Cancer Drugs Flashcards

1
Q

What are the important antimetabolites to know?

A
azathioprine/6-MP/6-TG
Gladribine
Cytarabine
5-FU
Methotrexate
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2
Q

What are the important details to know about 6-MP/azathioprine?

A

purine analog
azathioprine->metabolized into 6-MP
S phase antimetabolite
**metabolized by xanthine oxidase, so can get toxicity w/ use of allopurinol or febuxostat

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3
Q

What is special about 6-thioguanine?

A

works the same as 6-MP but is NOT metabolized by xanthine oxidase.
Can take allopurinol at the same time.

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4
Q

What are the important things to know bout cladribine?

A

purine analog antimetabolite, S phase

used for hairy cell leukemia

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5
Q

What’s the deal with cytarabine?

A

pyrimidine analog
S phase antimetabolite
inhibits DNA pol

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6
Q

Which meds inhibit viral DNA Pol?

A

acyclovir, gangciclovir

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7
Q

Which meds inhibits DNA dep RNA pol?

A

RIfampin

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8
Q

What are the important things to know about 5-FU

A
pyrimidine analog
S phase antimetabolite
inhibits thymidylate synthase
Good for: colon and pancreatic cancer.
Basal cell carcinoma and actinic keratoses

Myelosuppression reversible w/ uridine

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9
Q

What are the important things to know about methotrexate?

A
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

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10
Q

What are the anti tumor antibiotics?

A

bleomycin
dactinomycin
doxorubicin/daunorubicin

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11
Q

What are the important things to know about bleomycin?

A

causes free radical formation, break DNA
used to treat testicular cancer
can cause pulmonary fibrosis
minimal myelosuppression

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12
Q

What are the drugs used to treat testicular cancer?

A

bleomycin
etoposide
cisplatin

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13
Q

What are the important things to know about cisplatin?

A

intercalates w/ DNA

used in children’s cancers: wilms tumor, ewing sarcoma, rhabdomyosarcoma

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14
Q

What are the important things to know about doxorubicin and daunorubicin?

A

generate free radicals, intercalate w/ DNA
CARDIOTOXICITY (dilated cardiomyopathy) b/c heart lacks superoxide dismutase

Dexrazoxane can protect heart

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15
Q

What is the general MOA for alkylating agents?

A

attaches alkyl group to DNA, cross links DNA strands, can’t divide

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16
Q

What are the alkylating agents?

A

busulfan
cyclophosphamide, ifosfamide
Nitrosoureas: mustines

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17
Q

What are the important things to know about busulfan?

A

cross-links DNA

pulmonary fibrosis

18
Q

What are the important things to know about cyclophosphamide?

A

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.

19
Q

What are the important things to know about ifosfamide?

A

same as cyclophosphamide except used for testicular cancer, not for immunosuppression

20
Q

What are the important things to know about nitrosureas?

A

mustines. Put nitro in your mustang. Mustard gas affected CNS
crosses BBB–>CNS toxicity
good for brain tumors

21
Q
What are the following things used to counteract? 
Dexvazoxane
Leucovorin
Mesna
Uridine
A

Dexvazoxane: cardiotoxicity daunorubicin and doxorubicin
Leucovorin: methotrexate myelosuppression
Mesna: hemorrhagic cystitis from cyclophosphamide
Uridine: 5-FU myelosuppression. Forget you ursula!

22
Q

What are all the drugs (not just cancer) that inhibit microtubules?

A
vincristine/vinblastine
paclitaxel
griseofulvin
bendazoles
colchicine
23
Q

What are the cancer drugs that inhibit microtubules?

A

vincristine
vinblastine
paclitaxel

24
Q

What are the important things to know about paclitaxel?

A

stabilize microtubules so that they can’t go to anaphase
“taxing to stay polymerized”
causes hypersensitivity and myelosuppresssion

25
Q

What are the important things to know about vincristine/vinblastine?

A

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

26
Q

What are the important things to know about cisplatin and carboplatin?

A

cross-link DNA
Think platinum genitourinary.
Used for testicular, bladder, ovary cancers

Nephrotoxic! Also ototoxic

27
Q

What are all the drugs that are nephrotoxic and ototoxic?

A
VALC
vancomycin
aminoglycosides
loop diuretics
cisplatin, carboplatin
28
Q

What is important to know about etoposide and teniposide?

A

MOA: inhibits topoisomerase II

good for testicular, small cell lung, and prostate cancer

29
Q

Which drugs are used to treat testicular cancer? The cocktail?

A
  1. Etoposide
  2. Bleomycin–>can be switched for ifosfamide if you are like Lance Armstrong and don’t want pulmonary fibrosis
  3. Cisplatin
    Eradicate ball cancer
30
Q

What is important to know about irinotecan, topotecan?

A

tropicana tiki bird–>topoisomerase I
Irinotecan-colon cancer
topotecan–ovarian, small cell lung, cervical

31
Q

What is important to know about hydroxyurea?

A

inhibits ribonucleotide reductase
decreases DNA synthesis
used for cancer AND to increase HbF when you have sickle cell disease

32
Q

What is important to know about prednisone used in cancer treatment?

A

inhibits apoptosis in neutrophils, but stimulates it in certain cells, like lymphatic vessels
used in lymphomas

33
Q

What is important to know about Bevacizumab?

A

Beverly hills like veggies.
Inhibits VEGF and angiogenesis
used for metastatic cancers
But get increased bleeding and decreased wound healing

34
Q

What is important to know about Erlotinib?

A

EGFR tyrosine kinase inhibitor

non small cell lung cancer

35
Q

What is important to know about imatinib?

A

Imma eat some cream cheese.
tyrosine kinase inhibitor of BCR-ABL of philadelphia chromosome t(9;22)
CML treatment

36
Q

What is important to know about Rituximab?

A

Ri2*Ximab=20
monoclonal antibody against CD20
B cell neoplasms
increases risk of progression to progressive multifocal encephalopathy

37
Q

What is important to know about SERMs?

A

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

38
Q

WHat are the important things to know bout trastuzumab (perception)?

A

Trust her with your heart.
Her-2 monoclonal antibodies. Tyrosine kinase receptor.
good for gastric and breast cancer w/ Her-2
Cardiotoxic!

39
Q

What are the important things to know about vemurafenib?

A

BRAF oncogene inhibitor

treats metastatic melanoma

40
Q

What is important to remember about Romeo and Juliet?

A

Romeo-Paclitaxel, stabilizes microtubules to prevent Anaphase
hypersensitivity reactions.

Juliet–Vincristine, inhibits beta tubulin and microtubule synthesis
peripheral neuropathy–unfeeling woman