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Parker: Pulmonary pharmacology > Cancer drugs > Flashcards

Cancer drugs Flashcards

1
Q

List the nitrogen mustards

A
  1. Cyclophosphamide (Prodrug! Must be metabolized in liver)

2. Ifosfamide

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2
Q

What is the nitrogen mustard’s MOA?

A

Alkylate DNA by binding to N7 of guanine

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3
Q

Cyclophosphamide ADE?

A

Pulmonary fibrosis, hemorrhagic cystitis

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4
Q

Ifosfamide ADE?

A

CNS, infection. No pulmonary fibrosis and less renal tox than cyclophosphamide

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5
Q

Adjuvant therapy with the nitrogen mustards?

A

Mesna

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6
Q

List the platinum drugs

A
  1. Cisplatin

2. Carboplatin

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7
Q

MOA of platinum drugs?

A

Bind N7 of guanine on DNA and produce intra-strand cross links that inhibit replication

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8
Q

Cisplatin/Carboplatin ADE?

A

Renal and oto toxicity

THE DOSE LIMITING FACTOR FOR THE PLATINUM DRUGS IS NEPHROTOXICITY!

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9
Q

Cisplatin’s adjuvant therapy?

A

Amifostine

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10
Q

Folic acid analogs?

A
  1. Methotrexate

2. Pemetrexed

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11
Q

MOA of folic acid analogs?

A

Inhibit dihydrofolate reductase thus inhibiting DNA synthesis

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12
Q

Folic acid analogs have a ton of ADE’s. What might they do to the lungs?

A

Pulmonary fibrosis

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13
Q

Adjuvant therapy for methotrexate?

A

Leucovorin

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14
Q

List the pyrimadine analogs

A

Gemcitabine

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15
Q

MOA of Gemcitabine?

A

Pyrimadine analoge (cystine) –> inhibits DNA synthesis –> apoptosis

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16
Q

ADE of Gemcitabine?

A

Hand-foot syndrome (blisters on palms of hands and soles of feet)

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17
Q

Camptothecin analogs?

A
  1. Irinotecan

2. Topotecan

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18
Q

MOA of camptothecin analogs?

A

Stabilize topoisomerase I –> DNA breaks

19
Q

ADE of camptothecin analogs? (Hint: GG)

A

GI, contraindicated in Gilbert’s syndrome (high bilirubin), AChE inhibition (irinotecan only)

20
Q

Vinca alkaloids?

A

Vincristine, Vinorelbine

21
Q

MOA of vinca alkaloids?

A

Bind beta-tubulin of microtubules –> prevent microtubule assembly

22
Q

ADE of vinca alkaloids?

A

Peripheral neuropathy, FATAL with intrathecal (CSF) administration, extravasation

23
Q

What is the podophyllotoxin?

24
Q

Etoposide’s MOA?

A

Form complex with topoisomerase II & DNA

25
Q

ADE of etoposide?

A

Leukopenia- dose limiting. Also infection, bleeding

26
Q

What is the taxane?

A

Paclitaxel

27
Q

MOA of paclitaxel?

A

Bind beta tubulin to prevent microtubule disassembly (opposite of vinca alkaloids)

28
Q

ADE of paclitaxel?

A

Peripheral neuropathy, extravasation

29
Q

What is the anthracycline?

A

Doxorubicin

30
Q

Doxorubicin’s MOA?

A

Intercalate with DNA, complex with topoisomerase II/DNA, and generate free radicals from semiquinone

31
Q

ADE of doxorubicin?

A

Heart disease

32
Q

Adjuvant therapy of doxorubicin?

A

Dexroxazone

33
Q

VEGF blocker?

A

Bevaciuzmab

34
Q

MOA of bevacizumab?

A

Antibody that binds VEGF –> prevents angiogenesis for tumor growth

35
Q

ADE of bevacizumab?

A

Hemorrhage (esp with squamous NSCLC)

36
Q

TKI’s?

A

Erlotinib, Crizotinib

37
Q

MOA erlotinib?

A

EGFR inhibitor (and HER-1)

38
Q

ADE of erlotinib?

A

Interstitial lung disease, bleeding, BAD FACIAL RASH!

39
Q

MOA of crizotinib?

A

EML4-ALK inhibitor

40
Q

ADE of crizotinib?

A

GI, rash, edema

41
Q

How do you treat NSCLC?

A

First surgery then chemo- Cisplatin and Paclitaxel.. and maybe Erlotinib and maybe Bevacizumab

42
Q

How do you treat adenocarcinoma?

A

First surgery then chemo. Genetic testing is very important. Use Bevacizumab, Crizotinib, Erlotinib

43
Q

How to treat SCLC?

A

No surgery. Just chemo and radiation. Use Etoposide +cysplatin or carboplatin

44
Q

Is KRAS more common in smokers or non-smokers?

Parker: Pulmonary pharmacology (7 decks)

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