Chemo Agents part 1

Question 1

what is the MOA for alkyating agents?

Answer 1

• all are prodrugs with carbon
  they will go into their attakc phase, and will place an alkyl group on the DNA –> will go crazy

Question 2

what group is cyclophosphomide, ifosfomide part of?

Answer 2

alyklating groups
= nitrogen mustard

Question 3

what group is melphalan part of?

Answer 3

nitrogen mustards

Question 4

what group is chlorambucil part of?

Answer 4

nitrogen mustard

Question 5

what group is bendamustine part of?

Answer 5

nitrogen mustard

Question 6

what are the two types of cyclophosphamide drugs?

Answer 6

1. hydroxycyclophosphamide and aldophosphamide

Question 7

between hydroxyphosphoamide and aldophosphamide, which one makes TOXIC metabolices?

Answer 7

aldophosphamide

Question 8

what happens when normal cell vs cancer cells take up aldophosphamide ?

Answer 8

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 ?

Question 9

whats the diff between ifosfamide and cyclophosfamide? what are they metabolized by?

Answer 9

ifosfamide NEEDS HIGHER DOSEAGE TO GET 2 LOG KILL –> but has more toxicity like neuro issues

metabolized by 3A4 - ifosfamide
2B - cyclophosamide

Question 10

what FAMOUS PLACE will alkylating agent attack? and what are the others?

Answer 10

FAMOUS - N7 OF GUANINE
others:
N1 + N3 of adenine ring, N3 cytosine, O6 guinaine, amino/sulfhydryl

Question 11

what does CHOP stand for?

Answer 11

cylcophosphamide, hydroxy-daunorubicin, oncovin, predisone

Question 12

what does AC-T regime stand for?

Answer 12

adriamycin, cyclophosmaide, paclitaxel

Question 13

what are the indications for cyclophospamides?

Answer 13

NHL, breast + ovarian cancer, immune dz like RA, nephrotic syndrome, wegener syndrome

Question 14

what type of try is altretamine and thiotepa?

Answer 14

ethyleneimines - aklylating agent

Question 15

what type of drug is busulfan?

Answer 15

alkyl sulfonate - aklylating agent

Question 16

what type of drug is carmustine

Answer 16

nitrosoureas - aklylating agent

Question 17

what type of drug is streptozocin?

Answer 17

nitrosoureas - aklylating agent

Question 18

what type of drug is dacarbazine

Answer 18

triazene - aklylating agent

Question 19

what type of drug is temozolomide

Answer 19

triazene - aklylating agent

Question 20

what type of drug is procarbazine

Answer 20

triazene - aklylating agent

Question 21

what are bulsufan worst S/E?

Answer 21

myleosupression, seizures, neurotocitiy

Question 22

which aklying agent can casue renal failure?

Answer 22

ifosfamide + nitrosoureas such as ( Carmustine, Streptozocin)

Question 23

which agent casues pulmoanry fiborsis?

Answer 23

bleomycin!!!

Question 24

which drug class can casue permannt reproductive ammenorhea and azospermia?

Answer 24

cyclophosphamide

Question 25

what substance from cylcophosmaide runs the bladder lining?

Answer 25

acrolein which can cause hematuria

Question 26

which drugs casues hemorrhaigc cystitis?

Answer 26

cyclophosphamide and ifosfamide

Question 27

how do you prevent hemorragic cystitis?

Answer 27

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

Question 28

what are the four drugs that are part of the dacarbazine group? what the MOA of dacarbazine?

Answer 28

ABVD - adriamycin, bleomycin, vinblastine, darcabazine!

methylating agent will put methyl group on GUAININE AGENTS

Question 29

what are the nitrosoureas and which postion does it love?

Answer 29

it loves the O6 guanine postions
1. Carmustine
2. Streptozocin

Question 30

which drug can penetrate into BBB so its good for brain tumors?

Answer 30

carmustine - type of nitrosoureas (alkating agent)

Question 31

which drug would you give to someone with insulinoma?

Answer 31

give streptozocin b/c beta cells love to take up streptozocin since it has a glucose component in it

streptozoin - nitrosoureas - alkating agents

Question 32

who discovered cisplatin what does it tx?

Answer 32

Barnet Rosenburg - testicular cancer

Question 33

whats the MOA of cisplastin?

Answer 33

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

Question 34

what can cisplastin tx?

Answer 34

testicular cancer, ovarian ca, lung ca
other like cervical,endometrial,bladder,anal,rectal, head/neck

Question 35

what drug or drugS can you give for testicular ca?

Answer 35

testicular ca - bleomycin, etoposide, ifosfamide, OR vinblastine

Question 36

what drugs can you give to ovarian ca?

Answer 36

cisplastin + paclitaxel

Question 37

what drugs can you give to adenocarinoma lungs and small cell lung ca?

Answer 37

adenocarinoma - _ with cisplastin
small cell - etoposide w cisplastin

Question 38

which drugs can result in nephrotixciity and LOW mg?

Answer 38

cisplastin

Question 39

which drug can results into ototoxicity?

Answer 39

cisplastin

Question 40

what is carboplatin? whats the s/e

Answer 40

its similiar to cisplatin but NOT AS BAD OF nausea, ototoxicity, neurotocitiy, nephorticity

cisplastin is much worse !

but it has HIGHER myleosupression, thrombocytopenia

Question 41

what is oxaliplatin?

Answer 41

similiar to cisplatin but it SUPRESSES THYMIDYLATE SYNTHASE

Question 42

which drug supreses thymyidlate synthase?

Answer 42

oxaliplatin

Question 43

what is the spectrum and combo therpahy for colorectal and gastric cancer ?

Answer 43

FOLFOX - follinic acid, 5FU, oxaliplatin
colorectal, gastric cancer