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Pharm II Test 4 > Chemo III Antibiotic and Hormonal Agents > Flashcards

Chemo III Antibiotic and Hormonal Agents Flashcards

1
Q

Doxorubicin, Daunomycin, Idrarubicin, Epirubicin- Mech of Action

A

INTERCALATION BETWEEN BASE PAIRS OF DNA= STRAND BREAKS DUE TO INHIBITION OF TOPOISOMERASE II

target= DNA

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2
Q

Doxorubicin, Daunomycin, Idrarubicin, Epirubicin- Cell Cycle Specificity

A

No

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3
Q

Doxorubicin- Kinetics

A

metabolized by liver

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4
Q

Doxorubicin- Clinical Use

A

breast cancer
leukemia
sarcoma
Hodgkin’s & non-Hodgkin’s lymphoma

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5
Q

Doxorubicin- Resistance

A

MDR

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6
Q

Doxorubicin- Toxicities

A

MYELOSUPPRESSION- LIMITING

CUMULATIVE SCHEDULE-DEPENDENT CARDIAC TOXICITY- CARDIAC FUNCTION TESTING BEFORE STARTING DRUG

DRUG IS A VESSICANT

nausea
vomiting
hair loss
stomatitis

Do not exceed lifetime dose of 400mg/M2 in 9 administration schedule

96h infusion reduces cardiotoxicity

coadministration with Dexrazoxane is cardioprotective

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7
Q

Daunomycin- Clinical Use

A

Less effective in solid tumors

only used in leukemias

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8
Q

Daunomycin- Toxicities

A

far less cardiotoxic

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9
Q

Idrarubicin, Epirubicin- Clinical Use

A

leukemia

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10
Q

Idrarubicin, Epirubicin- Toxicities

A

less cardiotoxic

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11
Q

Irinotecan, Toptecan- Mech of Action

A

TOPOISOMERASE I INHIBITION= SSDNA BREAKS

target= DNA

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12
Q

Irinotecan, Toptecan- Cell Cycle Specificity

A

No

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13
Q

Irinotecan- Kinetics

A

significant hepatic metabolism- REDUCE DOSE IN JAUNDICE

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14
Q

Irinotecan- Clinical Use

A

GI malignancies

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15
Q

Irinotecan- Toxicities

A

MYELOSUPPRESSION- LIMITING

EARLY CHOLINERGIC DIARRHEA, LATE SECRETORY DIARRHEA

nausea
vomiting
stomatitis
hair loss

UGTIAI NEEDED FOR DRUG CLEARANCE–>MUTATIONS ASSOCIATED WITH DRUG TOXICITY

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16
Q

Toptecan- Clinical Use

A

OVARIAN CANCER RESISTANT TO CARBOPLATIN AND PACLITAXEL

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17
Q

Bleomycin- Mech of Action

A

BIND DNA
FREE RADICAL PRODUCTION LEADING TO SINGLE AND DOUBLE STRAND DNA BREAKS

target= DNA

18
Q

Bleomycin- Cell Cycle Specificity

A

G2-M PHASE

19
Q

Bleomycin- Clinical Use

A

TESTICULAR CANCER

lymphoma & squamous cell carcinoma in the past

20
Q

Bleomycin- Toxicities

A

CUMULATIVE PULMONARY TOXICITY

hyperpigmentation of skin
hyperkeratosis of palms
stomatitis
hair loss
fever 
chills

anaphylactoid reactions can happen

TEST DOSE GIVEN BEFORE FIRST DOSE TO MONITOR FOR SEVERE REACTIONS

risk of lung damage with O2 administration

21
Q

Prednisone- Mech of Action

A

exact mechanism unclear

target= steroid receptor

22
Q

Prednisone- Clinical Use

A

HODGKIN’S DISEASE AND NON-HODGKIN’S LYMPHOMA
multiple myeloma
some leukemias

23
Q

Prednisone- Toxicities

A 
euphoria
weight gain
increased appetite
mania
hypertension
sodium and fluid retention
aggravation of diabetes
hypokalemia
alteration of sleep cycle
peptic ulcers
...
24
Q

Dexamethasone- Mech of Action

A

less mineralocorticoid activity

25
Q

Dexamethasone- Clinical Use

A

reduce cerebral edema in patients with brain metastases

control emesis and nausea in chemo patients

26
Q

Tamoxifen, Raloxifene- Mech of Action

A

prodrug activated in the liver

ESTROGEN RECEPTOR ANTAGONIST IN BREAST TISSUE, AGONIST IN UTERUS

target= estrogen receptor

27
Q

Tamoxifen, Raloxifene- Toxicities

A

WEIGHT GAIN
HOT FLASHES
ENDOMETRIAL CANCER
THROMBOSIS

28
Q

Tamoxifen- Clinical Use

A

BREAST CANCER

favorable effects on lipid profile and decreases osteoporosis

29
Q

Raloxifene- Clinical Use

A

Prevention of breast cancer

30
Q

Anastrazole, Letrozole, Exemestane- Mech of Action

A

AROMATASE INHIBITOR= LOWER CIRCULATING ESTROGEN LEVELS

target= aromatase

31
Q

Anastrazole, Letrozole, Exemestane- Clinical Use

A

HORMONE RECEPTOR POSITIVE BREAST CANCER

32
Q

Anastrazole, Letrozole, Exemestane- Toxicities

A 
BONE LOSS 
OSTEOPOROSIS
hot flashes
mood disturbance
arthritis
arthralgia
bone pain
33
Q

Flutamide, Bicalutamide, Nilutamide- Mech of Action

A

INHIBIT UPTAKE AND BINDING OF TESTOSTERONE

target= testosterone receptor

34
Q

Flutamide, Bicalutamide, Nilutamide- Clinical Use

A

ANDROGEN DEPRIVATION THERAPY OF METASTATIC PROSTATE CANCER

35
Q

Flutamide- Toxicities

A

well tolerated

diarrhea and elevated liver enzymes

36
Q

Bicalutamide, Nilutamide- Toxicities

A

less diarrhea

37
Q

Leuprolide acetate- Mech of Action

A

GNRH RECEPTOR AGONIST= INITIAL INCREASE IN LH AND FSH FOLLOWED BY LONG TERM DECREASE

target= GnRH receptor

38
Q

Goserelin- Mech of Action

A

LHRH agonist

39
Q

Leuprolide, Goserelin- Clinical Use

A

PROSTATE CANCER

40
Q

Leuprolide, Goserelin- Toxicities

A

INITIAL WORSENING OF CANCER

hot flashes
general effects of androgen deprivation therapy: weakness, decreased libido, loss of muscle mass, erectile dysfunction, gynecomastia

PRETREAT WITH FLUTAMIDE OR BICALUTAMIDE TO PREVENT INITIAL WORSENING OF CANCER

Pharm II Test 4 (5 decks)

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