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AIM - Heme/Onc > Chemo Pharm > Flashcards

Chemo Pharm Flashcards

1
Q

Ondansetron

A
  • serotonin antagonist
  • acute antiemetic
  • blocks serotonin at CTZ 3 receptor
  • QT prolongation
  • headaches, hiccups, constipation, cardiotoxicity
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2
Q

aprepitant

A
  • NK-1 antagonist
  • acute and delayed antiemetic
  • blocks substance P
  • drug interactions (CYP inducer)
  • hiccups, fatigue
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3
Q

lorazepam

A
  • benzodiazepine
  • anticipatory antiemetic
  • GABA mediated

-sedation, retrograde amnesia

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4
Q

dexamethasone

A
  • glucocorticoid
  • delayed antiemetic
  • hormone
  • reduces number of lymphocytic cells
  • lymphocytic leukemias/lymphomas
  • ALL, NHL

-glucose intolerance, insomnia, agitation, HTN

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5
Q

Prochlorperazine

Metoclopramide

A
  • dopaminergic antagonists
  • acute and delayed antiemetic

-extrapyramidal, sedation

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6
Q

alkylators

A
  • cell cycle non specific
  • form DNA cross links that inhibit replication

side effects:

  • bone marrow suppression
  • N/V, diarrhea
  • sterility
  • amenorrhea
  • secondary malignancy
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7
Q

cyclophosphamide

A
  • nitrogen mustard
  • alkylator
  • prodrug, needs liver activation
  • binds to nucleophiles/purines
  • breast CA, leukemia, lymphoma
  • immunosuppressant
  • cardiac NECROSIS
  • delayed N/V
  • hemorrhagic cystitis (ACROLEIN)
  • neutropenia, lymphopenia, cardiotoxicity, SIADH
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8
Q

ifosfamide

A
  • nitrogen mustard
  • alkylator
  • isomer to cyclophosphamide, with longer half life
  • crosses BBB
  • prodrug, needs liver activation

-sarcomas, lymphomas, uterine CA

  • nephrotoxicity
  • neurotoxicity
  • hemorrhagic cystitis (ACROLEIN)
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9
Q

mesna

A
  • counteracts ifosfamide induced hemorrhagic cystitis caused by acrolein
  • binds acrolein in bladder
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10
Q

chlorambucil

A
  • nitrogen mustard
  • alkylating agent

AML
NHL
CLL

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11
Q

melphalan

A
  • nitrogen mustard
  • alkylating agent
  • multiple myeloma
  • primary myelofibrosis
  • AML
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12
Q

cisplatin

A
  • platinum analog
  • alkylator

-testicular, ovarian, lung CAs

  • severe acute and delayed N/V
  • nephrotoxicity
  • neurotoxicity (peripheral neuropathies, auditory impairment)
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13
Q

carboplatin

A
  • platinum analog
  • alkylator

-use if resistance develops to other analogs

  • neuropathies
  • increased toxicity if given before taxane
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14
Q

oxaliplatin

A
  • platinum analog
  • alkylating agent
  • DNA adducts between bases
  • colorectal, GI
  • if resistance to other platinum analogs
  • neurotoxicity triggered by COLD
  • electrolyte abnormalites, myelosuppression, hepatotoxicity
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15
Q

dacarbazine

procarbazine

A
  • triazenes
  • alkylator

ABVD/MOPP regimens for Hodgkin’s

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16
Q

antimetabolics/analogs

A
  • S phase specific

- block formation of DNA components

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17
Q

methotrexate

A

-antimetabolic
-S phase specific
-reversibly binds to dihydrofolate reductase
(no THF formed, no dTMP formed, no DNA synthesis)
-polyglutaminated form has higher efficacy

  • nephrotoxicity, GI toxicity, hepatotoxicity, mucositis, myelosuppression
  • methotrexate induced lung injury
  • leucovorin rescue
  • drain 3rd spaces
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18
Q

5-FU

A
  • antimetabolic
  • inhibits thymidylate synthase
  • S phase specific

-breast, colorectal, head/neck, basal cell carcinoma

  • myelosuppression
  • mucositis/diarrhea, hand-foot syndrome
  • CORONARY VASOSPASM (EKG changes)
  • neurotoxicity
  • PHOTOSENSITIVITY
  • synergistic with leucovorin
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19
Q

hydroxyurea

A
  • antimetabolic
  • inhibits ribonucleotide reductase
  • decreases WBC and platelet count
  • S phase specific
  • used for leukostasis in acute leukemia, sickle cell
  • myelosuppression
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20
Q

cytrabine (Ara-C)

A
  • pyrimidine analog
  • inhibits DNA polymerase
  • can cross BBB
  • S phase specific
  • AML, ALL, CML, NHL
  • intrathecally to treat lymphomatous meningitis
  • myelosuppression
  • mucositis
  • CNS toxicity (cerebellar, conjunctival)
  • pulmonary edema
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21
Q

gemcitabine

A
  • pyrimidine analog
  • inhibits DNA polymerase, ribonucleotide reductase
  • S phase specific
  • Pacreatic, NSCLC, bladder CA, sarcoma
  • myelosuppression, N/V, flu like sx, skin rash, proteinuria, hematuria
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22
Q

fludarabine

cladribine

A
  • purine analogs
  • interfere with DNA synthesis
  • CLL
  • immune damage to RBC causes hemolytic anemia
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23
Q

prednisone

A
  • glucocorticoid
  • homrone
  • decreases lymphocytes
  • lymphocytic leukemias/lymphomas
  • glucose intolerance, insomnia, agitation, appetite, wight gain, fluid retention
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24
Q

Danazol

Dihydrotestosterone

A
  • androgen hormone
  • suppress pituitary output of FSH, LH
  • used for bone marrow failure syndromes, myelodysplasia
  • NHL, leukemia, testicular

-edema, flushing, HTN, hirsuitism, voice changes

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25
Q

flutamide

bicalutamide

A
  • anti androgen (receptor antagonist)
  • prostate cancer
  • hot flashes, decr libido, gynecomastia
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26
Q

tamoxifen

raloxifene

A

competes with estrogen for binding to receptor

  • breast CA
  • menopausal sx, edema
  • tumor flare
  • DVT/PE
  • endometrial hyperplasia
27
Q

anastrozole

A
  • aromatase inhibitor
  • selective, reversible
  • used in post menopausal women with breast CA
  • hot flashes, tumor flare, edema, asthenia
28
Q

letrozole

A
  • aromatase inhibitor
  • selective, reversible

-causes arthralgias, musculoskeletal pain, hot flashes, LFTs

29
Q

leuprolide

A

-inhibits gonadotropin via negative feedback inhibition of the pituitary
-surge of estrogen, testosterone, then none

  • premenopausal women with breast CA
  • testicular CA
  • tumor flare
  • pain, flushing, peripheral edema, asthenia, hot flashes, gynecomastia, changes in serum lipids, bone loss long term
30
Q

exemestane

A
  • aromatase inhibitor
  • IRreversible

-hot flashes, fatigue, headache

31
Q

goserelin

A

-LHRH agonist

breast, prostate CA

32
Q

danorubicin

A
  • anti tumor antibiotic
  • cell cycle non specific
  • intercalates between DNA base pairs, breakage
  • inhibits Topo II
  • releases Fe to make free radicals

-leukemia

  • myelosuppression
  • alopecia
  • N/V
  • tissue necrosis (vesicant)
  • cardiotoxicity (systolic HF)
  • Fe release –> ROS
33
Q

doxorubicin

A
  • anti tumor antibiotic
  • cell cycle non specific
  • intercalates between DNA base pairs, breakage
  • inhibits Topo II
  • releases Fe to make free radicals

-lymphoma, solid tumors

  • myelosuppression
  • alopecia
  • N/V
  • tissue necrosis (vesicant)
  • cardiotoxicity (systolic HF)
  • Fe release –> ROS
34
Q

bleomycin

A
  • anti tumor antibiotic
  • G2 phase specific
  • binds to DNA
  • free radical formation

-Hodgkins

  • interstitial pneumonitis
  • pulmonary fibrosis
  • skin toxicity
35
Q

vincristine

A
  • vinca alkaloids
  • inhibits microtubules

NHL, ALL

-neuropathies (paresthesias, decreased autonomic function –> constipation)

vinCristine = Constipation

36
Q

vinblastine

A
  • vinca alkaloids
  • inhibits microtubules

Hodgkins, Testicular CA

-bone marrow suppression

vinBlastine = Bone marrow

37
Q

vinorelbine

A
  • vinca alkaloids
  • inhibits microtubules
  • NSCLC, breast CA
  • bone marrow suppression
38
Q

paclitaxel

A
  • plant alkaloid
  • Taxane
  • enhances microtubule formation (cannot break down – stuck in metaphase)

-breast, lung, ovarian

  • myelosuppression
  • neuropathy (long nerves)
  • hypersensitivity
  • HAND FOOT syndrome
39
Q

docetaxel

A
  • plant alkaloid: taxane
  • enhances microtubule formation (cannot break down, stuck in metaphase)

-breast, lung, ovarian

  • myelosuppression
  • neuropathy
  • hypersensitivity
  • HAND FOOT syndrome
40
Q

irinotecan

topotecan

A
  • plant alkaloid
  • camptothecin
  • TOPO I INHIBITOR
  • S to G2 phase specific

-colon, ovarian, prostate, esophageal, non Hodgkins

  • myelosuppression, neutropenia, thrombocytopenia
  • diarrhea (leads to vol depletion)

ATROPINE (anticholinergic) helps early onset SLUDD sx

LOPERAMIDE helps with late onset SLUDD Sx

41
Q

atropine

A
  • anticholinergic

- helps with early onset SLUDD (diarrhea) sx of camptothecans

42
Q

loperamide

A

-helps with late onset SLUDD (diarrhea) sx of camptothecans

43
Q

trastuzamab

A
  • mAb
  • anti HER2

-breast CA

  • infusion related (bronchospasm, dyspnea, angioedema, hypotension) from cytokine release
  • myelosuppression
  • cardiotoxicity
44
Q

bevacizumab

A
  • mAb
  • anti VEGF
  • blocks angiogenesis

-solid tumors

  • impaired wound healing
  • hypertension
  • thrombotic events
  • bleeding episodes
  • GI perf
45
Q

rituximab

A
  • mAb
  • anti CD20
  • apoptosis, ADCC, complement activation

-CD20+ NHL, CLL, autoimmune diseases

  • immunosuppressive
  • HEP B REACTIVATION
  • infusion related (hypotension, SOB, diaphoresis) due to cytokines
  • tumor lysis
  • skin reactions
  • N/V
46
Q

cetuximab

A
  • mAb
  • anti EGFR (tyrosine kinase receptor)
  • decreases cell growth/differentiation

-solid tumors

  • acneiform rash
  • N/V
  • hepatotoxicity
47
Q

eculizumab

A
  • mAb

- anti complement C5

48
Q

imatinib

A
  • tyrosine kinase inhibitor
  • BCR-ABL inhibitor
  • limits cell proliferation

-CML

  • edema
  • cytopenia
  • elevated LFTs
  • cardiotoxicity
49
Q

erlotinib

A
  • tyrosine kinase inhibitor
  • EGFR inhibitor
  • limits cell growth/proliferation

-lung cancer

  • acneiform rash
  • diarrhea
  • interstitial lung disease
50
Q

thalidomide

A
  • imid
  • antiangiogenesis (inhibit VEGF)
  • immunomodulatory (inhibits TNF, induces apoptosis)

-multiple myeloma

  • teratogenic
  • neurotoxicity
  • sedation
  • depression
51
Q

lenalidomide

A
  • imid
  • unknown MOA
  • more potent than thalidomide

-multiple myeloma

  • cytopenia
  • thrombotic events
  • teratogenic?
52
Q

azacytidine

A
  • demethylating agent
  • un silences tumor suppressor genes

-MDS

  • myelosuppression
  • N/V
  • diarrhea
53
Q

decitabine

A
  • demethylating agent
  • un silences tumor suppressor genes

-MDS

  • myelosuppression
  • N/V
  • diarrhea
54
Q

bortezomib

A
  • protease inhibitor
  • disrupts normal protein metabolism, downregulation of NF-kB
  • multiple myeloma
  • NHL
  • fatigue, malaise
  • myelosuppression
  • peripheral neuropathy
55
Q

ATRA

A

-vitamin A analog

  • acute promyelocytic leukemia
  • allows differentiation of RAR
  • curative
56
Q

ipilimumab

A
  • immune checkpoint inhibitor
  • blocks CTLA-4
  • augments T cell activation/proliferation

-AE: immune related (every “itis”) Tx: corticosteroids

57
Q

nivolumab

A
  • mAb
  • anti PD1
  • allows immune system to recogniza and kill tumor

AE
-hepatitis, gastritis, nephritis, thyroidits (Tx: corticosteroids)

58
Q

leucovorin

A
  • rescue for methotrexate

- synergistic with 5 FU

59
Q

glucarpidase

A
  • enzyme
  • cleaves MTX
  • absurdly expensive
60
Q

L-asparaginase

A
  • decreases MTX toxicity

- prevents cells from entering S phase

61
Q

intrathecal drugs

A
  • methotrexate
  • C Ara
  • Thiotepa (alkylator)
62
Q

dexrazoxane

A
  • iron chelator
  • limits cardiotoxicity
  • w/i 30 min of daunorubicin/doxorubicin
63
Q

atropine

A

-for acute N/V for irinotecan

64
Q

loperamide

A

-for delayed N/V for irinotecan

AIM - Heme/Onc (9 decks)

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