Cancer treatment

Question 1

Cyclophosphamide (Cytoxan) dosage, SE (2)

Answer 1

can be taken orally

hemorrhagic cystitis (hydrate aggressively)
inappropriate ADH secretion

Question 2

Cyclophosphamide cautions (2)

Answer 2

interactions w/ cytochrome P-450

hydrate aggressively- risk of hemorrhagic cystitis

Question 3

Cisplatin (Platinol) MOA, use, toxicities (3)

Answer 3

crosslinks DNA, sensitizes cells to radiation
solid tumors
renal toxicity
acoustic nerve damage**
anaphylaxis

Question 4

Nitrosourea drug class MOA

Answer 4

inhibit DNA/RNA synthesis
kills in all phases

(Carmustine, Lomustine)

Question 5

Carmustine (BCNV) and Lomustine (CCNU) use (3), SE

Answer 5

highly lipid soluble- brain tumors, oral CA, GI

delayed profound myelosuppression

Question 6

MTX MOA, SE (2)

Answer 6

inhibits dihydrofolate reductase

precipitates in renal tubules
hepatotoxicity

Question 7

resistance to MTX?

Answer 7

due to decreased uptake or increased amount of dihydrofolate reductase

Question 8

6-mercaptopurine (Purinethol) MOA, big drug interaction

Answer 8

metabolized by xanthine oxidase

allopurinol increases toxicity

Question 9

6-mercaptopurine (Purinethol) use, SE (2)

Answer 9

leukemias

bone marrow depression
jaundice

Question 10

5-fluorouracil (5-FU, Adrucil) MOA (2), use (2)

Answer 10

inhibits thymidylate synthase
blocks DNA synthesis

solid tumors (broad spectrum)
topical for basal cell carcinoma

Question 11

Doxorubicin (Adriamycin) MOA

Answer 11

intercalates into DNA –> free radicals

Question 12

Doxorubicin (Adriamycin) caution, SE (2)

Answer 12

effect incr. by iron - use a chelator to decr. toxicity

cardiotoxic
urine turns red

Question 13

Bleomycin (Blenoxane) MOA (2), dosage (2)

Answer 13

directly damages DNA
cell cycle specific

oral or into bladder
good for combo use due to small myelosuppressive effect

Question 14

Bleomycin (Blenoxane) SE (3)

Answer 14

little myelosuppression (good for combo use)
pulmonary fibrosis
anaphylactoid sx

Question 15

Vincristine SE (2)

Answer 15

neurotoxicity

low myelosuppression

Question 16

Vinblastine SE (2)

Answer 16

more myelosuppression

less neurotoxicity

Question 17

Paclitaxel (Taxol) SE (5)

Answer 17

quite toxic
myelosuppression
peripheral neuropathy
arthalgias/myalgias
hypersensitivity

Question 18

Imatinib (Gleevec) contraindication

Answer 18

avoid if recently vaccinated for polio

Question 19

Imatinib (Gleevec) MOA, SE

Answer 19

BCR-ABL inhibitor, used for CML

well tolerated: N/V, fluid retention

Question 20

EGF inhibitors (3)

Answer 20

Cetuximab
Erlotinib
Bevacizumab

Question 21

Bevacizumab SE (2)

Answer 21

bleeding

thromboembolism

Question 22

Bevacizumab MOA & use (2)

Answer 22

angiogenesis inhibitor
inhibits VEGF

many solid tumors
injected in eye for macular degeneration

Question 23

Mechlorethamine (Mustargen) use, SE (3)

Answer 23

Hodgkin’s disease

vesicant- tissue damage at injection site
hyperuricemia
renal damage