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BIIC_Pharmacology > BIIC Pharmacology Lecture 10_Chemotherapy of Lukemias > Flashcards

BIIC Pharmacology Lecture 10_Chemotherapy of Lukemias Flashcards

1
Q

What is the goal of therapy with Acute Lymphoblastic Leukemia (ALL)?

A

complete clinical and hematologic remission. This is often acheived in children but less frequently in adults

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2
Q

Doxorubicin, Daunorubicin, Epirubicin are all what kind of drug?

A

Anthracyclines

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3
Q

Drugs ending in -rubicin are typical of what drug class?

A

Anthracyclines

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4
Q

What is the MOA for Anthracyclines?

A
  1. Intercalation into DNA
  2. Inhibition of topoisomerase II
  3. Generation of semiquinone free radicals and oxygen free radicals
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5
Q

Why do anthracyclines negativly effect the heart so strongly?

A

Anthracyclines create free radical O2 which creates H2O2. The heart does not have catalase. The only way for the heart to process the H2O2 is through the fenton pathway. This forms a hydroxy radical.

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6
Q

When giving anthracyclines, what medication can be used to protect the heart?

A

dexrazoxane

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7
Q

What are the three main ADRs of anthracyclines?

A

Mucositis
Stomatitis
Cardiotoxicity

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8
Q

What is unique about Mitoxantrone?

A

It works like an anthracycline but it does not generate free radicals

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9
Q

What is the function of Imatinib?

A

It is a protein tyrosine kinase inhibitor that is used against the BCR-ABL gene. It results in cellular apoptosis.

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10
Q

What are the two main applications of imatinib?

A
  • Chronic myelogenous leukemia (CML)

* Gastrointestinal stromal tumors (GIST)

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11
Q

What is the purpose of Intrathecal methotrexate ± cranial irradiation in ALL treatment?

A

It can be used to irradicate cancer cells that are sequestered in immune privliged areas

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12
Q

What is the MOA of Methotrexate?

A

directly inhibits dihydrofolate reductase (stopes purine synthesis) and causes indirect inhibition of thymidylate synthase

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13
Q

What are the three main ADRs of Methotrexate?

A

o Mucositis
o Photosensitivity
o Nephrotoxicity

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14
Q

What is the “antidote” of Methotrexate?

A

Leucovorin

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15
Q

6-Mercaptopurine and 6-Thioguanine are both what kind of drug?

A

Purine Antagonists with a structure similar to guanine

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16
Q

Thiopurine methyl transferase does what?

A

It is the enzyme that metabolizes Thiopurines (like purine antagonists). Patients with reduced activity thiopurine get therapudic treatment at much lower levels of the purine antagonist.

17
Q

What is the main ADR of 6-Mercaptopurine

A

Hepatotoxicity (elevated liver enzymes)

18
Q

Cyclophosphamide & Ifosfamide are both matabloized into what? Why does this matter?

A

They are matabloized into Acrolein which causes hemorrhagic cystitis in the bladder.

19
Q

How can the effects of acroline be minimized?

A

Hydration and administration fo mensa

20
Q

What is the main ADR of Cyclophosphamide & Ifosfamide?

A

Hemorrhagic cystitis

21
Q

What is the clinical goal of Acute Myeloid Leukemia (AML)?

A

complete clinical and hematologic remission

22
Q

Cytarabine & Gemcitabine are both what kind of drugs>

A

Cytidine analogs

23
Q

What is the main ADR of Cytarabine?

A

Hand and Foot Syndrome

24
Q

Fludarabine, Cladribine, Clofarabine are what kind of drugs?

A

Halogenated adenosine analogs

25
Q

What is the main ADR of Fludarabine?

A

Cough

26
Q

What is the main ADR of Cladribine

A

Stomatitis

27
Q

Mechlorethamine, Melphalan, Chlorambucil, and Thiotepa are what kind of drugs>

A

Alkylating Agents

28
Q

What us the MOA of Alkylating Agents?

A

It cross links DNA

29
Q

What can be used ase a protective agent against Alkylating agents?

A

2% sodium thiosulfate

30
Q

What is the main risk of Alkylating agents?

A

Extravasation,

31
Q

What is unique about Thiotepa

A

Thiotepa distilled into bladder to treat bladder cancer

32
Q

What is the MOA Rituximab

A

It is a monoclonal antibody for CD 20. I binds CD20 on cancer and normal be cells and mediates the immune attack of these.

33
Q

What is the main ADR of Rituximab?

A

Steven-Johnson Syndrome

34
Q

Imatinib, Dasatinib, and Nilotinib are all what kind of drugs?

A

Tyrosine Kinase Inhibitors (BCR-ABL)

35
Q

What is the main ADR of Dasatinib?

A
  • Edema & pleural effusion

* Hemorrhage

36
Q

What is the main ADR of Nilotinib?

A

Electrolyte abnormalities

BIIC_Pharmacology (9 decks)

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