Chemo Agents part 1 Flashcards
what is the MOA for alkyating agents?
- all are prodrugs with carbon
they will go into their attakc phase, and will place an alkyl group on the DNA –> will go crazy
what group is cyclophosphomide, ifosfomide part of?
alyklating groups
= nitrogen mustard
what group is melphalan part of?
nitrogen mustards
what group is chlorambucil part of?
nitrogen mustard
what group is bendamustine part of?
nitrogen mustard
what are the two types of cyclophosphamide drugs?
- hydroxycyclophosphamide and aldophosphamide
between hydroxyphosphoamide and aldophosphamide, which one makes TOXIC metabolices?
aldophosphamide
what happens when normal cell vs cancer cells take up aldophosphamide ?
normal cells –> takes up aldophosphade and will attack it using gluthaionne and aldehyde dehydrogenase to kill it
cancer cells cannot make glutathione so the toxic metabolite builds up and kills the cell ?
whats the diff between ifosfamide and cyclophosfamide? what are they metabolized by?
ifosfamide NEEDS HIGHER DOSEAGE TO GET 2 LOG KILL –> but has more toxicity like neuro issues
metabolized by 3A4 - ifosfamide
2B - cyclophosamide
what FAMOUS PLACE will alkylating agent attack? and what are the others?
FAMOUS - N7 OF GUANINE
others:
N1 + N3 of adenine ring, N3 cytosine, O6 guinaine, amino/sulfhydryl
what does CHOP stand for?
cylcophosphamide, hydroxy-daunorubicin, oncovin, predisone
what does AC-T regime stand for?
adriamycin, cyclophosmaide, paclitaxel
what are the indications for cyclophospamides?
NHL, breast + ovarian cancer, immune dz like RA, nephrotic syndrome, wegener syndrome
what type of try is altretamine and thiotepa?
ethyleneimines - aklylating agent
what type of drug is busulfan?
alkyl sulfonate - aklylating agent
what type of drug is carmustine
nitrosoureas - aklylating agent
what type of drug is streptozocin?
nitrosoureas - aklylating agent
what type of drug is dacarbazine
triazene - aklylating agent
what type of drug is temozolomide
triazene - aklylating agent
what type of drug is procarbazine
triazene - aklylating agent
what are bulsufan worst S/E?
myleosupression, seizures, neurotocitiy
which aklying agent can casue renal failure?
ifosfamide + nitrosoureas such as ( Carmustine, Streptozocin)
which agent casues pulmoanry fiborsis?
bleomycin!!!
which drug class can casue permannt reproductive ammenorhea and azospermia?
cyclophosphamide
what substance from cylcophosmaide runs the bladder lining?
acrolein which can cause hematuria
which drugs casues hemorrhaigc cystitis?
cyclophosphamide and ifosfamide
how do you prevent hemorragic cystitis?
MENSA DRUG - it will find an acrolein and will pikc it up, neutrailzie it and will EXCRETE IT NORMALLY IN PEE
but to prevent the buildup of aroclien (if your on cylcophosphamide) you need to drink ODE water but be carefull bc it may inc ADH levels
what are the four drugs that are part of the dacarbazine group? what the MOA of dacarbazine?
ABVD - adriamycin, bleomycin, vinblastine, darcabazine!
methylating agent will put methyl group on GUAININE AGENTS
what are the nitrosoureas and which postion does it love?
it loves the O6 guanine postions
1. Carmustine
2. Streptozocin
which drug can penetrate into BBB so its good for brain tumors?
carmustine - type of nitrosoureas (alkating agent)
which drug would you give to someone with insulinoma?
give streptozocin b/c beta cells love to take up streptozocin since it has a glucose component in it
streptozoin - nitrosoureas - alkating agents
who discovered cisplatin what does it tx?
Barnet Rosenburg - testicular cancer
whats the MOA of cisplastin?
the cell has Cu transporter and will take up cisplatin –> transport will degrade and cisplastin is TRAPPED
in the cell, the Chlorine moleule will turn into H20 and the aquated Pt is highly reactive and will destroy the DNA
it also LOVES THE N7 GUANINE POSTION
what can cisplastin tx?
testicular cancer, ovarian ca, lung ca
other like cervical,endometrial,bladder,anal,rectal, head/neck
what drug or drugS can you give for testicular ca?
testicular ca - bleomycin, etoposide, ifosfamide, OR vinblastine
what drugs can you give to ovarian ca?
cisplastin + paclitaxel
what drugs can you give to adenocarinoma lungs and small cell lung ca?
adenocarinoma - _ with cisplastin
small cell - etoposide w cisplastin
which drugs can result in nephrotixciity and LOW mg?
cisplastin
which drug can results into ototoxicity?
cisplastin
what is carboplatin? whats the s/e
its similiar to cisplatin but NOT AS BAD OF nausea, ototoxicity, neurotocitiy, nephorticity
cisplastin is much worse !
but it has HIGHER myleosupression, thrombocytopenia
what is oxaliplatin?
similiar to cisplatin but it SUPRESSES THYMIDYLATE SYNTHASE
which drug supreses thymyidlate synthase?
oxaliplatin
what is the spectrum and combo therpahy for colorectal and gastric cancer ?
FOLFOX - follinic acid, 5FU, oxaliplatin
colorectal, gastric cancer