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M2 > Chemo Drugs I > Flashcards

Chemo Drugs I Flashcards

1
Q

Cyclophospamide

  • type
  • mechanism
  • tox (3)
A

Nitrogen Mustard=Alkylating Agent

Forms DNA cross links resulting in inhibition of DNA syn and fxn

Acute-N/V
Delayed-decease of peripheral BC
Excessive-Severe bone marrow depression and hemorrhagic cystitis

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2
Q

Carmustine

  • aka
  • type
  • mechanism
  • Tox (3)
  • delivery
A

Nitrosurea

Alkylating agent-DNA cross link of n7 and O6 of guanine and GC cross links

Acute-N/V
Delayed-Myelosuppresion
Rare-Gives interstitial lung disease or nephritis

Highly lipid soluble-can enter CNS, given orally

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3
Q

Procarbazine

  • type
  • mechanism
  • Tox (5)
A

Non-classic alkylating agent

inhibits DNA, RNA, and protein synthesis

  1. Acute-NV
  2. Delayed-myelosupression
    - high risk secondary malignancy
  3. Adverse drug reaction due to MAOI metabolite activity
  4. Adverse interaction with ETOH, CNS dep, antihistamines, anti-dep
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4
Q

Cisplatin

  • type
  • mechanism
  • part of CC when fxn best
  • Tox (2)
  • special
A

Pt based alkylating agent

sticks to DNA strands, cyto/nuc proteins

Cytotoxic at all stages of cell cycle

Acute-highly emeticgenic
Delayed-nepho/oto tox, and irreversible nerve dysfxn

synergy well with other chemo agents

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5
Q

Methotrexate

  • type
  • mechanism
  • part of CC when fxn best
  • Tox (4)
  • special (2)
A

Folic acid analog-binds and inhibits Dihydrofolate reductase and thymidylate synthase (cant make thymine)

S

Mucositis, diarrhea, neutropenia, and thombocytopenia (myelosup)

Leucovorin reverses effects
Resistance occurs

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6
Q

Leucovorin (2)

A

Reduced folate

Treats methotrexate poisoning

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7
Q

5-FU

  • aka
  • type
  • mechanism
  • part of CC when fxn best
  • Tox (4)
  • special
A

Fluorouracil

Antimetabolite-purine analog

Orally inactive
Inhibits TS while metabolites inhibit DNA and RNA fxn (DNAi/RNAi)

S

Myelosup
NVD/mucositis
neurotox
Hand-Foot blistering syndrome at continuous infusion

Severe tox in decreased/absent DPD

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8
Q

DPD-AKA and mech

A

dihydropyramidine dehydrogenase

DPD in saliva catalyzes 85% of dose of 5-FU

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9
Q

Capecitabine

  • type
  • mechanism
  • part of CC when fxn best
  • Tox (2)
A

Antimetabolic-purine analog

Orally active
Pro-pro drug of 5FU-active metabolites are generated in liver and then converted to 5FU in tumor (inhibit TS and D/RNAi stuff)

S

Continuous infusion-Hand-Foot and D
Alopecia

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10
Q

Cladribine

  • type
  • mechanism (2)
  • Tox (3)
A

Purine analog

Inhibit ribonucleotide reductase-inhibits DNA syn/repair
Incorporated into DNA to induce apop

Myelosup
Immunosup (CD4 and CD8 T cells)
N/V

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11
Q

6-Meracaptopurine

  • type
  • mechanism (2)
  • Tox (2)
  • Special (2)
A

Purine antagonist

Inhibits enzymes of purine syn
Incorporated into both RNA and DNA

Myelosup
diarrhea

Severe tox at TPMT def or Allopurinol (degraded by xanthine oxidase)

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12
Q

TPMT-aka and special

A

Thiopurine methyltrasferase

@deficiency gives severe myelosup and diarrhea when given with 6-Mercaptopurine

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13
Q

Allopurinol-mech and special

A

Xanthine oxidase inhibitor

XO inhibits 6-Meracaptopurine so results in toxicity when given together

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14
Q

Vincristine

  • type
  • mech
  • part of CC when fxn best
  • Tox (4)
A

Natural product-Vinca alkaloid

Binds to beta tubulin and inhibits assembly=arrest in M phase

M

Neurotox+peripheral neuropathy
ANS dysfxn (ortho htn, uriinary retention)
SIADH
Myelosupression

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15
Q

Paclitaxel

  • type
  • mech
  • part of CC when fxn best
  • Tox (2)
  • Special (2)
A

Taxane

Enhance microtubule polymerization

M

Acute NV and hypotension
Delayed-Neurotix, peripheral sensory neuropathy, and myelosuppresion

  • Acute-Hypersensitivity (prevent with dexamenthasome or diphenyldramine
  • p53 metabolism-adjust dose @liver dysfxn
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16
Q

Abraxane

  • type (2)
  • mech
  • part of CC when fxn best
  • Tox
A

Taxane
Paclitaxel bound to protein or albumin-avoids hypersensitivity

Enhance microtubule polymerization

M

Decreased tox when compared to Paclitaxel

17
Q

Irinotecan

  • Type
  • Mech
  • part of CC when fxn best
  • Tox (2.5)
A

Natural Product-Campthecin

Topisomerase I inhbiitor-DNA damage and S phase arrest

S

Serious diarrhea
-early is cholinergic
-late (2-10 days) is severe
Bone marrow sup

18
Q

Doxorubicin

  • Type
  • mech (2)
  • part of CC when fxn best
  • Tox (3)
  • Special
A

Antibiotic-Anthracycline

Inhibits Topisomerase II
-high affinity for DNA intercalation (blocks DNA and RNA syn
Generates quinine free radicals-binds to cell membranes and alters fluidity/transport

G1-G2

Cardiotox (via semi-quinone free radicals
-acute (2-3d) arrhythmias
-Chronic-dose dependent dilated cardiomyopathy
Myelosuppresion with neutropenia

Trx with Dexrazoxane-Can reduce cardiotox events in high risk pts

19
Q

Dexrazoxane (mech and special)

A

Fe chelator

Reduce cardiotox events in Doxorubicin pts

20
Q

Bleomycin

  • type
  • mech
  • part of CC when fxn best
  • Tox
A

Antibiotic

Binds DNA-causes breaks and inhibits DNA synthesis-G2 arrest

G2-M

Pulmonary fibrosis

21
Q

Mitomycin C

  • type
  • mech
  • part of CC when fxn best
  • tox (2)
  • special
A

Antibiotic

Potent cross linker via alkylation

Acts during all phases

NV and HUS

Needs to be reduced (tumors make hypoxic environment which favors reduction)

22
Q

DO CHEMO MAN

A

DO CHEMO MAN

M2 (3 decks)

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