

are used to treat …

A

highly lipophilic →cross BBB → treat brain tumors

  • glioblastoma multiform
    (“Brain tree”)
29
Q

Nitrosoureas

Carmustine
Lomustine
(“Mustang Centaurs”)

Streptozotocin
(“Striped zebra centaur”)

Side Effects

A

can cause neurotoxicity
(“Dizzy centaur”)

  • convulsions
  • dizziness
  • ​ataxia
30
Q

Busulfan Side Effects

(“Beautiful Sirens”)

A

-can cause lung toxicity

  • acute lung injury
  • interstitial fibrosis
  • ​alveolar hemorrhage

-can cause a hyperpigmentation reaction
(“Beautiful TAN sirens”)

31
Q

Name Cytotoxic Platinum analogs

A
  • *Cis**platin
  • *Carbo**platin
  • *Oxali**platin
32
Q

Cisplatin
Carboplatin
Oxaliplatin

MOA

A

bind DNA and form intrastrand and interstrand cross-links

(“Cross-linked helix necklace”)

33
Q

Cisplatin
Carboplatin
Oxaliplatin

can treat …

A

treat various solid malignancies

  • non-small cell lung cancer,
  • ​ small cell lung cancer,
  • ​ testicular cancer,
  • ​ovarian cancer, bladder cancer

(“Crumpled crab”)

34
Q

Cisplatin
Carboplatin
Oxaliplatin

Side Effects

A

can cause ototoxicity → especially cisplatin

  • sensorineural hearing loss, tinnitus
    (“Ototoxic earrings”)

can cause neurotoxicity→especially cisplatin

  • peripheral neuropathy
    (“Neuropathic gloves”)

can cause nephrotoxicity → especially cisplatin

  • acute kidney injury
    (“Nephrotoxic purse”)
  • ​amifostine (an organic thiophosphate) can prevent cisplatin-induced nephrotoxicity (“Amethyst”) → scavenges free radicals produced by cisplatin in the kidney (“Free, rare”)
  • ​IV saline diuresis prevents cisplatin-induced nephrotoxicity
    (“saline fluids”)

-can cause acute tubular necrosis

  • muddy brown casts
    (“Muddy drain tube”)

-can cause immunosuppression and increased risk of
infection→especially carboplatin
(“Immunosuppresed cane”)

​

-can cause myelosuppression→especially carboplatin (“Depleted bone jewelry box”)

​

35
Q

Name the Kinase Inhibitors

(“Broken nib”)

A

Imatinib
(“Imitating”)

Erlotinib
(“Earl Geoffrey”)

Sunitinib
(“Rising sun”)

Sorafenib
(“Soaring eagle”)

Vemurafenib
(“Venom”)

36
Q

Imatinib
(“Imitating”)

MOA

A

tyrosine kinase inhibitor
(“Inhibited tire swing”)

  • imatinib blocks the tyrosine kinase domain of the BCR/ABL fusion protein →in CML
    (“BREAKABLE”)
  • ​imatinib blocks the c-kit tyrosine kinase →in GIST (“Congress kit”)
37
Q

Imatinib can be used to treat

A

-treat a variety of hematologic and solid malignancies

  • chronic myeloid leukemia -CML (increased levels of mature granulocytes – eosinophils, neutrophils, basophils [[BCR/ABL]]
    (“Copious pink, white, and blue granules”)
  • ​gastrointestinal stromal tumors (GIST) [[c-kit]]
    (“Crab buttons on belly”)

(“Cracked crab”)

38
Q

Imatinib Side Effects

A

can cause fluid retention→ ankle and periorbital edema

(“Baggy pantaloons”)

39
Q

Erlotinib MOA

(“British Earl”)

A

Blocks the epidermal growth factor receptor (EGFR) tyrosine kinase

(“Earl Geoffrey”)

40
Q

Erlotinib

(“British Earl”)

A

treats solid tumors with EGFR overexpression

  • e.g. non-small cell lung cancer – NSCLC
    (“Big lapel with crab badge”)
41
Q

Erlotinib Side Effects

A

can cause a papulopustular acneiform rash
(“Spotty rash”)

can cause diarrhea
(“Muddy pantaloons”)

42
Q

Sunitinib/Sorafenib

MOA

(“Rising sun”)
(“Soaring eagle”)

A

inhibits the vascular endothelial growth factor receptor →VEGFR tyrosine kinase

(“Inhibiting vegetables”)

43
Q

Sunitinib and Sorafenib can treat…

A

cancer with VEGFR overexpression

  • e.g. renal cell carcinoma
    (“Flank crab buckles”)
44
Q

sunitinib and sorafenib
Side effects

A

can cause hyperkeratosis and skin rashes

VEGF-targeted therapies are associated with an increased risk of hemorrhage
(“Bleeding wound”)

(“Callused and sunburned”)

45
Q

Vemurafenib MOA

(“Venom”)

A

-blocks B-Raf kinase

(“B. Fra”)

46
Q

Vemurafenib can treat…

A

vemurafenib treats V600E BRAF positive malignant melanoma

(“Disseminated ink”)

47
Q

Name the Monoclonal Antibodies used in treatment of Cancer

A

Rituximab
(“coronation ritual”)

Cetuximab
(“tusks”)

Bevacizumab
(“Beverage lady”)

Alemtuzumab
(“Alms”)

Trastuzumab
(“Tapestry weaver”)

48
Q

Rituximab MOA

A

Rituximab and Cetuximab are chimeric monoclonal antibodies
(“Chimera sigil”)

binds CD20 on B-cells
(“Grabbing “XX” straps”)

rituximab depletes B cells (binds CD20)
(“Pulling down antibody archer”)

49
Q

Rituximab can be used to treat …

A

treats chronic lymphocytic leukemia (CLL)
(“Chronic tapestry with antibody archers and T knights”)

  • rituximab treats rheumatoid arthritis
  • disease modifying anti-rheumatic drug – DMARD

(“Rheumatic lantern”)

-is useful for immunosuppressive therapy

(e.g. microscopic polyangiitis, Wegener’s granulomatosis)
(“Torn antibody”)

50
Q

Rituximab Side Effects

A

can cause immunosuppression and increased risk of infection
(“Immunosuppressed cane”)

-may be associated with a higher risk of progressive multifocal leukoencephalopathy (PML)
(“White laurel leaves”)

-can cause an infusion reaction (e.g. headache, fever, skin rash, pruritus, dyspnea, hypotension)
(“Swollen cherub with ivy”)

-chimeric antibodies (e.g. rituximab, rarely cetuximab) can cause serum sickness e.g. fever, rash, arthralgia within 7-10 days
(“Delayed onset poisoning”)

51
Q

Cetuximab MOA

(“Tusks”)

A

binds the epidermal growth factor receptor (EGFR)

  • EGFR is a receptor tyrosine kinase
    (“Tire swing”)

(“Giraffe”)

52
Q

Cetuximab can treat …

A

treats solid tumors

  • e.g. colorectal cancer, squamous cell carcinoma

(“Cracked crab”)

53
Q

Cetuximab Side Effects

A

can cause a papulopustular acneiform rash
(“Red spots”)

54
Q

Bevacizumab MOA

(“Beverage Lady”)

A

binds VEGF

  • inhibits growth of blood vessels in tumors binds VEGF
    (“Chopping vessels”)

(“Chopped vegetables”)

55
Q

Bevacizumab can treat …

A

treats metastatic tumors

  • e.g. colorectal cancer, squamous cell carcinoma
    (“Cracked crab”)

-treats wet macular degeneration
(“Wet center of retina pillow”)

56
Q

Bevacizumab Side Effects

A

-can cause bleeding
(“Blood spatter”)

-increases the risk for thrombotic events
(“Ice clots”)

57
Q

Alemtuzumab MOA

(“Alms”)

A

-binds CD52 on B and Tcells

depletes B and T cells (binds CD52)
(“Pulling down antibody archer and T knight”)

(“52 pattern”)

58
Q

Alemtuzumab can treat…

A

treats chronic lymphocytic leukemia (CLL)
(“Chronic tapestry with antibody archers and T knights”)

59
Q

Trastuzumab MOA

(“Tapestry weaver”)

A

binds epidermal growth factor receptor 2

  • HER2, c-erbB2
  • ​HER2 is a receptor tyrosine kinase
    (“Tire swing”)

(“Her 2 babies”)

60
Q

Trastuzumab can treat …

A

treats HER2 positive breast cancer
(“Crab bra”)

61
Q

Trastuzumab can cause …

A

trastuzumab can cause cardiotoxicity

  • e.g. decreased LVEF, heart failure
    (“Unraveling heart”)

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