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Antineoplastics Flashcards

1
Q

Toxicity of Immunosuppressives (5)

A
  • Bone marrow
  • GI tract
  • Alopecia
  • Renal
  • Teratogenesis
  • Hyperuricemia
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2
Q

Alkylating Agents (3)

A
  • Mechlorethamine
  • Cyclophosphamide
  • Cisplatin
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3
Q

Nitrosoureas (2)

A
  • Carmustine

- Lomustine

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4
Q
  • Alkylate DNA
  • Cause miscoding, breakage, crosslinking
  • NOT cell-cycle phase specific
A

Alkylating Agents MOA

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5
Q

Alkylating Agents SE (6)

A
  • Vesicant
  • Affects rapidly proliferating cells
  • N/V
  • Bone marrow depression
  • Immunosuppression
  • Teratogenesis
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6
Q

Hodgkin’s dz

A

Mechlorethamine

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7
Q

Alkylating Agent that is NOT a vesicant

A

Cyclophosphamide

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8
Q
  • Hemorrhagic cystitis (tx: MESNA)

- Inappropriate ADH

A

Cyclophosphamide SE (2)

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9
Q

Curative testicular CA

A

Cisplatin

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10
Q
  • Acoustic nerve damage

- Anaphylaxis

A

Cisplatin

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11
Q
  • Kill in all phases
  • Bifunctional alkylators
  • Inhibit DNA/RNA synthesis
A

Nitrosoureas

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12
Q
  • Brain tumors

- Oral CA and GI

A

Nitrosoureas

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13
Q

Antimetabolites (Purine Analogues)

A
  • Methotrexate
  • 6 Mercaptopurine
  • 5-fluorouracil
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14
Q
  • Inhibits dihydrofolate reductase
  • No thymidylate
  • Blocks DNA, RNA, protein synthesis
A

Methotrexate

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15
Q

What drug acts as a rescue of Methotrexate (bypass blockade)

A
  • Leucovorin
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16
Q

Methotrexate SE (3)

A
  • Hepatotoxicity (more with immunosuppressant)
  • Precipitates in renal tubules (kidney problems when used in CA tx)
  • Pulmonary dz
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17
Q
  • Converted by HGPRT to nucleotide
  • Inhibit synthesis of purine nucleotides: DNA, RNA
  • Not cell cycle specific
A

Antimetabolites (Purine Analogues)

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18
Q
  • Metabolized by xanthine oxidase

- Allopurinol sometimes needed for hyperuricemia, but increases toxicity

A

6-Mercaptopurine

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19
Q

Drug used to tx Leukemias

A

6-Mercaptopurine

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20
Q

Drug that causes Jaundice

A

6-Mercaptopurine

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21
Q
  • Inhibits thymidylate synthase - block DNA synthase

- Cell-cycle specific - G1 and S phases

A

5-Fluorouracil

22
Q

Leucovorin increases response of what drug?

A

5-Fluorouracil

23
Q
  • Solid tumors

- Topical BCC

A

5-Fluorouracil Tx

24
Q
  • Intercalates into DNA
A

Doxorubicin MOA

25
Q

Iron increases effect of ______

A

Doxorubicin

26
Q

Antibiotics (3)

A
  • Doxorubicin
  • Bleomycin
  • Mitomycin
27
Q
  • Cardiotoxic, esp with herceptin
A

Doxorubicin

28
Q
  • Intercalates into DNA

- Generates free radicals, effect increased by iron

A

Doxorubicin

29
Q
  • Directly damage DNA

- Cell cycle specific - G2 and M

30
Q

Bleomycin SE

A
  • LITTLE myelosuppression
  • PULMONARY FIBROSIS
  • Anaphylactoid symptoms
31
Q

Plant Alkaloids (3)

A
  • Vincristine
  • Vinblastine
  • Paclitaxel
32
Q

Vincristine & Vinblastine MOA

A
  • Bind to tubulin - M phase

- Axonal transport affected

33
Q

Vincristine SE

A
  • Neurotoxicity

- Low myelosupression

34
Q

Vinblastine SE

A
  • More myelosupression

- Less neurotoxicity

35
Q

Paclitaxel MOA

A
  • Binds tubulin/microtubulin
  • Arrests mitosis
  • Disrupts axonal transport
36
Q

Tyrosine Kinase Inhibitors

A
  • Imatinib

- Erlotinib

37
Q

Inhibitor of Bcr-AbI fusion protein

A

Imatinib (Gleevec)

38
Q
  • CML

- Gastrointestinal Stromal tumor

A

Imatinib (Gleevec) Tx (2)

39
Q

Imatinib (Gleevec) SE

A
  • Immunosuppressive (avoid if recently immunized for polio)
40
Q

Epidermal Growth Factor Inhibitors

A
  • Cetuximab

- Erlotinib

41
Q

Angiogenesis Inhibitors

A
  • Bevacizumab
42
Q
  • EGF receptor, blocks cell growth

- Monoclonal antibody

43
Q
  • Blocks ATP binding to HER1/EGFR tyrosine kinase
44
Q
  • VEGF needed for angiogenesis, over expressed in tumor

- Decreases blood supply and slows tumor growth

A

Bevacizumab

45
Q
  • Solid tumors (renal and glioblastoma)

- Injected in eye for Macular degeneration (ranibizumab)

A

Bevacizumab

46
Q

Bevacizumab SE

A
  • Bleeding and thromboembolism risk increased with systemic use
  • Sunitinib (renal CA) and Sorafenib (hepatocellular CA) similar, SE similar
47
Q

Hormones and Antagonists (4)

A
  • Prednisone
  • Tamoxifen
  • Trastuxumab
  • Flutamide
48
Q
  • Lymphomas and leukemias
A

Prednisone

49
Q
  • Block estrogen receptor in breast

- Hot flashes, uterine hyperplasia

50
Q
  • Antibody to HER2 receptor

- Cardiac toxicity, esp doxorubicin

A

Trastuzumab

51
Q
  • Anti-androgen for prostate CA

Pharm (10 decks)

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