Chemo Agents

Question 1

METHOTREXATE

1. Indications
2. MOA
3. SEs and contraindications
4. Other

Answer 1

1. Immunosuppressant and sometimes anti-inflammatory
2. Inhibits dihydrofolate reductase which inhibits DNA synthesis
3. Hepatotoxicity
   Myelosuppression, which increases risk of opportunistic infections and lymphoma

Question 2

CYCLOSPORINE (Restasis)

1. Indications
2. MOA
3. SEs and contraindications
4. Other

Answer 2

1. Restasis: improves dry eye
2. Inhibits release and production of interleukin-2 (responsible for T-lymphocyte activation) which prevents rejections of organ transplants
3. Opportunistic infections
   HTN
   Kidney dysfunction
4. Responsible for RPLS (reversible posterior leukoencephalopathy syndrome)

Question 3

AZATHIOPRINE

1. Indications
2. MOA
3. SEs and contraindications
4. Other

Answer 3

1. RA
   Prevent rejection of kidney transplants
   Ocular myasthenia (rare)
2. Purine analog that inserts into DNA and RNA and stops replication
3. N/A

Question 4

TAMOXIFEN

1. Indications
2. MOA
3. SEs and contraindications
4. Other

Answer 4

1. Breast cancer
2. Partial agonist inhibitor of estradiol (estrogen antagonist)
3. Crystalline retinopathy
   Whorl keratopathy
   Thromboembolism (BRVO, CRVO)
   Fatty liver
   Hot flashes
   Increases risk of uterine cancer
4. Whorl can occur with or without crystalline retinopathy