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Cology 2 Exam 4 > Antineoplastic therapy - Antibiotics > Flashcards

Antineoplastic therapy - Antibiotics Flashcards

1
Q

How do the antibiotics work?

A

They directly bind DNA or intercalate between DNA base pairs, preventing DNA replication

They inhibit DNA polymerase

Avoid extravasation because it can cause severe tissue injury.

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2
Q

How does Dactinomycin work?

A

Intercalates DNA between guanine and cytosine, single strand breaks
NOT cell cycle specific

Note: It’s one of the most potent tumor agents

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3
Q

How is Dactinomycin administered?

A

IV only

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4
Q

Indications for Dactinomycin?

A

Rhabdomyosarcoma
Choriocarcinoma
Wilm’s tumor in children

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5
Q

Toxicities with Dactinomycin?

A 
Pancytopenia
Anorexia
Nausea and vomiting
Alopecia
GI effects
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6
Q

How do Daunorubicin, Doxorubicin work?

A

Intercalate into DNA, preventing uncoiling, inhibits Topoisomerase II which repairs strand breaks

Binds to cell membranes, alters IP3 activation, may play a role in cardiotoxicity

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7
Q

Which drug has a lifetime max dose because of cardiotoxicity?

A

Doxorubicin

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8
Q

Why do Daunorubicin, Doxorubicin cause cardiotoxicity?

A

Metabolism forms semiquinone intermediates, forming free radicals
Tumors AND cardiac tissue are low in superoxide dismutase, cardiac tissue is also low in catalase (H2O2)
May be important in cardiotoxicity

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9
Q

Indications for Daunorubicin?

A

AML

Liposomal prep is used for Kaposi sarcoma

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10
Q

Indications for Doxorubicin?

A 
Breast
Bladder
Lung
Ovarian
Testicular
Thyroid
Stomach
ALL
Hodgkin's and Non-hodgkin's
Sarcoma
Neuroblastoma
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11
Q

Toxicities of Daunorubicin, Doxorubicin

A 
Moderate nausea, vomiting, stomatitis
Dose limiting myelosuppression
Cardiac toxicity, related to cumulative dose (Doxy it's 550 mg/m2) 
Myocardial cell damage, heart failure
Discoloration in urine - turns red
Mucosal ulcerations
GI disturbances
Alopecia
Severe vesicant properties!!! NO EXTRAVASATION when administering it
Secondary leukemia's
Teratogenic
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12
Q

How can we prevent free radicals with Daunorubicin, Doxorubicin?

A

Dexrazoxane - Fe++ chelator prevents free radicals

Lipid complexes also are not taken into heart cells

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13
Q

Which antibiotic is used in the ABVD regimen? What’s that for?

A

Doxprubicin, in the Adriamycin part of the ABVD regimen for Hodgkin’s disease

Also Bleomycin!

ABVD = Adriamycin, Bleomycin, Vinblastine, Dacarbazine

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14
Q

What is Idarubicin used for?

A

AML
ALL
CML

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15
Q

How does Idarubicin compare to Doxorubicin, Daunorubicin?

A

More mucosistitis
Red urine still
Teratogenic
But less cardiotoxic

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16
Q

What is Epirubicin used for?

A

Bladder, head and neck, breast, lung, ovarian

17
Q

Toxicities with Epirubicin

A

Severe N & V, cardiac toxicity, red urine, teratogenic

18
Q

What is Valrubicin used for?

A

Introduced in 1998 for bladder tumors, reintroduced in 2009 for resistant bladder tumors

Red urine
Teratogenic

19
Q

What is Mitoxantrone used for?

A

AML
Prostate
Also used in progressive, relapsing MS

20
Q

Toxicities with Mitoxantrone?

A 
Less cardiotoxic
Bone marrow suppression
Alopecia
Hepatic toxicity
Sexual dysfunction
Blue green urine and nails (bc injection is blue)
Not the same vesicant properties. yay
21
Q

How is Bleomycin administered?

A

IV
IM
SubQ
Instilled in bladder

22
Q

How does Bleomycin work?

A

Flat ring structure can intercalate into DNA
Metal binding core complexes with Fe and Cu
In presence of O2, metal complex produces free radicals to break DNA and cause lipid peroxidation

SPECIFIC FOR G2 PHASE

23
Q

Indications for Bleomycin?

A 
Cervical
Bladder
Head & Neck
Pancreatic
Testicular
Ovarian
Hodgkin's and Non-hodgkin's lymphoma
Sarcoma
24
Q

Toxicities associated with Bleomycin?

A 
Low myelosuppression, teratogenic
Dry cough can lead to pulmonary fibrosis
Fever and chills
Mild nausea and vomiting
Alopecia
Mucosal ulcerations
Skin reactions, hyperpigmentation, blistering of skin
25
Q

What is Mitomycin used for?

A

Anal cancer

26
Q

Toxicities of Mitomycin?

A 
Cumulative severe bone marrow suppression (8 weeks between treatments)
Neurological abnormalities
Pulmonary toxicities
Alopecia
Secondary leukemias

Cology 2 Exam 4 (16 decks)

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