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Pharm > cancer > Flashcards

cancer Flashcards

1
Q

antimetabolites

A

azathioprine, 6 mercaptopurine, cladribine, cytarabine (arabinofuranosyl cytidine), 5-florouracil, methotrexat

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2
Q

azathioprine, 6 mercaptopurine mechanism

A

purine (thiol) analogs. decreae de novo purine sytnhesis. activated by HGPRT.

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3
Q

what is azathioprine metabolized into

A

6MP

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4
Q

use of azathioprine, 6 mercaptopurine

A

prevents organ rejection, RA, IBD, SLE;

used to wean patients off steroids in chronic disease and to treat steroid refractory chronic disease

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5
Q

SE of azathioprine, 6 mercaptopurine

A

myelosupression, GI liver.
azathioprine and 6MP are metabolized by xanthine oxidase; thus both have increase toxicity with allopurinol or febuxostat

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6
Q

antimetabolites block what phase of cellcycle

A

S phase

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7
Q

cladribine mechanism

A

purine analog; multiple mechanisms ( inhibiton of dna polymerase, dna strand breaks)

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8
Q

use of cladibrine

A

hairy cell leukemia

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9
Q

hairy cell leukemia treated by

A

cladibrine

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10
Q

se of cladibrine

A

myelosuppression, nephrotoxciity, neurotoxicity

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11
Q

an antimetaboilte that is a pyrimidein analog; causes inhibtion of dna polymerase

A

cytarabine

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12
Q

use of cytaribne

A

leukemias (AML), lymphomas

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13
Q

SE of cytarabine

A

myelosuppression with megaloblastic anemia. cytarabine causes pancytopenia
CYTarabine: panCYTopenia

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14
Q

5 fluorouracil mechanism

A

pyrimidine analog bioactivated to 5-FdUMP, which covalently complexes with thimidylate synthase and folic acid.

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15
Q

prodrug with similar activity to 5 fluorouracil

A

capecitabine

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16
Q

5 fluorouracil continued mechaism

A

complex inhibits thimydlate synthase : decrease dTMP and decreasing DNA syntehsis

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17
Q

use of 5 fluorouracil

A

colon cancer, pancreatic cancer, basal cell carcionma

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18
Q

the addition of leucovorin enhacnces the effect of

A

5 fluooruacila

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19
Q

SE of 5 fluoroucail

A

myelosuppression, palmar plantar erythrodysesthesia (hand foot syndrome)

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20
Q

methotrexate mechanism

A

folic acid analog that competitvely inhibits dihydrofolate reductase: decreasing dTMP; decreasing DNA synthesis

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21
Q

use of methotrexate

A

leukemias (ALL), lymphomas, choriocarcinoma, sarcomas;

non-neoplastic: ectopic pregnancy; medical abortion (with misoprostol), RA, psoriasis, IBD, vasculitis

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22
Q

ectopic pregnancy treamtnet

A

methotrexat (inhibits trophoblast division, therefore decreses trophoblast survival, hindering implantation, and encouraging expulsion

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23
Q

leucovorin rescue

A

methotrexate

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24
Q

se of methotrexate

A

myelosuppression (reversible w leucovorin), hepatotoxcicity (cirrhosis), mucositis, pulmonary fibrosis, bone marrow (pancytopenia, hair follicles (alopecia), GI mucosa (ulcerations - apthous - death of mucsoa)

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25
Q

after entering target cell, Methotrexate undergoes ____ which prevents movement ofe methotrexatioe out of cell

A

polyglutamation; which prevents movement of methotrexate

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26
Q

antitumor antiboitcs

A

bleomycin, dactinomycin (actinomycin D), doxorubicin, daunorubicin)

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27
Q

bleomycin mechanism

A

induces free radical formation: breaks in DNA strands

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28
Q

use of bleomycin

A

testicular cancer, hodgkin lymphoma

29
Q

se of bleomycin

A

pulmonary fibrosis, skin hyperpigmentation. minimal myelosuppression

30
Q

dactinomycin (actinomycin D) mechanism

A

intercalates in DNA

31
Q

use of dactinomycin

A

wilms tumor, ewing sarcoma, rhabdomyosarcoma. used for childhood tumors

32
Q

SE of dactinomycin

A

myelosuppression

33
Q

doxorubicin,

daunorubicin mechainsm

A

generates free radicals

intercaltes in DNA -> breaks in DNA -> decrease replication

34
Q

bleomycin and doxorubicin work at what phase

A

G2

35
Q

use of doxorubicin, daunorubicin

A

solid tumors, leukemias, lymphomas

36
Q

SE of doxorubicin, daunorubicin

A

cardiotoxicity (dilated cardiomyopathy, myelosuppression, alopecia)
cardiotoxicity forms from anthracyte : topoisomerase II complex that forms in healthy cardiomycoytes

37
Q

iron chelating agent used to prevent cardiotoxicty in doxorubicin

A

dexrazoxane

38
Q

alkylating agents

A

busulfan,
cyclophosphamide, ifosfamide
nitrosureas

39
Q

busulfan mechanism

A

cross links DNA

40
Q

use of busulfan

A

CML. also used to ablate bone marrow before bone marrow transplatntion

41
Q

SE of busulfan

A

severe myelosuppression (in almost all clses); pulmonary fibrosis, hyperpigmentation

42
Q

cyclophosphamide, ifosfamide mechanism

A

cross-link DNA at guanine N-7; require bioactivation by liver; a nitrogen mustard

43
Q

use of cyclopshopahmide, ifosfamide

A

solid tumors, leukkemai, lymphomas

44
Q

SE of cyclophosphamide, ifosfamide

A

myelosuppression; hemorraghich cystitis,

45
Q

hemorraghic cystiits in cyclophsomaide toxicity prevented with

A

mesna or n-acetylcysteine

46
Q

thiol group of ___ binds toxic metaboits in hemorraghich cystiits

A

mesna

47
Q

nitrosoureas mechanism

A

require bioactviation; cross BBB -> CNS. Cross link DNA

48
Q

use of nitrosoureas

A

brain tumors (including glioblastoma multiforme)

49
Q

SE of nitrosoureas

A

CNS toxicity (convulsions, dizziness, ataxia)

50
Q

microtubule inhibitors

A

paclitaxel, vincristine, vinblastine

51
Q

paclitaxel mechanism

A

hyperstabilize polymerized microtubules in M phase so that mitotic spindle cannot break down (anaphase cannot occur)

52
Q

microtuuble inhibitors work in

A

M phase

53
Q

use of paclitaxel

A

ovarian and breast carcinomas

54
Q

SE of paclitaxel

A

myelosuppression, neuropathy, hypersenstiivty

55
Q

vincristine , vinblatine mechanism

A

vinca alkaloids that bind B-tubulin and inhibit its polymerization into microtubules -> prevent mitotic spindle formation (M-phase arrest)

56
Q

use of vincristine vinblastine

A

solid tumors, leukemias, hodgkin (vinblastine) and non-hodgkin (vincristine) lymphomas

57
Q

vincristine SE

A

neurotoxicity (areflexia, peripheral neuritis), constipation (including paralytic ileus)

58
Q

cisplatin, carboplatin use

A

testicular bladder ovary lung carcinomas

59
Q

cisplatin carboplatin mechainsm

A

crross link DNA

60
Q

se of cisplatin, carboplatin

A

nephrotoxicity, peripihreal neuropathy, ototoxicity. prevent nephrotoxicity with amifostine (free radical scavenger) and chloride (saline) diuresis

61
Q

etoposide, teniposide mechanism

A

etoposide, teniposide inhibits sealing activity of topoisomerase II: increasing DNA degradation

62
Q

SE of etoposide , teniposide

A

myelosuppression, alopecia

63
Q

mechanism of etoposide, teniposide

A

solid tumors (particularly testicular and small cell lung cancer), leukemia lymphomas

64
Q

irinotecan, topotecan

A

inhibit topoisomerase I and prevent dna unwinding and replication

65
Q

use of irinotecan, topotecan

A

colon cancer (irinotecan); ovarian and small cell lung cancer (topotecan)

66
Q

SE of irinotecan, topotecan

A

severe myelosuppression, diarrhea

67
Q

hydroxyurea mechanism

A

inhibits ribonucleotide reductase : decrease DNA syntehsis (S phase specific)

68
Q

use of hydroxyurea

A

myeloproliferative disorders (CML, poly vera), sickle cell (increase HbF); melanoma

69
Q

se of hydroxurea

A

myelosuppresion

Pharm (13 decks)

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