chemo drugs

Question 1

alkylating agents

Answer 1

cyclophosphamide (nitrogen mustard), carmustine(nitrosureas), platinum compounds (cisplatin, carboplatin)

Question 2

antimetabolite drugs

Answer 2

methotrexate( folate analog), fluouracil(pyrimidine analog), mercaptopurine (purine analog)

Question 3

topoisomerase inhibitor drugs

Answer 3

anthracyclines( doxorubicin, daunorubicin), non-anthrocyclines (bleomycin)

Question 4

tubulin binding drugs

Answer 4

vinca alkaloids (vincristine, vinblastine, vinorelbine), taxanes (paclitaxel, docetaxel)

Question 5

signal transduction modifier drugs

Answer 5

antiestrogens(tamoxifen) antiandrogens (flutamide), monoclonal antibodies (gleevac(imantinib), bevaciumab), aromatase inhibitors

Question 6

most common drugs for extravasation

Answer 6

athracyclines (doxo, dauno), vinca alkaloids, taxanes (both tubulin binding drugs)

Question 7

carmustine big side effect

Answer 7

pulmonary toxicity

Question 8

bleomycin big side effects

Answer 8

pulm toxocity, avoid FI02>30%, BMS rare, hypersensitivities with lymphoma patients

Question 9

alkylating agent MOA

Answer 9

alkyl groups form covalent bonds with nucleotide bases in DNA or rNA–> disrupt DNA synthesis and cell division. platinum agents cross link via different structural elements (platinum atom, 2 amines, 2 Cl’s)

Question 10

antimetabolite MOA

Answer 10

work in S phase, structural analogs of natural metabolites (nucleic acid synthesis inhibitors), inhibit replication or repair of DNA by direct inhibition of enzymes needed for DNA repair or replication. methotrexate- binds to dihydrofolate reductase preventing FH2 being reduced to FH4, Fluorouracil inhibits DNA synthesis in another spot in metabolic pathway. inhibits thymidylate synthetase

Question 11

topoisomerase inhibitors MOA

Answer 11

inhibit topoisomerase I and II and intercalation with DNA
topo I- for repairing DNA that has sustained damage
topo II- relaxes DNA supercoil and breaks strand for replication, also important in putting strand back together
-also generation of free radicals (hydroxylones)

Question 12

tubulin binding drugs MOA

Answer 12

vinca alkyloids- bind to tubulin to block microtubule assemply, prevents polymerization of dimers –>arrests cell-> apoptosis
taxanes- prevent depolymerization of microtubules–> inhibits cell division–> apoptosis

Question 13

signal transduction modulators MOA

Answer 13

monoclonmal Abs, aromatase inhibitors, antiestrogens, antiandrogens

Question 14

alkylating agents anesthesia considerations

Answer 14

can cause muscle weakness, watch NMBs, impairs pseudocholinesterase for 2-3 weeks, BMS is the greatest concern with these drugs

Question 15

platinum compound alkylating agents unique side effect

Answer 15

mag and potassium wasting, nephrotoxicity, decreased GFR

Question 16

fluorouracil anesthetic considerations

Answer 16

increased risk of Mi for one week post administration, ataxia, hand and foot syndrome

Question 17

anthracycline anesthetic considerations

Answer 17

free radical production causes myocardial damage, acute or severe

Question 18

vincristine anesthetic considerations

Answer 18

neurotubule damage (sensory loss, weakness, ANS dysfunction) can affect cranial nerves (laryngeal and EOM). uncertain safety with regional anesthesia

Question 19

taxanes anesthetic considerations

Answer 19

(paclitaxel, docetaxyl)- severe BMS, 1% sepsis related deaths

Question 20

flutamide anesthetic considerations

Answer 20

can cause methemoglobinemia

Question 21

monoclonal Abs anesthetic considerations

Answer 21

will get flu like symptoms

Question 22

bevacizumab MOA

Answer 22

a monoclonal Ab (avastin)- prevents VEGF-A, stops angiogenesis

Question 23

chemo drugs that cause SIADH

Answer 23

alkylating agents, esp cyclophosphamide, vincristine