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ANTINEOPLASTICS Flashcards

1
Q

1 gram of tumor is equivalent to

A

10^9 or 1 billion cells

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2
Q

A very common adverse reaction of alkylating agents used in the tx of cancer

A

Alopecia

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3
Q

ALKYLATING AGENTS: NITROGEN MUSTARDS

Alkylating agents replace H with an alkyl group, which causes ____.

A

DNA strand breakage

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4
Q

ALKYLATING AGENTS: NITROGEN MUSTARDS

Mainstay therapy for solid tumors followed by autologous bone marrow transplantation

A

Thiotepa

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5
Q

ALKYLATING AGENTS: NITROGEN MUSTARDS

Dialkylating agent drug of choice for Hodgkin’s disease

A

Mechlorethamine

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6
Q

ALKYLATING AGENTS: NITROGEN MUSTARDS

For germ cell testicular cancer

A

Ifosfamide

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7
Q

ALKYLATING AGENTS: NITROGEN MUSTARDS

Causes sulfur stripping

A

Busulfan

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8
Q

ALKYLATING AGENTS: NITROGEN MUSTARDS

Cell cycle non-specific phosphoramide mustard (major metabolite)

A

Cyclophosphamide

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9
Q

ALKYLATING AGENTS: NITROGEN MUSTARDS

For multiple myeloma

A

Melphalan

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10
Q

ALKYLATING AGENTS: NITROGEN MUSTARDS

1st line agent for chronic lymphocytic leukemia and macroglobulinemia

A

Chlorambucil

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11
Q

ALKYLATING AGENTS: ORGANOPLATINUM

MOA of organoplatinum

A

DNA strands cross-linking

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12
Q

ALKYLATING AGENTS: ORGANOPLATINUM

Most reactive and most effective in platinating DNA

A

Cisplatin

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13
Q

ALKYLATING AGENTS: ORGANOPLATINUM

Carboplatin is administered with ____ to reduce toxicity

A

1,1-cyclobutane-dicarboxylate

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14
Q

ALKYLATING AGENTS: ORGANOPLATINUM

____ is administered with 1,1-cyclobutane-dicarboxylate to reduce toxicity

A

Carboplatin

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15
Q

ALKYLATING AGENTS: ORGANOPLATINUM

Activated in low chloride environment, not recognized by MMR

A

Oxaliplatin

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16
Q

ALKYLATING AGENTS

Alkylates DNA with restricted uncoiling and replication of strands

A

Nitrosoureas

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17
Q

ALKYLATING AGENTS: NITROSOUREAS

1st line agent for metastatic brain tumor

A

Lomustine

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18
Q

ALKYLATING AGENTS: NITROSOUREAS

2nd line agent for Hodgkin’s disease

A

Lomustine

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19
Q

ALKYLATING AGENTS: NITROSOUREAS

For brain tumors and can penetrate BBB

A

Carmustine

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20
Q

ALKYLATING AGENTS: OTHERS

3 agents for Hodgkin’s lymphoma

A
  1. Mechlorethamine
  2. Lomustine
  3. Procarbazine
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21
Q

ALKYLATING AGENTS: OTHERS

2 agents that form DNA adducts

A
  1. Dacarbazine
  2. Temozolomide
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22
Q

ALKYLATING AGENTS: OTHERS

Involved in hydroxylation of methyl group

A

Altretamine

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23
Q

ALKYLATING AGENTS: OTHERS

2nd line agent for ovarian cancer

A

Altretamine

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24
Q

ALKYLATING AGENTS: OTHERS

Induces hyperglycemia on animal model

A

Streptozocin

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25
Q

ALKYLATING AGENTS: OTHERS

Source of streptozocin

A

Streptomyces achromogenes subsp. Strepzoticus

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26
Q

ALKYLATING AGENTS: OTHERS

Antineoplastic that is not considered an anti-metabolite

A

Etoposide

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27
Q

Compounds closely related in structure to a cellular precursor (N-base)

A

Anti-metabolites

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28
Q

ANTI-METABOLITES

MOA of anti-metabolites

A

Prevention of biosynthesis by enzyme inhibition

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29
Q

ANTI-METABOLITES

Designed to interact at cofactor sites for enzymes involve in the biosynthesis of nucleic acid bases

A

Folates (Anti-folates)

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30
Q

ANTI-METABOLITES: FOLATES

First drug to produce substantial remissions in leukemia

A

Methrotrexate
(MTX)

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31
Q

ANTI-METABOLITES: FOLATES

MOA of Methrotrexate (MTX)

A
  1. Dihydrofolate reductase binding (DHFR)
  2. Thymidylate synthase (TS) interference
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32
Q

ANTI-METABOLITES: FOLATES

A pyrrolopyrimidine analog

A

Pemetrexed

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33
Q

ANTI-METABOLITES: FOLATES

MOA of Pemetrexed

A

Thymidylate synthase (TS) inhibition

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34
Q

ANTI-METABOLITES: FOLATES

Structually similar to MTX and approved for the tx of pneumocystis carinii pneumonia (PCP) in HIV/AIDS patients

A

Trimetrexate

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35
Q

ANTI-METABOLITES: FOLATES

MOA of hydroxyurea

A

Ribonucleotide Reductase inhibition

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36
Q

ANTI-METABOLITES: PURINES

MOA of 6-mercaptopurine

A

De Novo Purine synthesis blocking

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37
Q

ANTI-METABOLITES: PURINES

Primary treatment for acute leukemia

A

6-mercaptopurine + 6-thioguanine

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38
Q

ANTI-METABOLITES: PURINES

For chronic lymphocytic leukemia and non-Hodgkin’s lymphoma

A

Fludarabine

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39
Q

ANTI-METABOLITES: PURINES

Deoxyadenosine analog for hairy cell leukemia

A

Cladribine

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40
Q

ANTI-METABOLITES: PURINES

MOA of Pentostatin

A

Adenosine deaminase inhibition -> increase dATP

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41
Q

ANTI-METABOLITES: PYRIMIDINES

Palliative tx of carcinoma of the breast, colon, pancreas, rectim, and stomach

A

5-Fluorouracil
(5-FU)

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42
Q

ANTI-METABOLITES: PYRIMIDINES

Fluoropyrimidine deoxynucleoside analog for GI adenocarcinoma metastatic to the liver

A

Floxuridine
(FUDR)

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43
Q

ANTI-METABOLITES: PYRIMIDINES

MOA of 5-FU and FUDR

A

Thymidylate synthase (TS) inhibition -> DNA synthesis inhibition

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44
Q

ANTI-METABOLITES: PYRIMIDINES

Fluoropyrimidine carbamate prodrug of 5-FU for metastatic breast and colorectal cancer

A

Capecitabine

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45
Q

ANTI-METABOLITES: PYRIMIDINES

Drug of choice for locally advanced or metastatic adenocarcinoma of the pancreas

A

Gemcitabine

(+) Cisplatin

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46
Q

ANTI-METABOLITES: PYRIMIDINES

Drug of choice for inoperable locally advanced or metastatic NSCLC

A

Gemcitabine

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47
Q

ANTI-METABOLITES: PYRIMIDINES

A potent radiosensitizer

A

Gemcitabine

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48
Q

ANTI-METABOLITES: PYRIMIDINES

Cytosine arabinoside tx for acute agranulocytic leukemia

A

Cytarabine

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49
Q

ANTIBIOTICS

Antibiotic that do not possess clinically useful anti-malignant property

A

Streptomycin

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50
Q

ACTINOMYCIN

Source of dactinomycin

A

Strep. parvilus

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51
Q

ACTINOMYCIN

Tx of rhabdomyosarcoma and Wilms’ tumor in children

A

Dactinomycin

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52
Q

ACTINOMYCIN

Lifesaving tx for women with choriocarcinoma resistant to MTX

A

Dactinomycin

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53
Q

ANTHRACYCLINES

MOA of anthracyclines

A
  1. Topoisomerase II inhibition
  2. Intercalation of the planar ring system
54
Q

ANTHRACYCLINES

Isolated from Strep. peucetius for non-lymphocytic and lymphocytic leukemia

A

Daunorubicin

55
Q

ANTHRACYCLINES

Cardiotoxic isolated from Strep. peucetius var. caesius

A

Doxorubicin

56
Q

ANTHRACYCLINES

No 4-methoxy group and terminal side chain for blast phase chronic myelogenous carcinoma

Less cardiotoxic than doxorubicin

A

Idarubicin

57
Q

ANTHRACYCLINES

4’-epimer of doxorubicin

A

Epirubicin

58
Q

ANTHRACYCLINES

BCG-refractory carcinoma of urinary bladder

A

Valrubicin

59
Q

ANTHRACYCLINES

Tint urine blue

A

Mitoxantrone

60
Q

GLYCOPEPTIDES

Isolated from Streptomyces verticillus

61
Q

GLYCOPEPTIDES

Palliative treatment of squamous cell carcinoma with no myelotoxicity (bone marrow)

62
Q

GLYCOPEPTIDES

Isolated from Streptomyces caespitosus

A

Mitomycin C

63
Q

GLYCOPEPTIDES

Bioreductive alkylating agents

A

Mitomycin C

64
Q

EPIPODOPHYLLOTOXIN (PLANT PRODUCTS)

Source of epipodophyllotoxins

A

Mayapple (Mandrake) Root

65
Q

EPIPODOPHYLLOTOXIN (PLANT PRODUCTS)

MOA of epipodophyllotoxins

A

Inhibition of microtubule function (topoisomerase II)

66
Q

EPIPODOPHYLLOTOXIN (PLANT PRODUCTS)

For testicular cancer and small cell lung cancer

67
Q

EPIPODOPHYLLOTOXIN (PLANT PRODUCTS)

A more potent inhibitor of topoisomerase II for acute lymphoblastic leukemia

A

Teniposide

68
Q

CAMPTOTHECINS (PLANT PRODUCTS)

MOA of camptothecins

A

Inhibitors of topoisomerase I

69
Q

CAMPTOTHECINS (PLANT PRODUCTS)

Source of camptothecins

A

Camptotheca acuminata

70
Q

CAMPTOTHECINS (PLANT PRODUCTS)

Semi-synthetic analog of camptotechin

A

Irinotecan

71
Q

CAMPTOTHECINS (PLANT PRODUCTS)

Drug of choice for metastatic colon cancer

A

5-FU + Leucovorin + Irinotecan

72
Q

CAMPTOTHECINS (PLANT PRODUCTS)

2nd line single agent in colorectal cancer

A

Irinotecan

73
Q

CAMPTOTHECINS (PLANT PRODUCTS)

A/E: Microscopic hematuria (blood in urine)

74
Q

VINCA ALKALOIDS (PLANT PRODUCTS)

Source of vinca alkaloids

A

Catharanthus roseus (periwinkle)

75
Q

VINCA ALKALOIDS (PLANT PRODUCTS)

MOA of vinca alkaloids

A

Arrest of mitosis
(Inhibition of microtubule polymerization)

76
Q

VINCA ALKALOIDS (PLANT PRODUCTS)

Dihydroindole nitrogen attached to vincristine

77
Q

VINCA ALKALOIDS (PLANT PRODUCTS)

Dihydroindole nitrogen attached to vinblastine

78
Q

VINCA ALKALOIDS (PLANT PRODUCTS)

ABVD regimen used in the treatment of
Hodgkin’s lymphoma

A
  1. Adriamycin
  2. Bleomycin
  3. Vinblastine
  4. Dacarbazine
79
Q

VINCA ALKALOIDS (PLANT PRODUCTS)

Extravasation with the use of vincas is managed by ____.

A

Hyaluronic Acid + Heat

80
Q

VINCA ALKALOIDS (PLANT PRODUCTS)

Semi-synthetic agent for NSCLC

A

Vinorelbine

81
Q

TAXANES (PLANT PRODUCTS)

Source of taxanes

A

Taxus brevifolia or Taxus baccatta (pacific yew tree)

82
Q

TAXANES (PLANT PRODUCTS)

Taxanes are administered with ____ and ____ due to poor water solubility

A
  1. Cremophor EL
  2. Ethanol
83
Q

TAXANES (PLANT PRODUCTS)

MOA of taxanes

A

β-tubulin binding

same with vincas

84
Q

TAXANES (PLANT PRODUCTS)

Highly plasma protein bound drug that promotes assembly of microtubules and may cause bradycardia

A

Paclitaxel

85
Q

TAXANES (PLANT PRODUCTS)

Semi-synthetic taxane that can cause reversible fluid retention

86
Q

TAXANES (PLANT PRODUCTS)

Semisynthetic amide analog of epothilone B from Sorangium cellulosum

A

Ixabepilone

87
Q

PROTEIN (TYROSINE) KINASE INHIBITORS

Enzymes that add a phosphate (PO4) group to a protein or other organic molecule, which can turn a protein off

A

Protein kinases

88
Q

PROTEIN (TYROSINE) KINASE INHIBITORS

Inhibits epidermal growth factor receptor

A

Erlotinib

A/E: Acne, Diarrhea

89
Q

PROTEIN (TYROSINE) KINASE INHIBITORS

Inhibits BCR-ABL kinase and c-kit kinase

90
Q

PROTEIN (TYROSINE) KINASE INHIBITORS

Inhibits HER2/NEU activity

91
Q

PROTEIN (TYROSINE) KINASE INHIBITORS

Inhibits intracellular and cell surface kinase like VEGFR

92
Q

PROTEIN (TYROSINE) KINASE INHIBITORS

Inhibits receptor tyrosine kinases

93
Q

HORMONES

Androgen receptor antagonist for advance prostate cancer

A

Bicalutamide and Flutamide

94
Q

HORMONES

Binds to estrogen receptor for the tx of metastatic breast cancer

A

Fulvestrant

95
Q

HORMONES

Inhibits gonadotropin secretion for prostate cancer

A

Leuprolide acetate

96
Q

HORMONES

A progesterone antagonist for advanced breast or endometrial cancer

A

Megestrol acetate

97
Q

HORMONES

Selective Estrogen Receptor Modulator (SERM) for advanced breast cancer in postmenopausal women

98
Q

HORMONES

Selective Estrogen Receptor Modulator (SERM) for advanced breast cancer in postmenopausal women

99
Q

HORMONES

A non-steroidal triphenylethylene agent for advanced breast cancer

100
Q

HORMONES

Benzothiophene derivative SERM

A

Raloxifene

101
Q

HORMONES

Palliative treatment for advanced prostate carcinoma, breast cancer, and endometriosis

102
Q

HORMONES

For inoperable adrenal cortical carcinoma

103
Q

HORMONES

Palliative treatment for metastatic breast cancer

A

Dromostanolone

104
Q

HORMONES

Palliative treatment for advanced or disseminated breast cancer

A

Testolactone

105
Q

HORMONES

For Cushing’s syndrome

A

Aminoglutethimide

106
Q

HORMONES

SERM for metastatic breast cancer

A

Toremifene

107
Q

HORMONES

Blocks conversion of androgen to estrogen

A

Aromatase Inhibitors

108
Q

AROMATASE INHIBITORS (HORMONES)

For hormone dependent breast cancer

A

Exemestane

109
Q

AROMATASE INHIBITORS (HORMONES)

First specific aromatase inhibitor for locally advanced or metastatic breast cancer

A

Anastrozole

110
Q

AROMATASE INHIBITORS (HORMONES)

Nonsteroidal aromatase inhibitors for locally advanced or metastatic breast cancer

111
Q

IMMUNOTHERAPY

For hairy cell leukemia and hairy cell leukemia in patients 18 years old or older

A

Interferon Alfa-2A

112
Q

IMMUNOTHERAPY

For hairy cell leukemia and malignant melanoma

A

Interferon Alfa-2B

113
Q

IMMUNOTHERAPY

Stimulates T-Cell growth and regulation, proliferation and immunoglobulin production in B lymphocytes, and macrophage activity enhancement

A

Aldesleukin

114
Q

MONOCLONAL ANTIBODIES

Binds to B and T cells

A

Alemtuzumab

115
Q

MONOCLONAL ANTIBODIES

Binds to vascular endothelial growth factor

A

Bevacizumab

116
Q

MONOCLONAL ANTIBODIES

Binds to CD33 on leukemic cells

A

Gemtuzumab

117
Q

MONOCLONAL ANTIBODIES

Binds to CD20 on lymphoid cells

A

Tositumomab

118
Q

MONOCLONAL ANTIBODIES

Genetically engineered chimeric monoclonal antibody against CD20 antigen expressed on the surfaces of malignant B lymphocytes

119
Q

MONOCLONAL ANTIBODIES

Single agent for metastatic breast cancer

A

Trastuzumab

120
Q

MONOCLONAL ANTIBODIES

Binds with human epidermal growth factor receptor type 2 (HER2) and neu receptor

A

Trastuzumab

121
Q

PROTEOSOME INHIBITOR

2 proteosome inhibitors

A
  1. Bortezomib
  2. Vorinostat
122
Q

MISCELLANEOUS

For acute promyelocytic leukemia (APL)

A

Arsenic Trioxide

123
Q

MISCELLANEOUS

For cutaneous T-cell lymphoma in patient refractory prior to systemic theraphy

A

Bexarotene

124
Q

MISCELLANEOUS

Adjunct therapy to prevent rejection of renal heterotransplants

A

Azathioprine

125
Q

MISCELLANEOUS

Enzyme from E. coli

A

Asparaginase

126
Q

MISCELLANEOUS

MOA of Asparaginase

A

Reduces asparagine in plasma makng it unavailable for leukemic cells

127
Q

MISCELLANEOUS

Promotes bone marrow recovery in patients who underwent autologous bone marrow transplantation

A

Sargramostim

128
Q

MISCELLANEOUS

GM-CSF from Saccharomyces cerevisiae or E. Coli

A

Sargramostim

129
Q

CYTOPROTECTIVES

For ifosfamide-induced hemorrhagic cystitis

130
Q

CYTOPROTECTIVES

Reduce accumulative toxicity from cisplatin and xerostoma

A

Amifostine

131
Q

CYTOPROTECTIVES

Potent intracellular chelating agent to reduce doxurubicin toxicity

A

Dexrazoxane

MEDICINAL ORGANIC CHEMISTRY (17 decks)

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