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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
Dexamethasone- Clinical Use
reduce cerebral edema in patients with brain metastases control emesis and nausea in chemo patients
26
Tamoxifen, Raloxifene- Mech of Action
prodrug activated in the liver ESTROGEN RECEPTOR ANTAGONIST IN BREAST TISSUE, AGONIST IN UTERUS target= estrogen receptor
27
Tamoxifen, Raloxifene- Toxicities
WEIGHT GAIN HOT FLASHES ENDOMETRIAL CANCER THROMBOSIS
28
Tamoxifen- Clinical Use
BREAST CANCER favorable effects on lipid profile and decreases osteoporosis
29
Raloxifene- Clinical Use
Prevention of breast cancer
30
Anastrazole, Letrozole, Exemestane- Mech of Action
AROMATASE INHIBITOR= LOWER CIRCULATING ESTROGEN LEVELS target= aromatase
31
Anastrazole, Letrozole, Exemestane- Clinical Use
HORMONE RECEPTOR POSITIVE BREAST CANCER
32
Anastrazole, Letrozole, Exemestane- Toxicities
``` BONE LOSS OSTEOPOROSIS hot flashes mood disturbance arthritis arthralgia bone pain ```
33
Flutamide, Bicalutamide, Nilutamide- Mech of Action
INHIBIT UPTAKE AND BINDING OF TESTOSTERONE target= testosterone receptor
34
Flutamide, Bicalutamide, Nilutamide- Clinical Use
ANDROGEN DEPRIVATION THERAPY OF METASTATIC PROSTATE CANCER
35
Flutamide- Toxicities
well tolerated | diarrhea and elevated liver enzymes
36
Bicalutamide, Nilutamide- Toxicities
less diarrhea
37
Leuprolide acetate- Mech of Action
GNRH RECEPTOR AGONIST= INITIAL INCREASE IN LH AND FSH FOLLOWED BY LONG TERM DECREASE target= GnRH receptor
38
Goserelin- Mech of Action
LHRH agonist
39
Leuprolide, Goserelin- Clinical Use
PROSTATE CANCER
40
Leuprolide, Goserelin- Toxicities
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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