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Heme > Cancer Pharm > Flashcards

Cancer Pharm Flashcards

1
Q

mechlorethamine - how is it broken down?

A

non-enzymatic hydrolysis

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2
Q

mechlorethamine SE

A

myelosupression = dose-limiting

high incidence of secondary cancers (leukemia, lymphoma, MDS)

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3
Q

mechlorethamine MOA

A

alkalating agent

damages DNA in 4 ways: cross-linking, abnormal pairing w/ T residues, ring cleavage, depurination

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4
Q

cyclophosphamide (MOA and PK)

A

alkalating agent

activated by CYP450

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5
Q

cyclophosphamide SE

A

hemorrhagic cystitis - b/c metabolite acrolein in urine

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6
Q

MESNA

A

used to tx hemorrhagic cystitis from cyclophosphamide

binds to and inactivates acrolein

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7
Q

cisplatin (MOA and indication)

A

bifunctional alkating agent

used widely for lung, breast, ovarian, head & neck cancers

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8
Q

cisplatin SE

A

renal insufficiency

neuropathy

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9
Q

ondansetron (zofran) MOA

A

blocks 5HT stem of vagal nerve (maybe CNS too) –> prevents nausea

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10
Q

aprepitant

A

neurokinin 1 agonist. blocks substance P binding –> antiemetic, can be combined w/ ondansetron

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11
Q

methotrexate MOA

A

analogue of folic acid, inhibits DHFR by competitive inhibition

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12
Q

methotrexate SEs

A

marrow suppression, GI tox, renal failure

prevent renal failure w/ alkalinized urine

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13
Q

what do you give concurrently w/ really high dose of MTX to prevent lethal side effects?

A

leucovorin rescue

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14
Q

5 Fluoroucil (MOA and indication)

A

inhibits thymidylate synthase by suicide mech

indications: breast and GI malignancy

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15
Q

leucovorin action w/ 5FU

A

potentiates action of 5FU

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16
Q

cytarbine (ara-C) MOA

A

drug taken into cell and metabolized –> converted into ara-CTP–> inhibits DNA polymerase alpha + some drug incorporated into DNA to slow chain elongation and inhibit ligation
S-phase specific action

17
Q

ara-C use

A

for AML and lymphoma

continuous IV in AML induction chemo w/ daunarubicin (7+3)

18
Q

7+3 regimen

A

AML tx: ara-C and daunarubicin

19
Q

HiDAC

A

high dose ara-c for 3 days

SE: acute severe cerebellar toxicity

20
Q

ara-C side effects

A

marrow aplasia, GI tox, alopecia

21
Q

antracycline antibiotics - names

A

doxorubin and daunorubicin

22
Q

anthracycline abx MOAs

A
  1. inhibitor of topoisomerase II –> ds DNA breaks throughout genome
  2. incorporated into DNA –> blocks replication and RNA synthesis
23
Q

major SE of anthracycline abx

A

cardiac toxicity: cumulative dose-dependant cardiomyopathy - <400mg/m2 limit
cardiomyopathy can be reversible

24
Q

epidophyllotoxins

A

etoposide, VP-16
come from may apple plant
topoisomerase II inhibitor –> ds DNA breaks

25
Q

topotecan/irinotecan

A

topoisomerase I inhibitor: ss DNA breaks –> activation of DNA damage dependant apoptosis pathway

26
Q

vinca alkaloids (MOA and metabolism)

A

vinblastine and vincristine
MOA: microtubule inhibitor –> blocks cell division and induces apoptosis
- both have hepatic metabolism

27
Q

vincristine use and SE

A

tox: neuropathy
uses: lymphoma, sarcoma, breast, lung, cerviz

28
Q

vinblastine use and SE

A

tox: bone marrow
uses: lymphoma, testicular cancer

29
Q

taxol

A

stabilizes microtubules –> prevents depolymerization and induces apoptosis

30
Q

thalidomide

A

immunomodulatory

for multiple myeloma

31
Q

lenalidomide (indications and SE)

A

immunomodulatory
even better for multiple myeloma
also mantle cell NHL and MDS
causes peripheral neuropathy

32
Q

hematopoietic growth factors in cancer

A

to tx anemia, granulocytopenia, thrombocytopenia

33
Q

SE of G-CSF and GM-CSF

A

mild: bone pain, fever, headache

34
Q

SE of EPO

A

none, but if hgb goes to high HTN and stroke

35
Q

before stating EPO

A

check epo levels - won’t help if pt already has normal response to anemia

36
Q

IL2

A

approved for renal cell carcinoma, also works for melanoma

stimulates anti-tumor immune response

37
Q

IFN

A

biologic response modulator

RCCa, NHL, melanoma, CML, MS

38
Q

rituxin

A

targeted mAb against CD20 on pre-B and B-lymphocyes

  1. Fc-mediated phagocytosis (attracts macrophages)
  2. complement-mediated cytotoxicity
  3. apoptosis induction
39
Q

5-azacytidine

A

DNA methylation –> induces cellular differentiation

reversible!

Heme (16 decks)

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