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Chemotherapy drugs > Cancer Chemotherapy 1 > Flashcards

Cancer Chemotherapy 1 Flashcards

1
Q

a tumor is detectable by X-ray after about how many doublings

A

27 (size of .5cm in diameter)

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2
Q

after about how many doublings till the tumor is palpable on examination, also what size it is and what is its mass

A

30 doublings
1g
1cm diameter

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3
Q

what does the term remission mean

A

cancer is not detectable by the most sensitive measures

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4
Q

the combination therapy MOPP is given for what type of cancer

A

Hodgkin’s disease

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5
Q

the combination therapy ABVD is given for what type of cancer

A

Hodgkin’s disease

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6
Q

the combination therapy CHOP is given for what type of cancer

A

non-hodgkin’s lymphoma

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7
Q

the combination therapy CMF is given for what type of cancer

A

breast cancer

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8
Q

the combination therapy CAF is given for what type of cancer

A

breast cancer

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9
Q

the combination therapy PACE is given for what type of cancer

A

small cell lung cancer

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10
Q

the combination therapy VIP is given for what type of cancer

A

Germ cell cancer

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11
Q

the combination therapy BIP is given for what type of cancer

A

cervical cancer

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12
Q

the combination therapy M-BACOD is given for what type of cancer

A

lymphomas

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13
Q

the combination therapy BEP is given for what type of cancer

A

ovarian

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14
Q

the combination therapy CVD is given for what type of cancer

A

pheochromacytoma

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15
Q

the combination therapy PEB is given for what type of cancer

A

testicular

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16
Q

what is the restriction point (R point)

A

demarcates the commitment to enter S-phase (after R-point the cell is committed to cell division)

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17
Q

what drugs are M phase specific

A

vincristine
vinblastine
paclitaxel

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18
Q

what drugs are S phase specific drugs

A

cytosine arabinoside (cytarabine), topoisomerase I inhibitors (Camptothecin, Topotecan, Irinotecan)

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19
Q

what drugs are S phase specific self-limiting

A

6-mercaptopurine

methotrexate

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20
Q

what are some problems with cancer chemotherapy (in general)

A

dose-limiting toxicities
resistance to chemotherapeutic agents
multi drug resistance p-glycoprotein pumps
second cancers (leukemia and lymphoma)

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21
Q

alkylating reagents involve reactions with what from DNA

A

N-7 guanine

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22
Q

what is the mechanism of action of alkylating reagents

A

cross linking DNA of two different strands- blocking replication and transcription

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23
Q

what is the most common alkylating agent

A

cyclophophamide (aka cytoxan)

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24
Q

what drug has a similar structure to phenylalanine and is taken up by the cell

A

Melphalan

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25
Q

mechlorethamine (mustragen) is what class of chemotherapy drug and what is it used to treat

A

alkylating agent

treats hodgkins’ disease (stages III and IV)

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26
Q

what alkylating agent is taken up rapidly but not excreted

A

mechlorethamine (mustragen)

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27
Q

which alkylating agents require CYP-450 activation

A

cyclophosphamide and iphosphamide (these are prodrugs)

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28
Q

cyclophosphamide has what toxicities associated with it

A

hemorrhagic cystitis

SIADH (water intoxication)

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29
Q

cyclophosphamide is used to treat what

A

Burkitt’s lymphoma
Aute Lymphotoxic leukemia (ALL)
other lymphomas and leukemias

30
Q

what is hemorrhagic cystitis and what drug is it a side effect of

A

dysuria, hematouria, hemorrhage

side effect of cyclophosphamide

31
Q

chlorambucil has what toxic side effect(s)

A

hepatotoxicity

32
Q

chlorambucil is used to treat what

A

chronic lymphocytic leukemia (CLL)

33
Q

what is acrolein and what does it cause

A

byproduct of cyclophosphamide activation and leads to hemorrhagic cystitis

34
Q

Na-2-Mercaptoethanesulfonate (MESNA) is used for what

A

to decrease hemorrhagic cystitis produced by acrolein

35
Q

how does one prevent hemorrhage cystitis associated with the cyclophosphamide-metabolte acrolein

A

MESNA

36
Q

Estramustine phosphate (Emcyt) works via what mechanism

A

anti mitotic effects rather than alkylating effects (CCNS and M-phase)

37
Q

Estramustine phosphate (Emcyt) is given how and why

A

orally- phosphate is cleaved during absorption and it can bind beta-tubulin in vivo

38
Q

what toxic side effect is related to busulfan

A

pulmonary fibrosis

hyper pigmentation of the skin

39
Q

what drugs are nitrosoureas

A

carmustine (BCNU)
lomustine (CCNU)
semustine (methyl-CCNU)
streptozotocin

40
Q

what toxicity is associated with nitrosourea drugs

A

pulmonary fibrosis

nephrotoxicity

41
Q

what is the mechanism of action of nitrosourea drugs

A

breakdown in vivo to liberate alkylating and carbamylating species; highly lipophilic

42
Q

what toxicity is associated with the nitrosourea streprocotocin

A

pancreatic

43
Q

procarbazine (mutulane) mechanism of action

A

decreases DNA, RNA, protein synthesis

via chromatid breakage and translocation inhibits G1 to S phase in cell

44
Q

it is important to avoid what treatment along with procarbazine

A

MAO inhibitors and alochol

45
Q

Dacarbazine (DTIC) and Temozolomide (T) work via what mechanism

A

methylates DNA and RNA-preventing transcription and translation (CCNS)

46
Q

Cisplatin has what MOA

A

forms intrastrand crosslinks with purine bases on DNA (guanine adducts are preferred)- interferes with replication and mitosis
CCNS

47
Q

what is the toxicity associated with cisplatin and platinum drugs in general

A

nephrotoxicity- often have to stop treatment b/c of it

peripheral neuropathy

48
Q

how can one reduce the nephrotoxicity associated with cisplatin and platinum drugs

A

furosemide- it gets rid of toxic metabolites in kidney via diuresis

49
Q

doxorubicin used to go by what name

A

red death

50
Q

what is the MOA of doxorubicin and daunorubicin

A

tight binding b/w base pairs(intercalates) in DNA thus blocking topoisomerase II activity
generates free radicals
histone eviction in open chromatin
CCNS

51
Q

what chemotherapies are anthracyclines

A

doxorubicin and daunorubicin

52
Q

what toxicity is associated with doxorubicin and related anthracyclines

A

cardiotoxicity

53
Q

cardiotoxicity induced by doxorubicin may be prevented by what

A

dexrazoxane

54
Q

uses of doxorubicin

A

breast cancer, sarcoma, MOPP-resitant Hodgkins

55
Q

epirubicin and idarubicin is similar to what drug but has what difference

A

similar mechanism of action to doxorubicin but less cardiotoxic

56
Q

mitoxantrone MOA

A

binda to DNA like doxorubicin to produce drug-DNA-topoisomerase II complexes that lead to DNA strand breaks

57
Q

mitoxantrone has what advantage over doxorubicon

A

lower incidence of cardiotoxicity

58
Q

what drugs are epipodophyllotoxins

A

etoposides

tenopside

59
Q

what is the MOA of epipodophyllotoxins

A

forms a ternary complex with DNA-toposiomerase II

S and G2 phase specific

60
Q

camptothecin analogs include what drugs

A

camptothecin
topotecan
irinotecan

61
Q

camptothecin analogs MOA

A

inhibitors of topoisomerase I

S-phase specific

62
Q

irinotecan is a produce activated by what to what

A

activated by tissue carboxyesterases (high in carcinoma)

active form is SN-38

63
Q

SN-38 is the active form of what drug

A

irinotecan

64
Q

camptothecin analogs have what side effects

A

diarrhea- can lead to stoppage of therapy

65
Q

bleomycins are most active in what cell cycle phase

A

G2

66
Q

what toxicities are associated with bleomycin

A

pulmonary fibrosis and pneumonitis

minimal BM supression

67
Q

bleomycin are used to treat what

A

advanced testicular cancer

68
Q

MOA of bleomycin

A

bind to reduced iron in cells and lead to free radical production

69
Q

Dactinomycin MOA

A

interaction of peptide loops at purine-pyrimidine vase pairs of DNA and intercalate b/w DNA strands
prevents transcription
CCNS

70
Q

what is the most potent anti-tumor agent known

A

dactinomycin

71
Q

what toxicities are associated with dactinomycin

A

oral and GI ulceration

somatitis

72
Q

what happens to a tumor from 30-40 doublings

A

goes from 1g to 1kg

Chemotherapy drugs (2 decks)

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