Cancer Drugs Flashcards by michelle granstrom

What are the important antimetabolites to know?

azathioprine/6-MP/6-TG
Gladribine
Cytarabine
5-FU
Methotrexate

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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

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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.

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What are the important things to know bout cladribine?

purine analog antimetabolite, S phase

used for hairy cell leukemia

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What’s the deal with cytarabine?

pyrimidine analog
S phase antimetabolite
inhibits DNA pol

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Which meds inhibit viral DNA Pol?

acyclovir, gangciclovir

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Which meds inhibits DNA dep RNA pol?

RIfampin

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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

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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

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What are the anti tumor antibiotics?

bleomycin
dactinomycin
doxorubicin/daunorubicin

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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

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What are the drugs used to treat testicular cancer?

bleomycin
etoposide
cisplatin

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What are the important things to know about cisplatin?

intercalates w/ DNA

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

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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

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What is the general MOA for alkylating agents?

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

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What are the alkylating agents?

busulfan
cyclophosphamide, ifosfamide
Nitrosoureas: mustines

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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?

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

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