Cancer Drug Hardy Flashcards
Platinum complexes
DNA alkylating agents-cross links base pair and bends DNA
Cisplatin
Carboplatin
Oxaliplatin
Nitrogen mustards
DNA alkylating agent
Mechlorethamine
Cyclophosphamide
Alkyl sulfonate
DNA alkylating agent
Bushel fan
DNA alkylating agent mechanism
Cross links DNA-interferes with unwinding ability
Mechlorethamine
Most reactive nitrogen mustard
Toxicity of cyclophosphamide
Cardio toxicity, hemorrhagic cystitis, hematuria
MESNA
Added to cyclophosphamide to prevent toxicities
Cisplatin toxicity
Renal damage (reduced hydration), ototoxicity with hearing loss, peripheral sensory neuropathy
Busulfan toxicity
Bone marrow depression (stem cells)
Antimetabolites
Methotrexate Fluorouracil Capecitabine Cytarabine Mercaptopurine Asparaginase
Methotrexate mechanism
Analog of folic acid
Competitive inhibitor of dihydrofolate reductase
Blocks dTMP synthesis which is required for DNA synthesis
Inhibits folate dependent enzymes
Methotrexate toxicity
Hepatic necrosis
Bone marrow depression
Fluorouracil mechanism
Makes fraudulent dUMP
Inhibits thymidylate synthase
Flurouracil toxicity
Sever ulceration of oral and GI mucosa
Diarrhea
Cytarabine toxicity
Bone marrow depression
6 mercaptopurine
Metabolized in liver (xanthine oxidase and TPMT)
Toxicity=bone marrow depression
Xanthine oxidase inhibitors= reduce drug 75%
Don’t give pts with TPMT and HGPRT
Asparginase Erwinia chrysanthemi (erwinaze)
Mechanism: hydrolyze asparagine to aspartic acid and ammonia
Toxicity =risk of anaphylaxis
Microtubule inhibitors
Paclitaxel
Docetaxel
Mechanism= metaphase arrest leads to apoptosis
Toxicity= bone marrow, peripheral sensory neuropathy
Topoisomerase inhibitors
Doxorubicin
Irinotecan
Mechanism= no way to fix nicked DNA
Anthracycline antibiotics
Inhibits topoisomerase II
Toxicity= acute and chronic cardiac toxicity
Doxorubicin toxicity
ECG changes, ventricular arrhythmia, cardiotoxicity, bone marrow depression
Does this by free radical damage
Dexrazoxane
Used to protect from cardiotoxicity and extravasation from IV doxorubicin
Irinotecan
Severe GI toxicity
UGT1A1 28 polymorphism
Used for colon cancer
Bleomycin
Free radical generator, DNA fragmentation
NO bone marrow toxicity
Pulmonary fibrosis
Hormone inhibitors
Examastane
Letrozole
Anastrozole
Goserelin acetate
Exemestane, letrozole, anastrozole mechanism
Block androgen to estrogen
Pamidronate disodium
Used for bone density loss to do hormone inhibitors
Tyrosine kinase inhibitors
Trastuzumab Bevacizumab Cetuximab Rituximab Tamoxifen Imatinib
Trastuzumab
Antibody to HER2 receptor
Toxicity: weaken heart muscle, congestive heart failure
Bevacizumab
Antibody to VEGF
Used fir metastatic colorectal cancer
Toxicity: CHF, GI perforations
Cetuximab
Binds EGFR or HER1
Colorectal cancer
Only for people who express wildtype KRAS
Rituximab
Antibody to CD20
Used for B cell malignancies
Side effects: HBV reactivation, PML
Tamoxifen
Binds estrogen receptor
Estrogen dependent breast cancer
Toxicity: endometrial cancers, venous thrombosis, pulmonary emboli
Lapatinib
HER2 and HER1 inhibitor
Imatinib
Inhibitor of constitutive active Bcr-alb tyrosine kinase
Nilotinib
Inhibitor of Bcr-abl tyrosine kinase
Pronatinib
Inhibits unmutated and all mutated forms of Bcr-abl
ATRA
Toxicity: retinoids acid syndrome
Target: APL
ATO
Toxicity: atrial or ventricular arrhythmias
Target: relapsed APL
