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
1
Q
Busulfan
A
- 2 sulfide groups: MOA Alkylation and ROS production
- use: CML, BMT
- SE: busulfan lung (pulmonary fibrosis), hep tox, NV, seizures
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
3
Q
Melphalan
A
- MOA: alkylator
- use: MM
- Sx: myelosupression, NVD
4
Q
Bendamustine
A
- MOA: alkylation
- Use: CLL, NHL
- Sx: decreased blood count x4, pyrexia, NV, HSN
- Sx profile worse than chlorambucil
5
Q
Procarbazine
A
- MOA: non-classical alkylator, H2O2
- Use: NHL, HL, brain tumors
- Sx: disulfiram like rxn, myelosupression, MAOI interactions
6
Q
Carmustine
A
- DNA alkylation; crosses BBB
- HL, Mycosis Fung, BMT (high dose)
- Sx: admin with EtOH vehicle (burning, EtOH tox)
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
8
Q
Cytarabine
A
- cytadine analog, halts DNA replication
- Use: AML, NHL
- Neuro, oculo toxicity
9
Q
Mercaptopurine
A
- MOA: purine analog
- Use: ALL
- Sx: inxn with allopurinol, dose limiting, hepatic dysfunction
10
Q
Vincristine
A
- MOA: plant alkaloid, bind and stabilize microtubule
- ALL, NHL, HL, M
- Sx: neuropathy/neurotoxic constipation
11
Q
Doxorubicin
A
- MOA: anthracyclines; DNA intercalation, ROS production
- Use: HL, NHL, leukemia, myeloma
- Sx: cardiotoxicity, myelosupression, red urine, vesicant, Mucositis, diarrhea
12
Q
Mitoxantrone
A
- MOA: anthracycline, DNA intercalation
- Use: NHL, AL
- Sx: fewest of anthracyclines, less cardiomyopathy, NVD, Blue/green secretions
13
Q
Bleomycin
A
- MOA: free radical formation
- H/NHL
- Sx: pulmonary fibrosis, fever chills, Mucositis
14
Q
Hydroxyurea
A
- MOA: ribonucleotide reductase inhibitor -> decreases DNA synthesis
- Use: CML
- Sx: myelosupression, NVD, rash/Mucositis, hyperpigmentation
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
