Antineoplastic Drugs Flashcards
Methotrexate MOA
-inhibition of DHF reductase
(“meat sticks chef trying to replace the folate leafs”)
Methotroxate is useful in treating ...
-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”)
Methotrexate Side Effects
-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”)
what is the antidote for Methotroxate toxcity ?
folinic acid
(“Lucky feline”)
5’-Fluorouracil MOA
inhibits thymidylate synthase to block thymidine production
- increase dUMP via inhibition of thymidylate synthase
(“Buildup of dumpling plates”)
(“Full guy”)
5’-Fluorouracil Side Effects
-diarrhea
(“Stained pants”)
-photosensitivity and rash
(“Sensitive photos”)
-increases myelosuppression and infection
(“Falling pan of sushi”)
5 -Fluorouracil Antidote
NO ANTIDOTE! MUAHAHAHAHA!!!!!!!
(“Knocked over cat”)
Hydroxyurea MOA
(“Hydro rock area”)
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”)
Hydroxyurea can treat …
sickle cell anemia
-
increase HbF, protection against HbS
(“Raised baby with Hb coin”)
(“Zen sickle”)
Hydroxyurea Side Effect
myelosuppression and increased infection side effect
(“Falling pan of sushi”)
6 Mercaptopurine MOA
(“CAPTured gypsy”)
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”)
6-Mercaptopurine can treat …
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”)
6-Mercaptopurine Side Effects
-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”)
Mycophenolate Mofetil MOA
(“quasimoto”)
-IMP dehydrogenase inhibitor
- decrease GMP synthesis, decreased lymphocyte production
(“knocking over GruMPy statue”)
Mycophenolate Mofetil is used to treat …
(“Quasimoto”)
-for immunosuppressive therapy
- grafts
- SLE
- MG
- rheumatoid arthritis (DMARD)
(“swinging on lanterns”)
Mycophenolate Mofetil Side Effects
(“Quasimoto”)
-GI effects
(“nauseated quasi-mofetil”)
-immunosuppressive side effects
(“nuns”)
-increased infection in immunosuppressed
(“cane”)
Cladribine, Cytarabine, Gemcitabine MOA
-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”)
Cladribine can treat …
hairy cell leukemia
(“Hairy caveman”)
Cytarabine can treat …
only active against hematologic malignancies
(“Scratched out antibody archers and T-cell swordsman”)
- AML
- non-Hodgkin lymphoma
Gemcitabine can treat…
(“gems inside geode”)
- active against both hematologic malignancies and
- *solid** tumors
(“Cracked crab fossil on solid rocks”)
Cladribine, Cytarabine, Gemcitabine Side Effects
-can cause immunosuppression and increased risk of infection
(“Immunosuppressed cane”)
-can cause myelosuppression
(“Broken marrow”)
Name the Alkylating agents
Cyclophosphamide
(“Cyclops Polyphemus”)
Busulfan
(“Beautiful sirens”)
Nitrosureas
(“Mustang”)
- Carmustine
- Lomustine
Ifosfamide
Cyclophosphamide
Busulfan
Nitroureas
MOA
alkylating agents donate an alkyl group → DNA cross-links
- cell cycle NON-specific
**Cyclophosphamide is activated by CYP450**
Cyclophosphamide can be used to treat …
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”)
Cyclophosphamide Side Effects
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”)
Busulfan can be used to treat …
(“beautiful sirens”)
useful as a conditioning agent prior to bone marrow transplantation
(“Severely depleted marrow”)
Nitrosoureas
Carmustine
Lomustine
(“Mustang Centaurs”)
Streptozotocin
(“Striped zebra centaur”)
are used to treat …
highly lipophilic →cross BBB → treat brain tumors
- glioblastoma multiform
(“Brain tree”)
Nitrosoureas
Carmustine
Lomustine
(“Mustang Centaurs”)
Streptozotocin
(“Striped zebra centaur”)
Side Effects
can cause neurotoxicity
(“Dizzy centaur”)
- convulsions
- dizziness
- ataxia
Busulfan Side Effects
(“Beautiful Sirens”)
-can cause lung toxicity
- acute lung injury
- interstitial fibrosis
- alveolar hemorrhage
-can cause a hyperpigmentation reaction
(“Beautiful TAN sirens”)
Name Cytotoxic Platinum analogs
- *Cis**platin
- *Carbo**platin
- *Oxali**platin
Cisplatin
Carboplatin
Oxaliplatin
MOA
bind DNA and form intrastrand and interstrand cross-links
(“Cross-linked helix necklace”)
Cisplatin
Carboplatin
Oxaliplatin
can treat …
treat various solid malignancies
- non-small cell lung cancer,
- small cell lung cancer,
- testicular cancer,
- ovarian cancer, bladder cancer
(“Crumpled crab”)
Cisplatin
Carboplatin
Oxaliplatin
Side Effects
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”)
Name the Kinase Inhibitors
(“Broken nib”)
Imatinib
(“Imitating”)
Erlotinib
(“Earl Geoffrey”)
Sunitinib
(“Rising sun”)
Sorafenib
(“Soaring eagle”)
Vemurafenib
(“Venom”)
Imatinib
(“Imitating”)
MOA
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”)
Imatinib can be used to treat
-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”)
Imatinib Side Effects
can cause fluid retention→ ankle and periorbital edema
(“Baggy pantaloons”)
Erlotinib MOA
(“British Earl”)
Blocks the epidermal growth factor receptor (EGFR) tyrosine kinase
(“Earl Geoffrey”)
Erlotinib
(“British Earl”)
treats solid tumors with EGFR overexpression
- e.g. non-small cell lung cancer – NSCLC
(“Big lapel with crab badge”)
Erlotinib Side Effects
can cause a papulopustular acneiform rash
(“Spotty rash”)
can cause diarrhea
(“Muddy pantaloons”)
Sunitinib/Sorafenib
MOA
(“Rising sun”)
(“Soaring eagle”)
inhibits the vascular endothelial growth factor receptor →VEGFR tyrosine kinase
(“Inhibiting vegetables”)
Sunitinib and Sorafenib can treat…
cancer with VEGFR overexpression
- e.g. renal cell carcinoma
(“Flank crab buckles”)
sunitinib and sorafenib
Side effects
can cause hyperkeratosis and skin rashes
VEGF-targeted therapies are associated with an increased risk of hemorrhage
(“Bleeding wound”)
(“Callused and sunburned”)
Vemurafenib MOA
(“Venom”)
-blocks B-Raf kinase
(“B. Fra”)
Vemurafenib can treat…
vemurafenib treats V600E BRAF positive malignant melanoma
(“Disseminated ink”)
Name the Monoclonal Antibodies used in treatment of Cancer
Rituximab
(“coronation ritual”)
Cetuximab
(“tusks”)
Bevacizumab
(“Beverage lady”)
Alemtuzumab
(“Alms”)
Trastuzumab
(“Tapestry weaver”)
Rituximab MOA
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”)
Rituximab can be used to treat …
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”)
Rituximab Side Effects
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”)
Cetuximab MOA
(“Tusks”)
binds the epidermal growth factor receptor (EGFR)
- EGFR is a receptor tyrosine kinase
(“Tire swing”)
(“Giraffe”)
Cetuximab can treat …
treats solid tumors
- e.g. colorectal cancer, squamous cell carcinoma
(“Cracked crab”)
Cetuximab Side Effects
can cause a papulopustular acneiform rash
(“Red spots”)
Bevacizumab MOA
(“Beverage Lady”)
binds VEGF
- inhibits growth of blood vessels in tumors binds VEGF
(“Chopping vessels”)
(“Chopped vegetables”)
Bevacizumab can treat …
treats metastatic tumors
- e.g. colorectal cancer, squamous cell carcinoma
(“Cracked crab”)
-treats wet macular degeneration
(“Wet center of retina pillow”)
Bevacizumab Side Effects
-can cause bleeding
(“Blood spatter”)
-increases the risk for thrombotic events
(“Ice clots”)
Alemtuzumab MOA
(“Alms”)
-binds CD52 on B and Tcells
depletes B and T cells (binds CD52)
(“Pulling down antibody archer and T knight”)
(“52 pattern”)
Alemtuzumab can treat…
treats chronic lymphocytic leukemia (CLL)
(“Chronic tapestry with antibody archers and T knights”)
Trastuzumab MOA
(“Tapestry weaver”)
binds epidermal growth factor receptor 2
- HER2, c-erbB2
- HER2 is a receptor tyrosine kinase
(“Tire swing”)
(“Her 2 babies”)
Trastuzumab can treat …
treats HER2 positive breast cancer
(“Crab bra”)
Trastuzumab can cause …
trastuzumab can cause cardiotoxicity
- e.g. decreased LVEF, heart failure
(“Unraveling heart”)
