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Heme > Antineoplastics > Flashcards

Antineoplastics Flashcards

0
Q

Chlorambucil

A
  • MOA: alkylating agent (N-mustard derivative)
  • use: CLL, NHL
  • decreased blood counts (tcytopenia, neutropenia, anemia) pyrexia, NV
  • usually dosed with prednisone
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1
Q

Busulfan

A
  • 2 sulfide groups: MOA Alkylation and ROS production
  • use: CML, BMT
  • SE: busulfan lung (pulmonary fibrosis), hep tox, NV, seizures
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2
Q

Cyclophosphamide (cytoxan) (MOA, use (2), Sx (2), rescue (2))

A
  • MOA: alkylator, activated to phosphoramides and acrolein
  • use: leukemias and lymphomas; high doses for BMT
  • Sx: hemorrhagic cystitis, bone marrow toxicity (dose limiting)
  • Mesna to rescue, hyper-hydration
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3
Q

Melphalan

A
  • MOA: alkylator
  • use: MM
  • Sx: myelosupression, NVD
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4
Q

Bendamustine

A
  • MOA: alkylation
  • Use: CLL, NHL
  • Sx: decreased blood count x4, pyrexia, NV, HSN
  • Sx profile worse than chlorambucil
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5
Q

Procarbazine

A
  • MOA: non-classical alkylator, H2O2
  • Use: NHL, HL, brain tumors
  • Sx: disulfiram like rxn, myelosupression, MAOI interactions
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6
Q

Carmustine

A
  • DNA alkylation; crosses BBB
  • HL, Mycosis Fung, BMT (high dose)
  • Sx: admin with EtOH vehicle (burning, EtOH tox)
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7
Q

Methotrexate

A
  • MOA: antimetabolite (DHFR inhibition)
  • Use: ALL
  • Sx: myelosupression, NVD, Mucositis (SJS), hepato,neuro,nephrotoxicity,
  • leucovorin rescue, intrathecally admin, toxic with glucarpidase
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8
Q

Cytarabine

A
  • cytadine analog, halts DNA replication
  • Use: AML, NHL
  • Neuro, oculo toxicity
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9
Q

Mercaptopurine

A
  • MOA: purine analog
  • Use: ALL
  • Sx: inxn with allopurinol, dose limiting, hepatic dysfunction
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10
Q

Vincristine

A
  • MOA: plant alkaloid, bind and stabilize microtubule
  • ALL, NHL, HL, M
  • Sx: neuropathy/neurotoxic constipation
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11
Q

Doxorubicin

A
  • MOA: anthracyclines; DNA intercalation, ROS production
  • Use: HL, NHL, leukemia, myeloma
  • Sx: cardiotoxicity, myelosupression, red urine, vesicant, Mucositis, diarrhea
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12
Q

Mitoxantrone

A
  • MOA: anthracycline, DNA intercalation
  • Use: NHL, AL
  • Sx: fewest of anthracyclines, less cardiomyopathy, NVD, Blue/green secretions
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13
Q

Bleomycin

A
  • MOA: free radical formation
  • H/NHL
  • Sx: pulmonary fibrosis, fever chills, Mucositis
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14
Q

Hydroxyurea

A
  • MOA: ribonucleotide reductase inhibitor -> decreases DNA synthesis
  • Use: CML
  • Sx: myelosupression, NVD, rash/Mucositis, hyperpigmentation
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15
Q

Etoposide

A
  • MOA: topoisomerase II inhibitor
  • Use: NHL, high dose for BMT
  • Sx: myelosupression, GI irritation, alopecia
16
Q

Bertezomib

A
  • MOA: 26s proteosome inhibitor, disruption of ubiquitin (cytotoxic)
  • Use: 2nd line for MM
  • Sx: anesthesia, NV, anorexia, constipation, tcytopenia, peripheral neuropathy, pyrexia
17
Q

Imatinib

A
  • MOA: TRKi (BCR/abl)
  • Use: CML
  • NVD, Rash, edema, hepatotoxity, arthralgia, hemorrhage, less myelosupression
  • p450 metabolism
18
Q

Thalidomide

A
  • MOA: anti-angiogenic agents- TNFa inhibitor -> ^ IL10, reduction in PMN adhesion and expression, enhanced cell mediated immunity
  • Use: myeloma
  • Sx: category X, VTEs, peripheral neuropathy, somnolence, constipation, rash
19
Q

Leanidomide

A
  • MOA: TNFa inhibitor -> ^ IL10, reduce PMN adhesion and expression, enhanced cell med immunity
  • Use: MM, myelodysplastic syndromes
  • Sx: decreased blood counts, VTEs, teratogenicity
20
Q

Ruxolitib

A
  • MOA: JAK1/2 inhibitor
  • Use: myelofibrosis
  • Sx: decreased blood count (Tcyt, Anemia), bruising, dizziness, HA, withdrawal syndrome (refractory splenomegaly)
  • reduce dose with 3A4 inhibitors
21
Q

Carfilzomib

A
  • MOA: proteasome inhibiting agent
  • Use: drug resistant MM (req 2 failed trts)
  • Sx: edema, HTN, CHF, NVD, constipation, fatigue, fever, insomnia, chills, myelosuppression
22
Q

Brentuxumab

A
  • MOA: MoAb anti-cd30, linked to cytotoxicity
  • Use: refractory HL, PTs who have failed autologous cell transplant, large cell Anaplastic lymphoma who have failed first trt
  • Sx: neutropenia, periph neuropathy, fatigue, NVD, anemia, URI, pyrexia, tcytopenia
  • caution with 3A4
23
Q

Liposomal Vincristine

A
  • MOA: vinca alkaloid
  • Use: Ph 9;22 ALL after 2 relapses
  • Sx: constipation, ND, fatigue, peripheral neuropathy

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