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Blood & Lymph > Chemo Rx > Flashcards

Chemo Rx Flashcards

1
Q

CYTOTOXIC Chemotherapeutic agents can be divided into two groups based on their effects at different stages of the cell cycle and have effects on different types of cancer:

A
  1. Cell-cycle specific (CCS): hematologic malignancies, solid tumors high growth fraction
  2. Cell-cycle non-specific (CCNS): solid tumors with low or high growth fraction
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2
Q

What are the 3 bone-marrow sparing chemotherapy agents?

A
  1. bleomycin
  2. cisplatin
  3. vincristine
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3
Q

Alkylating agents are mutagenic and can lead to _____. Which is the most likely to cause this?

A
  • leukemia
  • Procarbazine
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4
Q

List the 4 alkylating agents (chemo rx)

A
  1. Cyclophosphamide
  2. Procarbazine
  3. Cisplatin
  4. Carboplatin
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5
Q

Which 2 alkylating agents are platinum analogs?

A
  1. cisplatin
  2. carboplatin

(-“platin” rx = platinum)

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6
Q

The log kill hypothesis says that chemotherapy drugs are ______ kinetics

A

first order

(3 log kill = 109 -10 6 cancer cells)

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7
Q

_______ (3 chemotherapeutic agents) cause pulmonary side effects .

A
  1. Bleomycin
  2. Busulfan
  3. Procarbazine

(“Bleomycin & Busulfan Block your Breath”)

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8
Q

________( 2 chemotherapeutic agents) cause cardiotoxicity.

A
  1. Mitoxantrone (least cardiotoxic)
  2. Dexrazoxane (delayed CHF)
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9
Q

Which chemo rx cause nephrotoxicity?

A
  1. Cisplatin
  2. Methotrexate (Pemetrexed)
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10
Q

______ treats nephrotoxicity caused by Cisplatin

A

Amifostine

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11
Q

Side effect shared by vinka alkaloids, -“taxanes” and Procarbazine

A

neurotoxicity

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12
Q

_____ is the chemo rx least likely to cause neurotoxicity

A

Vinblastine

(does BLAST the Bone marrow though)

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13
Q

Hemorrhagic cystitis is an adverse reaction to ________ (chemo rx).

A

Cyclophosphamide

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14
Q

______ is a second generation platinum analog (alkylating agent) and therefore, has less toxicity.

(myelosuppression is the main dose-limiting toxicity)

A

carboplatin

(second gen. to cisplatin)

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15
Q

Neurotoxicity and ototoxicity are the side effects of _______.

A

cisplatin

(platinum analog - alkylating agent)

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16
Q

The MOA for the alkylating agents is the alkyl group forms a _______ leading to DNA strand breakage.

A

cross-link

(cell-cycle checkpoints will recognize → apoptosis)

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17
Q

Hepatic VOD is an adverse effect of the ______ class of chemo rx.

A

alkylating agents

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18
Q

5 Mechanisms of resistance against alkylating agents

A
  1. increase glutathione
  2. increase DNA repair
  3. decrease permeability to agent
  4. degrade rx
  5. impair apoptotic pathways
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19
Q

Cyclophosphamide is converted into _______ which alkylates DNA → cytotoxicity.

A

phosphoramide mustard & acrolein

20
Q

Which alkylating agent treats NHL, breast, ovarian, neuroblastoma and leukemia?

A

cyclophosphamide

21
Q

______ (alkylating agent) makes free radicals and converts CYP into methylating species.

A

Procarbazine

(inhibits DNA & RNA synthesis)

22
Q

Procarbazine is also a ______ inhibitor.

A

MAO

(caution w/patients on SSRI/SNRI)

23
Q

______ (alkylating agent) treats Hodgkin and brain tumors

A

Procarbazine

24
Q

BM suppression, pulmonary toxicity, neurotoxicity are _____ (alkylating agent) side effects

A

Procarbazine side effects

25
Q

Platinum analogs form intra- and inter-strand cross-links causing cytotoxicity used to treat ________ (5) cancers.

A

solid tumor: breast, lung, bladder, testicular, ovarian

26
Q

Antimetabolite chemo rx are considered ____(CCS/CCNS)

27
Q

Antimetabolic chemo rx inhibit DNA and RNA synthesis by interfering with ________.

A

purine or pyrimidine nucleotide precursors

28
Q

________ MOA: inhibits dihydrofolate reductase → decreased thymidylate, purine nucleotides and amino acids.

A

methotrexate & pemetrexed

29
Q

Decreased rx transport into cell, increased dihydrofolate reductase & decreased sensitivity to rx are the mechanisms of resistance to _______ (antimetabolite chemo rx)

A

methotrexate & pemetrexed

30
Q

Which 2 antimetabolite chemo rx treat leukemia, lymphoma & breast cancer?

A
  1. methotrexate & pemetrexed
  2. mercaptopurine & thioguanine

(5-fluorouracil also treats breast cancer)

31
Q

Which antimetabolite chemo rx are pyrimidine antagonists*** and which are pyrimidine ***analogs?

A
  • antagonists: cytarabine, capecitabine
  • analog: fluorouracil

(not to be confused w/the purine antagonist: Fludarabine)

32
Q

_______ (antimetabolite chemo rx) is a DNA polymerase inhibitor → terminates chain elongation.

A

Cytarabine

(tx for AML)

33
Q

Cytarabine is the only antimetabolite chemo rx that treats _____.

34
Q

Fluorouracil has no antineoplastic activity, but is converted to _____→ inhibits DNA synthesis by inhibiting _____. How does it inhibit RNA synthesis?

A
  • 5-FdUMP
  • thymidylate synthase
  • conversion to 5-FdUTP
35
Q

Fluorouracil treats solid tumors, such as : (3)

A
  1. breast
  2. colon
  3. gastric

(can cause life-threatening diarrhea)

36
Q

2 Resistance mechanisms of 5-FU

A
  1. increase thymidylate synthase levels
  2. increase DPD (dihydropyrimidine) → catabolize 5-FU

(pts w/decreased DPD → toxicity)

37
Q

Caution in combo therapy: cisplatin & ______ have a drug interaction

A

methotrexate

38
Q

Capecitabine is a prodrug that is converted into ______.

A

5-FU

(same MOA & target cancers)

39
Q

______ is a unique side-effect of Capecitabine (antimetabolite chemo rx).

A

Hand-foot syndrome

(erythema of hands and feet)

40
Q

______ inhibits ribonucleotide reductase → decreasing the pool of nucleotides for DNA synthesis

A

Gemcitabine (antimetabolite chemo rx)

(must be phosphorylated first)

41
Q

Which antimetabolite chemo rx treats pancreatic, non-small cell lung and bladder cancer?

A

Gemcitabine

42
Q

Which antimetabolite chemo rx treats low-grade NHL & CLL?

A

Fludarabine

43
Q

________ (2) are converted to TIMP by HGPRT → blocks purine synthesis

A
  1. Mercaptopurine (6MP)
  2. Thioguanine (6TG)

(antimetabolite chemo rx)

44
Q

Doses of 6MP must be reduced in patients taking ______.

A

allopurinol

45
Q

Skin pigmentation, adrenal insufficiency, and pulmonary fibrosis are side effects of ______.

Blood & Lymph (29 decks)

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