Antineoplastics Flashcards
Mechlorethamine: (explain/give the following) a. Class b. Mechanism c. Pharmacokinetics d. Therapeutic use e. adverse effects
a. Alkylating agent (nitrogen mustard) b. Type I. Bifunctional alkylating agent: produces cross-links in DNA. c. IV. No CNS penetration. Highly reactive. Disappears from blood in seconds to minutes d. Hodgkin’s and non-hodgkin’s lymphoma e. nausea/vomiting, myelosuppression, mild alopecia
Name three alkylating agent antineoplastic drugs
- mechlorethamine (nitrogen mustard) 2. cyclophosphamide (nitrogen mustard) 3. carmustine (BCNU) (nitrosourea)
Name two vinca alkaloid antineoplastic drugs
- Vinblastine 2. Vincristine
Name five antimetabolite antineoplastic drugs
- methotrexate (MTX) 2. 5-fluorouracil (5-FU) 3. cytarabine (Ara-C) 4. mercaptopurine (MCP) 5. hydroxyurea
Name one taxane antineoplastic drug
- Paclitaxel
Name four antiestrogenic antineoplastic drugs and the sub-class of each
- temoxifen (TAM) - nonsteroidal antiestrogen 2. letrozole - aromatase (CYP19) inhibitor 3. leuprolide - GnRH analog 4. flutamide - nonsteroidal antiandrogen
Name one corticosteroid antineoplastic drug
- prednisone
Name one atypical alkylating agent antineoplastic drug
- procarbazine
Name one metal complex used as an antineoplastic drug
- cisplatin (platinum coordination complex)
Name one monoclonal antibody used as an antineoplastic drug
- trastuzumab (Herceptin)
Name two antibiotic agents used as antineoplastic drugs
- doxorubicin 2. bleomycin (BLM)
Name one epipodphyllotoxin used as an antineoplastic drug
- etoposide (VP16)
Name one BRM used as an antineoplastic drug
- filgrastim
Mechlorethamine: mechanism of action
Type I (nitrogen mustard). Bifunctional alkylating agent: produces cross-links.
Cyclophosphamide: mechanism of action
Type III (nitrogen mustard). Prodrug activated in liver by CYP450 → active compound phosphoramide mustard acts as akylating agent. Acrolein (byproduct) causes bladder toxicity
Mechanism of action: carmustine (BCNU)
alkylating agent. produces cross-links in DNA
Mechanism of action: Methotrexate
antimetabolite:
Binds to DHFR → blocks formation to FH4 → blocks purine and pyrimidine synthesis
Mechanism of action: 5-fluorouracil (5-FU)
antimetabolite
Pyrimidine analog → activated to FUTP → inhibits RNA synthesis
Pyrimidine analog → activated to FdUMP → interferes with thymidylate synthase → inhibit DNA synthesis
Mechanism of action: cytarabine (Ara-C)
antimetabolite
Pyrimidine (cytadine) analog → competes for phosphorylation of cytidine → also competes with cytidine for incorporation into DNA → causes chain termination
Mechanism of action: mercaptopurine
antimetabolite
Purine analog → converted in cells (by HGPRT) to ribonucleotide that inhibits purine synthesis. Further converted and misincorporated into DNA and RNA
Mechanism of action: hydroxyurea
antimetabolite
Substituted urea → inhibits ribonucleotide reductase → blocks conversion to dNTPs → prevents DNA synthesis → arrests cell at G1-S interface
Mechanism of action: vinblastine
vinca alkaloid
Binds tubulin → prevents formation of microtubules and mitotic spindle
Mechanism of action: vincristine
vinca alkaloid
Binds tubulin → prevents formation of microtubules and mitotic spindle