Chemo 3 and 4

Question 1

What are the 3 classes of antimitotic (spindle poisons) drugs

Answer 1

• Vinca Alkaloids

- Taxanes

Question 2

What are the 3 Vinca alkaloids

Answer 2

• Vinblastine
• Vincristine
• Vinorelbine

Question 3

What do vinca alkaloids inhibit

Answer 3

tubulin polymerization which blocks assembly of microtubules

Question 4

What are the 2 Taxanes

Answer 4

• Taxol (Paclitaxel)

- Taxotere (Docetaxel)

Question 5

What do Taxanes do

Answer 5

enhance tubulin polymerization to stabilize microtubules

Question 6

Therapeutic use of Vinblastin

Answer 6

• testicular cancers (with bleomycin and cisplatin)
• lymphomas
• neuroblastoma

Question 7

therapeutic use of vincristine

Answer 7

• ALL
• lymphoma
• neuroblastoma
• Wilms tumor
• Ewings sarcoma

Question 8

therapeutic use of vinorelbine

Answer 8

-Advanced NSCLC

Question 9

in general what are Taxanes effective against

Answer 9

solid tumors

Question 10

therapeutic use of Paclitaxel?

Docetaxel?

Answer 10

• advanced breast and ovarian cancer

- advanced breast and ovarian recurrence

Question 11

What vinca alkaloid causes peripheral neuropathy

Answer 11

Vincristine

Question 12

What cell cycle phase do Vinca Alkaloids and Taxanes affect

Answer 12

M-phase

Question 13

If you give Vincristine and neuropathy is severe, what should you replace it with

Answer 13

Vinblastine

Question 14

Treatment with Vinca and Taxane drugs commonly leads to multi drug resistance due to increased expression of what?

Answer 14

P-glycoprotein

Question 15

Cancer drugs with mechanisms that involve what are NOT prone to P-glycoprotein multi-drug resistance?
What are the important drugs in this category?

Answer 15

• the exterior cell surface

- monoclonal antibodies

Question 16

What are the 2 classes of topoisomerase inhibitors?

tell which topoisomerase they inhibit ans what kind of breaks they cause

Answer 16

• Epipodophyllotoxins (topoisomerase II . . double strand)

- Camptothecins (top. I . . single strand)

Question 17

What are the 2 Epipodophyllotoxins?

Answer 17

• Etoposide

- Teniposide

Question 18

What are the 2 Camptothecins?

Answer 18

• Irinotecan (active metabolite SN38)

- Topotecan

Question 19

Therapeutic use of Etoposide

Answer 19

• Oat cell carcinoma of Lung

- Testicular cancer (with cisplatin and bleomycin)

Question 20

Therapeutic use of Teniposide

Answer 20

-Glioma and neuroblastoma

Question 21

Therapeutic use of irinotecan

Answer 21

-metastatic colorectal cancer

Question 22

therapeutic use of Topotecan

Answer 22

-2nd line after failed drugs

Question 23

How are Etoposide and Teniposide metabolized

Answer 23

CYP450 . .Liver

Question 24

How are Irinotecan and Topotecan metabolized

Answer 24

Renal clearance

Question 25

what is the dose limiting toxicity of Irinotecan

Answer 25

-Severe Diarrhea (may be life threatening and require treatment with loperamide)

Question 26

What phase of the cell cycle to topoisomerase II inhibitors affect? topoisomerase I?

Answer 26

- Mixed | - S phase

Question 27

What are the 2 classes of drugs that cause DNA intercalation and Oxidative Scission

Answer 27

- Antibiotics | - Anthracyclines

Question 28

What are the 2 antibiotics used?

Answer 28

- Bleomycin | - Dactinomycin

Question 29

What are the Anthracyclines?

Answer 29

- Doxorubicin - Daunorubicin - Epirubicin - Idarubicin - MItoxantrone

Question 30

What does Bleomycin do

Answer 30

Fe mediated free radical generation which breaks DNA

Question 31

What does Dactinomycin do

Answer 31

DNA intercalating

Question 32

What do Doxorubicin, Daunorubicin, Epirubicin, and Idarubicin do

Answer 32

intercalating agents

Question 33

What does Mitoxantrone do

Answer 33

inhibits topoisomerase II

Question 34

Therapeutic use of Bleomycin

Answer 34

Testicular cancer

Question 35

Therapeutic use of Doxorubicin and Epirubicin

Answer 35

-Wide spectrum . . Breast and ovarian

Question 36

Therapeutic use of Mitoxantrone

Answer 36

Breast

Question 37

dose limiting toxicity of Bleomycin

Answer 37

pulmonary fibrosis

Question 38

dose limiting toxicity of Anthracyclines

Answer 38

Cardiotoxicity, dilated cardiomyopathy, congestive heart failure

Question 39

Co treatment with what other cardiotoxic agent is a risk factor for Anthracyclin Cardiotoxicity

Answer 39

Trastuzumab

Question 40

Why does Bleomycin cause skin and lung damage?

Answer 40

those tissues do not have the enzyme hydrolase required to metabolize it

Question 41

Does Bleomycin cause significant myelosuppression?

Answer 41

No

Question 42

What phase of the cell cycle does Bleomycin affect

Answer 42

G2 phase

Question 43

What phase of the cell cycle do Anthracyclines affect?

Answer 43

S and G2

Question 44

name the drugs and the toxicities in the ABVD regimen for Hodgkin's lymphoma

Answer 44

- Adriamycin (Doxorubicin): Cardiotoxic - Bleomycin: pulmonary fibrosis - Vinblastine: peripheral neuropathy - Dacarbazine: Nausea/vomiting, myelosuppression

Question 45

Name the drugs and toxicities in the CHOP regimen for NHL

Answer 45

- Cyclophosphamide: hemorrhagic cystitis - Hydroxy-daunorubicin (doxorubicin): cardiotoxicity - Oncovin (Vincristine): peripheral neuropathy - Prednisone: hyperglycemia, osteopenia

Question 46

What are the Xanthine drugs that can have over exposure when given with gout medications Allopurinol and Febuxostat?

Answer 46

- 6-Mercaptopurine - Azothioprine - Theophylline

Question 47

What drug is given with drugs that cause tumor lysis syndrome

Answer 47

Allopurinol

Question 48

What are the results from Tumor lysis syndrome

Answer 48

- Hyperkalemia - Hyperphosphatemia - HYPERURICEMIA: crystals and Acute renal failure