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Heme Onc > Chemo Drugs > Flashcards

Chemo Drugs Flashcards

1
Q

Cisplatin

A

Platinum complexes
MOA: antineoplasm: Crosslink between and within DNA –> Apoptosis
AE: highly emetogenic, n/v, nephrotoxicity: tubular, electrolytes: hypocalcium/magnesium/potassium, peripheral neuropathy, ototoxicity

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2
Q

Etoposide

A

Topo II Inh.
MOA: Forms a complex with DNA and Topo II–> prevents religation of DNA breaks which occur when coils unwind–> apoptosis
AE: n/v, myelosuppression, alopecia

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3
Q

Bleomycin

A

Abx antineoplastic
MOA: Induction of DNA breaks
AE: pulmonary fibrosis, may cause oxygen toxicity, be careful with people going to get general anesthesia b/c it may cause acute pulmonary toxicity

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4
Q

Cyclophosphamide

A

Alkylating agent: cross-links DNA and prevents uncoiling or prevents gene transcription.
AE: n/v, alopecia, myelosuppression, hemorrhagic cystitis (exretion of acrolein through bladder)

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5
Q

Anti- metabolites

A

Mtx, cytosine arabinoside, 5-FU, fludarrabine, gemcitabine
MOA: interferes with nucleic acid synthesis by incorporating into RNA or DNA or by interefering with enzymes required for synthesis

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6
Q

5-FU (5-Fluorouracil)

A

Antimet.
MOA: prevents uracil turning into thymine and inhibits DNA syn., also inhibits RNA synthesis
AE: stomatitis, sometimes with ulceration, n/v, diarrhea, myelosuppression

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7
Q

MTX

A

Antimet.
MOA: MTX binds to DHFR and inhibits dihydrofolate from becoming tetrahydrofolate; thereby inhibiting thymidine which is essential for DNA synthesis
AE: stomatitis, sometimes with ulceration, n/v, diarrhea, myelosuppression

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8
Q

Gemcitabine

A

Antimet.
MOA: The diphosphate molecule blocks DNA synthesis by inhibiting
ribonucleotide reductase and the triphosphate form is incorporated into DNA and inhibits DNA

polymerase.

AE: stomatitis, sometimes with ulceration, n/v, diarrhea, myelosuppression

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9
Q

Vincristine

A

Vinca alkaloids
MOA: antimicrotubules, bind to tubulin dimers and prevent their incorporation into MT. Cannot synthesize MT
AE: Peripheral neuropathy- paresthesias–> myasthenia
ANS-impaired gut motility w/ constipation and/or paralytic ileus, orthopnea, bladder atony

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10
Q

Doxorubicin

A

Anthracycline
MOA: 1- Intercalation into DNA, 2- Topo II inhib., 3- Generation of free radicals
AE: dose-related CM w/ decreased EF, n/v, stomatitis, diarrhea, myelosuppression, alopecia

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11
Q

Paclitaxel

A

Taxane
MOA: bind to tubulin and inhibit MT disassembly
AE: peripheral neuropathy, n/v, oral mucositis, diarrhea, alopecia, myelosuppression

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12
Q

Irinotecan

A

Topo I inhib.
MOA: converted to active metabolite (SN-38) in the liver, binds to topo I-DNA cmoplex and prevents religating the DNA strand breaks–> apoptosis
AE: myelosupression, diarrhea-very serious and potentially life-threatening

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13
Q

Monoclonal antibodies

A

Rituximab

Trastuzumab

Bevacizumab

Cetuximab

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14
Q

Rituximab

A

Monoclonal antibody
MOA: CD20 Ab, ADCC, complement activation, apoptosis
AE: Infusion: hypotension, broncho-spasm, urticarial and cardiac arrhythmia; HBV: reactivation of the infection

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15
Q

Trastuzumab

A

Monoclonal Ab
MOA: Extracellular binding of HER2 & ADCC
AE: CM w/ reduced LVEF (esp. in pts. with anthracycline regimen); infusion rxns: fever, chills, n/v, HA

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16
Q

Bevacizumab

A

Monoclonal Ab
MOA: Ab to VEGF and inhibits downstream signaling, which is necessary for angiogensis
AE: cause or worsen HTN, hemorrhage, infusion rxns, wound healing-withhold 28 days prior/after to surgery

17
Q

Cetuximab

A

Monoclonal Ab
MOA: Binds to EGFR
AE: Acneiform rash-correlated with disease response and prolonged survival; infusion rxn: bronchospasm and hypotension

18
Q

Imatinib

A

Small molecule inhibitors
MOA: TKI, notably bcr-abl & c-kit, sits at the site where ATP binds.
AE: myelosuppression, n/v, diarrhea

19
Q

Sorafenib

A

Small molecule inhibitors
MOA: TKI, VEGFR and Raf kinase
AE: Derm: palmar-plantar erythrodysesthesia, alopecia and rashes; diarrhea, abd. pain and anorexia

20
Q

Erlotinib

A

Small molecule inhibitors
MOA: reversible TKI, EGFR
AE: Derm: acneiform rash affecting face and neck, anorexia and diarrhea

21
Q

Vemurafenib

A

Small molecule inhibitors
MOA: Inhibits the BRAF kinase enzyme in activating mutation V600E
AE: Derm: cutaneous sq. cell carcinomas, keratoacanthomas, and melanoma

22
Q

Prostate cancer treatment

A

Leuprolide- GnRH agonist

Bicalutamide- Androgen receptor inhibitor

Abiraterone- CYPc17 blockade

23
Q

Leuprolide

A

Prostate CA tx
MOA: binds irreversibly to pituitary GnRH receptors and acts as an agonist
AE: decreased libido and ED; loss of bone density; initial surge in LH/FSH cause bone pain, bladder outlet obs. vertebral body mets, spinal cord compression

24
Q

Abiraterone

A

Prostate CA tx
MOA: Irreversibly inhibits the enzyme 17 alpha-hydroxylase/c17, 20-lyase-necessary for the precusor molecules to test., DHEA and androstenedione
AE: decreased libido and impotence

25
Q

Breast Cancer treatment

A

Tamoxifen

Anastrozole

26
Q

Tamoxifen

A

Breast Cancer treatment
MOA: SERM, acts on estrogen receptors in breast cancer cells as an antagonist. Recruits other co-repressors and then binds to DNA to modulate gene expression
AE: females: vasomotors side effects (eg hot flashes and night sweats), DVT/PE, slight risk of uterine cancer

27
Q

Anastrozole

A

Breast cancer treatment
MOA: aromatase inhibitor-ncessary to convert androstenedione to estrone and test to estradiol
AE: Females: risk of developing reduced bone mineral density and may have an increased risk of bone fractures

28
Q

All trans retinoic acid (tretinoin)

A

Acute promyelocytic leukemia (APL: t(15;17) treatment
MOA: Dissociate co-repressors from the PML-RAR complexes and the inhibition of maturation is then removed
AE: 25%- APL differentiation syndrome: fever, dyspnea–> ARDS- initiate steroids with consideration of starting anthracycline chemo; 40% rapid leukocytosis; 50% elevated LFTs

29
Q

AML tx

A

7d (cytosine arabinose) + 3d (doxorubicin)

30
Q

DLBCL tx

A

R (rituximab), C (cyclophosphamide),

H (Doxorubicin), O (Vincristine), P (Prednisone)

31
Q

HL tx

A

A (adriamycin), B (bleomycin), V (Vincristine), D (Decarbazine)

32
Q

Decarbazine

A

Alkylating agent
MOA: Adds akyl group to DNA and causes apoptosis
AE: No special associated side effects

33
Q

Antimetabolite Drugs: Classes

A

Folic Acid Analogs
Pyrimidine Analogs
Purine Analogs

Heme Onc (3 decks)

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