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Heme and Lymph Midterm > Chemo Lecture 3-4: Antimitotic and G/M phase drugs- Fitzpatrick > Flashcards

Chemo Lecture 3-4: Antimitotic and G/M phase drugs- Fitzpatrick Flashcards

1
Q

List classes of antineoplastic drugs that are antimitotic drugs

A
  • Vinca alkaloids

- Taxanes

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2
Q

List the drugs that are vinca alkaloids

A
  • Vinblastine
  • Vincristine
  • Vinorelbine
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3
Q

List drugs that are taxanes

A
  • Taxol (paclitaxel)

- Taxotere (docetaxel)

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4
Q

MOA of Vinca Alkaloids

A

Binds to beta tubulin at forming end (+) of microtubules and inhibit tubulin polymerization –> block assembly of microtubules –> inhibit microtubule elongation: rate of depolymerization (fraying&raquo_space; rate of polymerization (assembly)

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5
Q

MOA of taxanes

A

Binds to beta tubulin at the forming end (+) of microtubules and as the microtubule continues to form and fray, the bound taxanes reaches the fraying end (-) and inhibit fraying (disassembly) –> Enhance tubulin polymerization–> stabilize microtubules

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6
Q

Therapeutic use of Vinblastine

A
  • Testicular cancer (w/ bleomycin and cisplatin)
  • Lymphomas
  • Neuroblastoma
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7
Q

Therapeutic use of Vincristine

A
  • ALL (peds)
  • lymphoma
  • neuroblastoma
  • Wilm’s tumor
  • Ewing’s sarcoma
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8
Q

Therapeutic use of Vinorelbine

A

Advanced NSCL cancer

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9
Q

Therapeutic use of paclitaxel

A

Advanced breast and ovarian (w/ cisplatin)

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10
Q

Therapeutic use of Docetaxel

A

Advanced breast, ovarian recurrence

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11
Q

Taxanes in general are effective against which types of tumors, solid or liquid?

A

Solids tumors

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12
Q

Dose limiting toxicity of vinblastine and vinorelbine

A

Bone marrow suppresssion; visicant-blisters

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13
Q

Dose limiting toxicity of vincristine

A

Neurotoxicity; peripheral neuropathy; paralytic ileus; vesicant- blisters

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14
Q

Dose limiting toxicity of paclitaxel

A

neutropenia; thrombocytopenia; peripheral neuropathy; severe hypersensitivity during infusion

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15
Q

Dose limiting toxicity of docetaxel

A

neutropenia; peripheral neuropathy

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16
Q

Vinca alkaloids and taxanes drugs impair spindle integrity and works during which phase of the cell cycle?

A

M phase

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17
Q

If pt experiences severe neuropathy taking administering vincristine, what drug should be substituted?

A

Vinblastine

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18
Q

Vinca and taxanes drugs commonly leads to multi drug resistance due to increased expression of _

A

P-glycoprotein and its enhanced extrusion of drugs from tumor cells. This is the reason for treatment failure in over 90% of pts with advanced metastatic cancer

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19
Q

Monoclonal antibodies chemo drugs are NOT prone to P-glycoproteins multi drug resistance because _

A

these drugs’ mechanism of action involve the exterior cell surface

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20
Q

Class of antineoplastic drugs that which are topoisomerase inhibitors

A
  1. Epipodophyllotoxins

2. Camptothecins

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21
Q

Antineoplastic drugs that are epipodophyllotoxins

A
  • Etoposide
  • Teniposide

(EET)

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22
Q

Antineoplastic drugs that are camptothecins

A
  • Irinotecan
  • Topotecan

(CIT)

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23
Q

Epipodophyllotoxins inhibits _ and causes DNA _ stand breaks

A

topoisomerase II –> double strand breaks

24
Q

Camptothecins inhibits _ and causes DNA _ strand breaks

A

Topoisomerase I –> single strand breaks

25
Q

Therapeutic use of Etoposide

A
  • Oat Cell carcinoma of lung

- testicular cancer (with cisplatin and bleomycin)

26
Q

Therapeutic use of Teniposide

A

Efficacy vs glioma and neuroblastoma

27
Q

Therapeutic use of ironotecan

A

metastatic colorectal cancer

28
Q

Therapeutic use of topotecan

A

2nd line drug for various cancers – used after 1st line has failed

29
Q

Dose limiting tox of etoposide

A

Leukopenia; secondary cancer (Leukemia)

30
Q

Dose limiting tox of teniposide

A

leukopenia

31
Q

Dose limiting tox of ironotecan

A

Severe diarrhea

myelosuppression

32
Q

Dose limiting tox of Topotecan

A

Neutropenia; mucositis

33
Q

Ironotecan and topotecan work during which phase of the cell cycle?

A

S phase

34
Q

Etoposide and Teniposide work during which phase of the cell cycle?

A

Mixed

35
Q

Classes of drugs that which causes DNA intercalation and oxidative scission

A
  • Antibiotics

- Anthrocyclines

36
Q

Which antibiotics causes DNA intercalation and oxidative scission

A

Bleomycin and Dactinomycin

37
Q

Which anthrocyclines causes DNA intercalation and oxidative scission

A
  • Doxorubicin
  • Daunorubicin
  • Epirubicin
  • Idarubucin
  • Mitoxanthrone
38
Q

MOA of bleomycin

A

Fe 2+/3+ mediated free radical generation –> DNA strand breaks

39
Q

MOA of dactinomycin

A

DNA intercalating agents

40
Q

MOA of Anthracyclines

A
  • All except mitoxanthrone: inhibit topoisomerase II, DNA intercalating agents, free radical generation (superoxide, H2O2), all leading to DNA strand breaks
  • Mitoxantrone inhibits topoisomerase II –> DNA DS break
41
Q

Therapeutic use of Bleomycin

A
  • Testicular cancer
42
Q

Therapeutic use of Doxorubicin and epirubicin

A
  • Breast and Ovarian cancers and others
43
Q

Therapeutic use of Idarubicin

A

Leukemia (AM, ALL, CML n blast crisis)

44
Q

Therapeutic use of daunorubicin

A

Leukemia (AML, ALL)

45
Q

Therapeutic use of Mitoxantrone

A

Breast cancer among others

46
Q

Dose limiting tox of bleomycin

A
  • Pulmonary fibrosis.

- Causes skin and lung damage cuz these tissues do not have enzyme hydrolase thats required to metabolize bleomycin

47
Q

Dose limiting tox of all anthrocyclines except mitoxantrone

A

Cardiotoxicity dilated cardiomyopathy, congestiv heart failure over time. Pts with risk factors are at increased risk

48
Q

Dose limiting tox of mitoxantrone

A
  • similar to -rubicins
49
Q

Bleomycin and antracyclines work during which phase of cell cycle?

A

Bleomycin: S/G2 phase
Antracyclines: S/G2 phase and S phase

50
Q

What drug combo is used for Hodgkin’s lymphoma?

A
  • Adriamycin (doxorubicin)
  • Bleomycin
  • Vinblastine
  • Dacarbazine

ABVD

51
Q

What toxicities are associated with hodgkin’s lymphoma treatment

A

The drug combo used, each drug has it’s own unique tox.

  • Adriamycin (doxorubicin): Cardiotoxicity
  • Bleomycin: Pulm fibrosis
  • Vinblastine: peripheral neuropathy
  • Dacarbazine: N/V and myelosuppression
52
Q

What drug combo is used for Non-Hodgkin’s Lymphoma?

A

CHOP

  • Cyclophosphamide
  • Hydroxy-daunorubin (doxorubicin)
  • Oncovin (vincristine)
  • Prednisone
53
Q

What tox are associated with non-hodgkin’s lymphoma treatment

A

CHOP

  • Cyclophosphamide: hemorrhagic cystitis
  • Hydroxy-daunorubin (doxorubicin): cardiotoxicity
  • Oncovin (vincristine): peripheral neuropahty
  • Prednisone: hyperglycemia, osteopenia
54
Q

What is tumor lysis syndrome?

A

Chemotherapy induced cell death of vast numbers of tumor cells, e.g. especially in leukemia or lymphoma –> Chemicals released from dying cells into circulation –> can produce hyperuricemia & related life-threatening electrolyte complications

55
Q

In tumor lysis syndrome, how is acute nephrotoxicity produced by excessive uric acid managed?

A

Allopurinol ( a xanthine oxidase inhibitor)

56
Q

what electrolyte imbalance is seen with tumor lysis syndrome?

A
    • Hyperkalemia
  • Hyperphosphatemia
  • hypocalcemia
  • hyperuricemia
57
Q

Hyperuricemia associatd with malignancy (tumor lysis syndrome) can be managed by what drug?

A

Pegloticase (uric acid odixdase)

Heme and Lymph Midterm (7 decks)

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