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Pharm week > Cancer Pharm > Flashcards

Cancer Pharm Flashcards

1
Q

What is the MOA of alkylating agents?

A

They form covalent linkages with DNA to prevent them from unwinding and replicating

non cycle specific

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2
Q

What is the acute toxicity associated with alkylating agents

A

nausea and vomiting within 30-60 mins

Pretreat with a serotonin antagonist

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3
Q

What are the delayed toxicities assoc with alkylating agents

A

bone marrow depression with leukopenia, thrombocytopenia, nephrotoxicity, alopecia, mycosal ulceration, intestinal denudation

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4
Q

What specific toxicity is associated with cyclophosphamide

A

hemorrhagic cystitis

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5
Q

What specific toxicity is associated with cisplatin

A

renal tubular damage, ototoxicity

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6
Q

What specific toxicity is associated with busulfan

A

pulmonary fibrosis

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7
Q

What are the main categories of antimetabolites

A 
folic acid analogs (methotrexate)
pyrimidine analogs (5FU)
Purine analogs (6-MP)
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8
Q

MOA of methotrexate

A

Methotrexate inhibits dihydrofolate reductase

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9
Q

What drug is used in conjunction with high-dose methotrexate therapy to rescue normal cells

A

leucovorin

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10
Q

MOA of 5-FU

A

pro-drug
FdUMP blocks synthesis of thymidylate
FdUTP gets incorporated into DNA and interferes with DNA synthesis and function
FUTP gets incorporated into RNA and interferes with RNA processing and mRNA translation

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11
Q

MOA of 6-MP

A

metabobolized by HGPRT to form monophosphate nucleotide 6-thioinosinic acid

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12
Q

Simultaneous administration of _____ and PO 6-MP results in increased levels of 6-MP and increased toxicity

A

allopurinol

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13
Q

Pharm effects of antimetabolites

A

S phase specific
relatively little acute toxicity after initial dose
Common toxicities include diarrhea, myelosuppression, nausea, vom, immunosuppression, thromobocytopenia, leukopenia, hepatotoxicity

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14
Q

MOA of vinca alkaloids (vinblastine and vincristine

A

bind to B-tubulin and inhibit microtubule assembly (depolarization)

M phase specific

common adverse effects include alopecia and bone marrow suppression

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15
Q

Vinblastine adverse effect

A

causes myelosuppression to a greater extent than vincristine

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16
Q

Vincristine adverse effect

A

cumulative neurological toxicities compared to vinblastine

17
Q

MOA of taxanes

A

bind to B-tubulin and stabilize microtubule formation
M phase specific

Paclitaxel is the only relevant one right now

18
Q

clinical relevance of paclitaxel

A

side effects: hypersensitivity rxns in hands and toes, change in taste

traditional treatment of breast cancer

19
Q

What do epipodophyllotoxins (etoposide) and anthracycline antibiotics (doxorubicine) inhibit?

A

topoisomerase II

20
Q

Effective antitumor antibiotic agents

A

anthracyclines
dactinomycin
bleomycin
mitomycin

21
Q

Pharmacology of anthracyclines (doxorubicine)

A

topoisomerase II inhibitor, DNA intercalation
cell cycle nonspecific
produce free radicals - leads to significant cardiotoxicity
cumulative cardiac damage can lead to dysrhythmias and heart failure

22
Q

pharmacology of bleomycin

A

single and double stranded DNA breaks
causes minimal myelosuppression- useful in combination
Can cause significant pulmonary toxicity and usually presents as pneumonitis with cough, dyspnea, dry inspiratory crackles

23
Q

Pharmacology of L-asparaginase

A

targeted therapy for ALL
ALL tumor cells lack the enzyme as

G1 specific

24
Q

MOA of L asparaginase

A

hydrolyzes circulating L asparagine into aspartic acid and ammonia, effectively inhibiting protein synthesis

25
Q

Toxicities of L asparaginase

A

Acute hypersensitivity rxn

delayed: increased risk of coughing and bleeding, pancreatitis, and CNS toxicity including lethargy, confusion, hallucinations, and coma

26
Q

Imatinib

A

small molecule inhibitor of the ABL tyrosine kinase

can also inhibit the RTKs PDGFR and KIT

27
Q

Rituximab

A

CD20 antigen

used to treat Non-Hodgkin’s lymphoma

28
Q

Which drugs are the most active cytotoxic agents to use for malignant melanoma

A

Dacarbazine and cisplatin

29
Q

Which drugs have been approved for unresectable or metastatic melanoma as monotherapy

A

Nivolumab and pembrolizumab

Pharm week (9 decks)

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