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Pharmacology > Cancer Chemotherapy > Flashcards

Cancer Chemotherapy Flashcards

1
Q

Alkylating Agents

A 
CELL CYCLE NON-SPECIFIC
Mechlorethamine
Cyclophosphamide
Isofosfamide
Carmustin/Lomustin
Busulfan
Cisplatin
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2
Q

Antimetabolites

A 
CELL CYCLE SPECIFIC
Methotrexate
6-MP
Fluorouracil
Capecitabine
Cytarabine
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3
Q

Antibiotics

A 
CELL CYCLE NON-SPECIFIC - except Bleo
Doxorubicin
Epirubicin
Dactinomycin
Bleomycin
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4
Q

From plants

A 
CELL CYCLE SPECIFIC
Vincristine
Vinblastine
Paclitaxel (Taxol)
Docetaxel
Etoposide
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5
Q

Aromatase Inhibitors

A

Exemestane
Letrozole
Anastrozole

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6
Q

RTK Inhibitors

A

Tamoxifen

Imatinib

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7
Q

Monoclonal Antibodies (RTK)

A

Trastuzumab
Cetuximab
Bevacizumab

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8
Q

Raf/Mek Inhibitors

A

Sorafenib

Vemurafenib

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9
Q

Mechlorethamine

A

Reactive nitrogen mustard
Must be mixed right before administration
Nausea, vomiting, BM toxicity

(not in FA)

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10
Q

Cyclophosphamide

A

Crosslink DNA at guanine N7
Prodrug that is activated by CYP450 in liver

TX: Highly effective against Burkitt’s

Acrolein - toxic compound that causes hemorrhagic cystitis. Must take with lots of water.
MESNA - will bind toxic acrolein and reduce its effects

SE: Hematuria
Myelosuppression

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11
Q

Isofosfamide

A

Greater activity than Cyclophosphamide, must give with MESNA

SE: Neurotoxicity, Nephrotoxicity, Hematuria, Cardiac tox at high dose
Myelosuppression

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12
Q

Carmustin/Lomustin

A

Nitrosoureas
Lipid soluble - can cross BBB

TX: Brain tumors

SE: Delayed myelosuppression, PULMONARY FIBROSIS, CNS toxicity

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13
Q

Busulfan

A

TX: CML

SE: Myelosuppression, Pulmonary Fibrosis

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14
Q

Cisplatin

A

Cross-links GC base pairs with platinum

TX: Treat testicular cancer
(Bleomycin, Etoposide, Vinblastine - 85% cure)

SE: Renal damage, Ototoxicity, Peripheral neuropathy

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15
Q

Methotrexate

A

Folate analog - Inhibits DHFR
No THF (dTMP) generated
S-phase specific

TX: Pediatric ALL, Choriocarcinoma
(Psoriasis, IBD, RA, Vasculitis)

SE: Hepatic Necrosis, Myelosuppression, Pulmonary Fibrosis, Mucositis

Reversal: Leucovorin

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16
Q

6-Mercaptopurine

A

(same as Azathioprine - Aza is metabolized to 6-MP)
Inhibits guanine synthesis

TX: Maintenance of ALL

SE: Myelosuppression

17
Q

Fluorouracil (5-FU)

A

Pyrimidine analog
Inhibits Thymidylate Synthase - prevent dTMP
Potentiated by leucovorin

TX: Colon cancer, Pancreatic cancer, Basal Cell Carcinoma

SE: PHOTOSENSITIVITY, Oral/GI ulcers, Hand Foot Syndrome, Myelosuppression

18
Q

Capecitabine

A

Orally prodrug of 5-FU

not GI toxic

19
Q

Cytarabine

A

Cytosine analog - Inhibits DNA polymerase

TX: AML, Hairy Cell Leukemia

SE: Myelosuppression with Megaloblastic anemia, Pancytopenia

20
Q

Doxorubicin

A

Free radicals that bind to topo II nicked DNA

TX: Solid tumors, breast cancer

SE: Dilated Cardiomyopathy, severe local tissue damage with extravasation, Myelosuppression

Dexrazoxane - Prevents cardiac myopathy. Iron chelating agent

21
Q

Epirubicin

A

Doxorubicin analog
Can use it at higher doses than Doxorubicin

SE: Chronic cardiac toxicity
Interacts with Cimetidine (H2 Receptor blocker) - serum concentration will rise

22
Q

Dactinomycin

A

Intercalates DNA between adjacent GC base pairs
Inhibits RNA pol
Blocks topo II nicked strands

TX: Pediatric Rhabdomyosarcoma, Wilm’s Tumor, Ewing’s sarcoma
(along with surgery, Vincristine/Cyclophosphamide)

SE: Severe tissue damage with extravasation, Myelosuppression

23
Q

Bleomycin

A

Generates free radicals (O2 and OH-) that fragment DNA

TX: Hodgkin lymphoma, squamous cell carcinomas, testicular cancer, germ cell tumor of ovary

SE: PULMONARY FIBROSIS, Minimal Myelosuppression

24
Q

Mild Bone Marrow Suppression

A

Bleomycin and Vincristine

25
Q

Vincristine

A

Inhibits tubulin polymerization
M-Phase specific

TX: Pediatric leukemia, Non-Hodgkin lymphomas

SE: Sensory neuropathy, paralytic ileus
Mild myelosuppression

26
Q

Vinblastine

A

TX: Testicular cancer (w/ Bleo and cisplatin)

SE: Myelosuppression, less neurotoxic

27
Q

Paclitaxel/Docetaxel

A

Stabilizes polymerized microtubules

TX: Cisplatin resistant solid tumors

SE: Peripheral neuropathy

28
Q

Etoposide

A

Inhibits topoisomerase II - causes ds breaks

TX: Testicular cancer, SCLC
leukemias, lymphomas

SE: Myelosuppression

29
Q

Vinblastine/Cisplatin/Bleomycin/Etoposide

A

Testicular Cancer

30
Q

Exemestane, Letrozole, Anastrozol

A

Aromatase inhibitors - block conversion of androgen to estrogen

TX: Estrogen receptor positive breast cancer

SE: MSK pain, Headache, Fatigue, Difficulty breathing

31
Q

Tamoxifen

A

Inhibits Estrogen Receptor directly

TX: Estrogen dependent breast cancer

SE: Can increase the risk of endometrial cancer
Prevents bone loss and reduces serum cholesterol

32
Q

Imatinib

A

Inhibits BCR-ABL

TX: CML, CMML

SE: Inhibits platelet derived growth factor

33
Q

Trastuzumab

A

Inhibits Her2

TX: Her2 positive metastatic breast cancer

SE: Weakening of heart muscle, CHF, neutropenia, anemia, hypersensitivity reactions

34
Q

Cetuximab

A

Inhibits EGFR (Her1)

TX: EGFR positive colorectal cancer

SE: Severe infusion reactions, Hypotension, Serum sickness, Papulopustular acneiform rash

35
Q

Bevacizumab

A

Inhibits VEGF
Blocks angiogenesis and neovascularization

TX: Colorectal Cancer

SE: Hypertension, CHF, Proteinuria, Hemorrhage, GI perforation

36
Q

Sorafenib

A

C-Raf, VEGF, PDGFR inhibitor

TX: Kidney, Liver, Thyroid cancer

SE: Hemorrhage, Hypertension

37
Q

Vemurafenib/Dabrafenib

A

B-Raf inhibitor

TX: METASTATIC MELANOMA carrying V600E B-Raf mutation
Given with Trametinib

Pharmacology (19 decks)

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