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Pharmacology > Cancer Chemotherapy > Flashcards

Cancer Chemotherapy Flashcards

1
Q

What is the most common malignancy in the pediatric population?

A

Leukemia (Acute Lymphocytic leukemia)

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2
Q

Type of chemotherapy used for systemic cancers:

A

Induction chemotherapy

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3
Q

Type of chemotherapy used for localized cancers:

A

Neoadjuvant chemotherapy

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4
Q

Chemotherapy used as part of a combination of treatment modalities:

A

Adjuvant chemotherapy

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5
Q

The therapeutic goals of chemotherapy:

A

Cure some malignancies
Decrease the rate of relapse
Palliate symptoms
Reduce the size and extent of the primary tumor

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6
Q

These are anti-cancer drugs that act on one or several phases of the cell cycle; as such they are ____.

A

Cell Cycle Specific Drugs (CCS); schedule dependent drugs

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7
Q

Cell cycle nonspecific drugs act ____ the cell cycle; as such they are____.

A

inside and outside; dose dependent drugs

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8
Q

Most CCNS drugs are ____ and antibiotics (except for ___)

A

Alkylating agents; Bleomycin

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9
Q

Cancers with high growth fractions are?

A

Leukemia

Lymphoma

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10
Q

Cancers with low growth fractions are?

A

Solid tumors:
Ovarian CA
Colon CA
Lung CA

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11
Q

Cancer cell growth plateaus due to:

A

Depletion of nutrients (main cause)
Increase in competition
Confinement

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12
Q

The cardinal rule of chemotherapy:

A

There is an invariable inverse relation between cancerous cell numbers and curability

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13
Q

What are some factors affecting cell kill?

A 
Dose intensity
Schedule
Drug Resistance
Tumor site
Patient's health status
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14
Q

What is the single drug used to treat choriocarcinoma?

A

Methotrexate

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15
Q

What is the single drug used Burkitt’s lymphoma?

A

Cyclophosphamide

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16
Q

ECV drug regimen hlung cancer?

A

Etoposide
Cisplatin
Vincristine

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17
Q

CMF drug regiment for breast cancer?

A

Cyclophosphamide
Methotrexate
Fluorouracil

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18
Q

Drugs that do NOT cause myelosuppression?

A 
Hormones
Streptozocin
Vincristine
Bleomycin
Asparaginase
Cisplatin
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19
Q

Serotonin antagonists used to treat N&V caused by CA treatment?

A

Ondansetron

Granisetron

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20
Q

What is the most common mechanism in multi-drug resistance?

A

P-glycoprotein mediated efflux of drug from cell

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21
Q

Anti-metabolic chemotherapy drugs?

A

Folic Acid analogs - Methotrexate
Purine analogs - Mercaptopurine
Pyrmidine Analogs - Flurouracil, Cytarabine

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22
Q

Source of reduced folates for treating MTX toxic effects?

A

Leucovorin + Folinic Acid

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23
Q

Uses of Methotrexate?

A 
Acute Leukocytic Leukemia (ALL)
Choriocarcinoma
Non-Hodgkins Lymphoma
Psoriasis
GVHD
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24
Q

Mercaptopurine is converted to a T-IMP by HGPRT and then replaces what nucleotide purine?

A

Guanine

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25
Q

Similar to 6-MP but is not metabolized by xanthine oxidase and can be given with allopurinol:

A

Thioguanine

26
Q

5-FU is converted to ___, which binds___, causing “___”.

A

FdUMP; thymidylate synthetase; thymineless death

27
Q

Uses of 6-MP?

A

ALL
AML
CML

28
Q

Uses of Flourouracil?

A

Adenocarcinoma
Severe psoriasis
Basal cell CA
Colorectal CA

29
Q

Hand foot syndrome is associated with which pyrmidine analog?

A

Flourouracil

30
Q

Cytarabine is used only in which malignancies?

A

NOT in solid tumors

Hematologic Malignancies:
AML (single most effective agent)
non-Hodgkins Lymphoma
ALL

31
Q

Which phase of the cell cycle is most susceptible to alkylation?

A

G1 and S phase

32
Q

Alkylation may result in:

A

DNA fragmentation
Mispairing
Cross linking

33
Q

The major site of DNA alkylation is what?

A

N7 position of guanine - 2 alkyl groups must alkylate 2 guanine groups

34
Q

Advantages of Cyclophosphamide (alkylating agent):

A

Favorable therapeutic index
Broadest spectrum of activity
High bioavailability

35
Q

Antidote to cyclophosphamide?

A

MESNA+

36
Q

This is the slowest acting nitrogen mustard, used for ____, with ADRs of ___

A

Chlorambucil;
CLL and primary (Waldenstrom) macroglobulinemia;
Pulmonary toxicity, secondary leukemia

37
Q

Carmustine and Lomustine are useful for treating___, but have characteristic toxicity of:

A

Malignant astrocytoma and malignant brain tumors;

Delayed hematopoietic depression

38
Q

Anti-tumor antibiotics?

A

Dactinomycin
Plicamycin
Anthracyclines

39
Q

What are the anthracyclines?

What is their MOA?

A 
Inhibition of topoisomerase II:
Daunorubicin
Doxorubicin
Idarubicin
Eprubicin
Mitoxantrone
40
Q

MOA and uses of Bleomycin:

A

Causes DNA fragmentation (unique MOA):
Squamous CA of head, neck and lungs
Lymphomas
Testicular tumor

41
Q

Anti-tumor antibiotic associated with mucocutaneous and pulmonary toxicity:

A

Bleomycin

42
Q

Adverse effects of doxorubicin (anti-tumor antibiotic):

A

Irreversible, dose-related cardiomyopathy
Local tissue necrosis
Red discoloration of urine
Adriamycin flare (benign local allergic reaction)

43
Q

Adverse effect of cyclophosphamide which manifests as frank hematuria:

A

Sterile hemorrhagic cystitis

44
Q

MOA and uses of Dactinomycin:

A 
Causes single stranded breaks in DNA:
Rhabdymyosarcoma,
Wilm's tumor
Kaposi sarcoma
Ewing's tumor
45
Q

Anti-tumor antibiotic associated with local tissue necrosis and radiation recall reaction:

A

Dactinomycin

46
Q

Antidote to anti-tumor antibiotics in general, and its MOA:

A

Dexrazoxane; iron chelator

47
Q

Uses of Doxorubicin:

A

BEST agent for metastatic thyroid CA
Acute leukemia
Malignant lymphoma
Breast cancer

48
Q

Vinca alkaloids bind to __, inhibiting ___ and causing ___ specific arrest:

A

tubulin; microtubule assembly; M-phase

49
Q

Viscristine adverse affects?

A

dose-limiting neurotoxicity of the periphery

50
Q

Vinblastine adverse affects?

A

Myelosuppression (B = bone marrow)

51
Q

Taxanes ___ microtubule assembly and are useful in:

A

Promote (prevent microtubule disassembly); breast and ovarian cancer

52
Q

Epipodophyllotoxins are derived from the ____ and inhibit ___

A

American mandrake; topoisomerase II

53
Q

Campthecins are derived from ____ and inhibit ____, which causes ___ specific arrest:

A

The happy tree; topoisomerase I; S-phase

54
Q

Used in the treatment of endometrial CA?

A

Megestrol (Progestins)

55
Q

Palliative treatment for advanced breast CA?

A

Tamoxifens (anti-estrogen)

56
Q

___ is an anti-androgen, used in combination with ___ in the treatment of prostatic CA:

A

Flutamide; GnRH

57
Q

The cytokine biological response modifiers?

A

Interferon-a (CML, Kaposi’s sarcoma)
IL-2 (Renal cell CA, Melanoma)
BCG (Urinary CA in situ)

58
Q

Monoclonal antibody BRM?

A

(MoAbs/Mabs) Ritixumab + Mabthera

Target CD20 B-cell antigen

59
Q

Tyrosine kinase inhibitors (TKIs) inhibit the action of ____, ___, and ____

A

BCR-ABL
c-kit
PDGFR- beta tyrosine kinase

60
Q

Examples of CCS drugs:

A

Antimetabolites
Bleomycin
Plant alkyloids
Hormones

60
Q

Plant alkaloids:

A

Vinva alkaloids
Podophyllotoxins
Taxanes
Campothecins

60
Q

Cyclophosphamide is activated to ___ and ___ hepatically:

A

Phospharamide; acrolein

Pharmacology (14 decks)

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