Cancer Drugs Flashcards
What are the important antimetabolites to know?
azathioprine/6-MP/6-TG Gladribine Cytarabine 5-FU Methotrexate
What are the important details to know about 6-MP/azathioprine?
purine analog
azathioprine->metabolized into 6-MP
S phase antimetabolite
**metabolized by xanthine oxidase, so can get toxicity w/ use of allopurinol or febuxostat
What is special about 6-thioguanine?
works the same as 6-MP but is NOT metabolized by xanthine oxidase.
Can take allopurinol at the same time.
What are the important things to know bout cladribine?
purine analog antimetabolite, S phase
used for hairy cell leukemia
What’s the deal with cytarabine?
pyrimidine analog
S phase antimetabolite
inhibits DNA pol
Which meds inhibit viral DNA Pol?
acyclovir, gangciclovir
Which meds inhibits DNA dep RNA pol?
RIfampin
What are the important things to know about 5-FU
pyrimidine analog S phase antimetabolite inhibits thymidylate synthase Good for: colon and pancreatic cancer. Basal cell carcinoma and actinic keratoses
Myelosuppression reversible w/ uridine
What are the important things to know about methotrexate?
folic acid analog inhibits dihydrofolate reductase inhibits pyrmidine synthesis antimetabolite S phase **use for cancer, ectopic pregnancy, inflammatory dx
Myelosuppression reversible w/ leucovorin
causes pulmonary fibrosis
teratogen-NTD
What are the anti tumor antibiotics?
bleomycin
dactinomycin
doxorubicin/daunorubicin
What are the important things to know about bleomycin?
causes free radical formation, break DNA
used to treat testicular cancer
can cause pulmonary fibrosis
minimal myelosuppression
What are the drugs used to treat testicular cancer?
bleomycin
etoposide
cisplatin
What are the important things to know about cisplatin?
intercalates w/ DNA
used in children’s cancers: wilms tumor, ewing sarcoma, rhabdomyosarcoma
What are the important things to know about doxorubicin and daunorubicin?
generate free radicals, intercalate w/ DNA
CARDIOTOXICITY (dilated cardiomyopathy) b/c heart lacks superoxide dismutase
Dexrazoxane can protect heart
What is the general MOA for alkylating agents?
attaches alkyl group to DNA, cross links DNA strands, can’t divide
What are the alkylating agents?
busulfan
cyclophosphamide, ifosfamide
Nitrosoureas: mustines
What are the important things to know about busulfan?
cross-links DNA
pulmonary fibrosis
What are the important things to know about cyclophosphamide?
cross links DNA at guanine
requires bioactivation by liver
used for cancer and as immunosuppression for lupus nephritis and polyarteritis nodosa
can cause hemorrhagic cystitis b/c of acrolein metabolite
Mesna is protective for this.
Increased risk for transitional cell carcinoma
**think toilet cycling water down.
What are the important things to know about ifosfamide?
same as cyclophosphamide except used for testicular cancer, not for immunosuppression
What are the important things to know about nitrosureas?
mustines. Put nitro in your mustang. Mustard gas affected CNS
crosses BBB–>CNS toxicity
good for brain tumors
What are the following things used to counteract? Dexvazoxane Leucovorin Mesna Uridine
Dexvazoxane: cardiotoxicity daunorubicin and doxorubicin
Leucovorin: methotrexate myelosuppression
Mesna: hemorrhagic cystitis from cyclophosphamide
Uridine: 5-FU myelosuppression. Forget you ursula!
What are all the drugs (not just cancer) that inhibit microtubules?
vincristine/vinblastine paclitaxel griseofulvin bendazoles colchicine
What are the cancer drugs that inhibit microtubules?
vincristine
vinblastine
paclitaxel
What are the important things to know about paclitaxel?
stabilize microtubules so that they can’t go to anaphase
“taxing to stay polymerized”
causes hypersensitivity and myelosuppresssion
What are the important things to know about vincristine/vinblastine?
vinca alkaloids
bind beta tubulin and inhibit polymerization of microtubules
M phase arrest
Vincristine–Hodgkin, Wilms, Ewing, Choriocarcinoma
Vincristine: neurotoxic, peripheral neuritis
Vinblastine: blasts the bone–myelosuppression
What are the important things to know about cisplatin and carboplatin?
cross-link DNA
Think platinum genitourinary.
Used for testicular, bladder, ovary cancers
Nephrotoxic! Also ototoxic
What are all the drugs that are nephrotoxic and ototoxic?
VALC vancomycin aminoglycosides loop diuretics cisplatin, carboplatin
What is important to know about etoposide and teniposide?
MOA: inhibits topoisomerase II
good for testicular, small cell lung, and prostate cancer
Which drugs are used to treat testicular cancer? The cocktail?
- Etoposide
- Bleomycin–>can be switched for ifosfamide if you are like Lance Armstrong and don’t want pulmonary fibrosis
- Cisplatin
Eradicate ball cancer
What is important to know about irinotecan, topotecan?
tropicana tiki bird–>topoisomerase I
Irinotecan-colon cancer
topotecan–ovarian, small cell lung, cervical
What is important to know about hydroxyurea?
inhibits ribonucleotide reductase
decreases DNA synthesis
used for cancer AND to increase HbF when you have sickle cell disease
What is important to know about prednisone used in cancer treatment?
inhibits apoptosis in neutrophils, but stimulates it in certain cells, like lymphatic vessels
used in lymphomas
What is important to know about Bevacizumab?
Beverly hills like veggies.
Inhibits VEGF and angiogenesis
used for metastatic cancers
But get increased bleeding and decreased wound healing
What is important to know about Erlotinib?
EGFR tyrosine kinase inhibitor
non small cell lung cancer
What is important to know about imatinib?
Imma eat some cream cheese.
tyrosine kinase inhibitor of BCR-ABL of philadelphia chromosome t(9;22)
CML treatment
What is important to know about Rituximab?
Ri2*Ximab=20
monoclonal antibody against CD20
B cell neoplasms
increases risk of progression to progressive multifocal encephalopathy
What is important to know about SERMs?
Tamoxifene, Raloxifene
antagonist to ER receptors in breast, agonists for ER receptors in bone. Help with osteoporosis.
Tamoxifene–partial agonist in endometrium, increased risk for endometrial cancer, but can also be used to treat it. Just used for breast cancer.
Raloxifene: RElax, no risk of endometrial cancer. Good for osteoporosis
WHat are the important things to know bout trastuzumab (perception)?
Trust her with your heart.
Her-2 monoclonal antibodies. Tyrosine kinase receptor.
good for gastric and breast cancer w/ Her-2
Cardiotoxic!
What are the important things to know about vemurafenib?
BRAF oncogene inhibitor
treats metastatic melanoma
What is important to remember about Romeo and Juliet?
Romeo-Paclitaxel, stabilizes microtubules to prevent Anaphase
hypersensitivity reactions.
Juliet–Vincristine, inhibits beta tubulin and microtubule synthesis
peripheral neuropathy–unfeeling woman
