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Heme and Lymph > Chemo 3 and 4 > Flashcards

Chemo 3 and 4 Flashcards

1
Q

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

A
  • Vinca Alkaloids

- Taxanes

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2
Q

What are the 3 Vinca alkaloids

A
  • Vinblastine
  • Vincristine
  • Vinorelbine
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3
Q

What do vinca alkaloids inhibit

A

tubulin polymerization which blocks assembly of microtubules

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4
Q

What are the 2 Taxanes

A
  • Taxol (Paclitaxel)

- Taxotere (Docetaxel)

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5
Q

What do Taxanes do

A

enhance tubulin polymerization to stabilize microtubules

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6
Q

Therapeutic use of Vinblastin

A
  • testicular cancers (with bleomycin and cisplatin)
  • lymphomas
  • neuroblastoma
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7
Q

therapeutic use of vincristine

A
  • ALL
  • lymphoma
  • neuroblastoma
  • Wilms tumor
  • Ewings sarcoma
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8
Q

therapeutic use of vinorelbine

A

-Advanced NSCLC

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9
Q

in general what are Taxanes effective against

A

solid tumors

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10
Q

therapeutic use of Paclitaxel?

Docetaxel?

A
  • advanced breast and ovarian cancer

- advanced breast and ovarian recurrence

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11
Q

What vinca alkaloid causes peripheral neuropathy

A

Vincristine

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12
Q

What cell cycle phase do Vinca Alkaloids and Taxanes affect

A

M-phase

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13
Q

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

A

Vinblastine

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14
Q

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

A

P-glycoprotein

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15
Q

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

A
  • the exterior cell surface

- monoclonal antibodies

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16
Q

What are the 2 classes of topoisomerase inhibitors?

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

A
  • Epipodophyllotoxins (topoisomerase II . . double strand)

- Camptothecins (top. I . . single strand)

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17
Q

What are the 2 Epipodophyllotoxins?

A
  • Etoposide

- Teniposide

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18
Q

What are the 2 Camptothecins?

A
  • Irinotecan (active metabolite SN38)

- Topotecan

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19
Q

Therapeutic use of Etoposide

A
  • Oat cell carcinoma of Lung

- Testicular cancer (with cisplatin and bleomycin)

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20
Q

Therapeutic use of Teniposide

A

-Glioma and neuroblastoma

21
Q

Therapeutic use of irinotecan

A

-metastatic colorectal cancer

22
Q

therapeutic use of Topotecan

A

-2nd line after failed drugs

23
Q

How are Etoposide and Teniposide metabolized

A

CYP450 . .Liver

24
Q

How are Irinotecan and Topotecan metabolized

A

Renal clearance

25
Q

what is the dose limiting toxicity of Irinotecan

A

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

26
Q

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

A
  • Mixed

- S phase

27
Q

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

A
  • Antibiotics

- Anthracyclines

28
Q

What are the 2 antibiotics used?

A
  • Bleomycin

- Dactinomycin

29
Q

What are the Anthracyclines?

A
  • Doxorubicin
  • Daunorubicin
  • Epirubicin
  • Idarubicin
  • MItoxantrone
30
Q

What does Bleomycin do

A

Fe mediated free radical generation which breaks DNA

31
Q

What does Dactinomycin do

A

DNA intercalating

32
Q

What do Doxorubicin, Daunorubicin, Epirubicin, and Idarubicin do

A

intercalating agents

33
Q

What does Mitoxantrone do

A

inhibits topoisomerase II

34
Q

Therapeutic use of Bleomycin

A

Testicular cancer

35
Q

Therapeutic use of Doxorubicin and Epirubicin

A

-Wide spectrum . . Breast and ovarian

36
Q

Therapeutic use of Mitoxantrone

A

Breast

37
Q

dose limiting toxicity of Bleomycin

A

pulmonary fibrosis

38
Q

dose limiting toxicity of Anthracyclines

A

Cardiotoxicity, dilated cardiomyopathy, congestive heart failure

39
Q

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

A

Trastuzumab

40
Q

Why does Bleomycin cause skin and lung damage?

A

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

41
Q

Does Bleomycin cause significant myelosuppression?

A

No

42
Q

What phase of the cell cycle does Bleomycin affect

A

G2 phase

43
Q

What phase of the cell cycle do Anthracyclines affect?

A

S and G2

44
Q

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

A
  • Adriamycin (Doxorubicin): Cardiotoxic
  • Bleomycin: pulmonary fibrosis
  • Vinblastine: peripheral neuropathy
  • Dacarbazine: Nausea/vomiting, myelosuppression
45
Q

Name the drugs and toxicities in the CHOP regimen for NHL

A
  • Cyclophosphamide: hemorrhagic cystitis
  • Hydroxy-daunorubicin (doxorubicin): cardiotoxicity
  • Oncovin (Vincristine): peripheral neuropathy
  • Prednisone: hyperglycemia, osteopenia
46
Q

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

A
  • 6-Mercaptopurine
  • Azothioprine
  • Theophylline
47
Q

What drug is given with drugs that cause tumor lysis syndrome

A

Allopurinol

48
Q

What are the results from Tumor lysis syndrome

A
  • Hyperkalemia
  • Hyperphosphatemia
  • HYPERURICEMIA: crystals and Acute renal failure

Heme and Lymph (27 decks)

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