Antineoplastics Flashcards
Mechlorethamine
Nitrogen mustard Alkylating agent crosslinking of DNA PREVENTS STRAND SEPARATION AT MITOSIS Cell cycle non specific (CCNS) Hodgkin's Tx SE: VESICANT (burning)
Cyclophosphamide
Nitrogen mustard Alkylating agent
crosslinking of DNA PREVENTS STRAND SEPARATION AT MITOSIS
CCNS
SE: less Heme probs than others
HEMORRHAGIC CYSTITIS (Treat with MESNA)
SIADH (water is a huge issue for Cyclo use)
Cisplatin
Alkylating agent
Platinum compound causes intra-strand crosslinking
SE: RENAL, ACOUSTIC NERVE DAMAGE
Methotrexate
Dihydrofolate reductase inhibitor to inhibit thymadine-- Blocks RNA/DNA synthesis Used for leukemia and immunosuppression SE: HEPATOTOXICITY TERATOGENIC Leucovorin is used to rescue toxicity
6-Mercaptopurine
Purine analog- blocks DNA/RNA synthesis
SE: Cholestatic Jaundice, HYPERURICEMIA
Metabolized via XO– Decrease 6-MP dose
Decreased HGPRT is cause of resistance
5-Fluorouracil
Pyrimadine analog
CCS for G1/S Phase
Combine with Leucovorin for rectal cancer (increases efficacy)
topically for keratosis and BCC
Doxyrubicin
Antibiotic
Intercalates DNA between BP of adjacent strands to destroy DNA
SE: CARDIOMYOPATHY– Decrease the risk if given Fe Chelators to decrease free radicals
DISCONTINUE ANY Fe FOR ANEMIA TREATMENT
Bleomycin sulfate
Antibiotic
Large glycoprotein that causes chain break and fragments DNA
SE: PULMONARY FIBROSIS (Lance Armstrong wouldn’t take for testicular cancer), ARTERITIS
VERY LITTLE MARROW SUPPRESSION
Vinblastine sulfate
Plant Alkaloid
CCS FOR M PHASE: Bind tubulin and disrupt spindle fiber function
SE: MORE BONE MARROW SUPPRESSION
(Vinblastine BLASTS bone marrow), less neurotox
No CNS PENETRATION
Vincristine sulfate
Plant alkaloid
CCS FOR M PHASE: Bind tubulin and disrupt spindle fiber function
SE: MORE PERIPHERAL NEUROPATHY AND NEUROPATHY (Vincristine crisps the nerves and makes you CRazy), less bone marrow suppression
Paclitaxel
Plant alkaloid
Binds tubulin and arrests mitosis by inhibiting disassembly of microtubules
SE: Very active drug but HIGHLY TOXIC
Peripheral neuropathy, bone marrow– especially neutro, hypersensitivity (pretreat with corticosteroids and antihistamines)
Imantinib
Tyrosine kinase inhibitor
CML tx
Cannot receive immunizations
Cetuximab
Binds Epidermal Growth Factor
IV only for EGFR positive CRC
Rituximab and alemtuzumab are used for lymphomasa
Erlotimib
inhibits HER1/EGRF TK
For NSCLC, Pancreatic cancer
Bevacizumab (Avastin)
Inhibits VASCULAR endothelial growth factor to block angiogenesis
CRC, lung, renal, breast cancer, MACULAR DEGENERATION tx
SE: Increased risk of VTE, or vessel injury and bleeding
