Antineoplastics (Cancer) Flashcards
What is the primary MOR associated with the Antineoplastics (cancer medications)?
Drug efflux
When should Leucovorin be used BEFORE administering this medication?
What phase does this medication work in?
5-Fluorouracil
- S-phase
When should Leucovorin be used AFTER administering these two medications?
What phase do these medications work in?
- Methotrexate
- 6-Mercaptopurine
- S-phase
What are the four medications that utilize alkylating DNA as their MOA? What are they all used to treat?
Antineoplastics (cancer medications)
- Cyclophosphamide
- Carmustine
- Cisplatin
- Doxorubicin
What two diseases can Cyclophosphamide be used to treat?
- Cancer
- Immunosuppression
What is the primary toxicity associated with Cyclophosphamide? How can this be prevented (2)?
Hemorrhage cystitis
- Prevent with MESNA and hydration
What does acrolein accumulation cause? What drug is this toxicity associated with?
Hemorrhage cystitis
- Toxicity of Cyclophosphamide
How do you prevent hemorrhage cystitis (2)?
- MESNA
- Hydration
Which of the Antineoplastics (cancer medications) can cross the BBB?
Carmustine
What are the two primary toxicities associated with Cisplatin?
- Nephrotoxicity
- Acoustic nerve damage
What three medications have an MOA that affects cells in the S PHASE?
- Methotrexate
- 6-Mercaptopurine
- 5-Fluorouracil
What are the two primary toxicities associated with Methotrexate as a cancer medication? What is its other use?
- Mucositis
- Thrombocytopenia
Also used as an immunosuppressant
What are the two primary toxicities associated with 6-Mercaptopurine?
- Bone marrow suppression
- Jaundice
What should ALWAYS be ruled out with 6-Mercaptopurine?
Use of Allopurinol
- If used, combination can be potentially fatal
What are the two primary toxicities associated with 5-Fluorouracil?
- Oral ulcers
- GI ulcers
What three medications have an MOA that affects cells in the M PHASE?
- Paclitaxel
- Vincristine
- Vinblastine
What are the two primary toxicities associated with Paclitaxel?
- Myelosuppression
- Anemia
What is the primary toxicity associated with Vincristine?
Neurotoxicity
What is the primary toxicity associated with Vinblastine?
Myelosuppression
What is the primary toxicity associated with Doxorubicin?
Cardiotoxicity
What phase of the cell cycle does Paclitaxel affect?
M phase
What phase of the cell cycle does Vincristine affect?
M phase
What phase of the cell cycle does Vinblastine affect?
M phase
What phase of the cell cycle does Methotrexate affect?
S phase
What phase of the cell cycle does 6-Mercaptopurine affect?
S phase
What phase of the cell cycle does 5-Fluorouracil affect?
S phase
What phase of the cell cycle does Bleomycin affect?
G2-M phase
What are the three primary toxicities associated with Bleomycin?
- Hypersensitivity
- Pulmonary fibrosis
- Mild myelosuppression
What is the MOA of Imatinib (Gleevec)?
Inhibits Bcr-Abl fusion to TKR protein
- TKR inhibitor
What MUST be ruled out before administering Imatinib (Gleevec)?
Bcr-Abl fusion mutation
What is the primary toxicity associated with Imatinib (Gleevec)?
Edema (eyes, ankles)
What MUST be checked before administering Cetuximab or Erlotinib? What results would indicate NOT starting the medication?
EGFR expression/mutation
- If levels are NORMAL, do NOT start these drugs
What is the MOA of Cetuximab?
Antibody binds to EGFR and inhibits EGFR kinase activity
What is the MOA of Erlotinib?
Blocks ATP binding to EGFR and inhibits EGFR kinase activity
What are the two primary toxicities associated with Cetuximab?
- Acneiform
- Hypomagnesemia
What is the MOA of Bevacizumab?
Binds VEGF to prevent binding to VEGF-R (receptor)
What are the two primary toxicities associated with Bevacizumab?
- Bleeding
- Thromboembolism
What medication should be combined with Dexrazoxane to chelate iron and avoid free radical toxicity?
Combine Doxorubicin with Dexrazoxane
What medication should be combined with Amifostine to reduce nephrotoxicity?
Combine Cisplatin with Amifostine
