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Chemo Rx 2 Flashcards

1
Q

List the sub-classes of the mitotic inhibitor class of chemo rx.

A
  1. vinka alkaloids
  2. -“taxanes”
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2
Q

Mitotic inhibitors are _____ (CCS/CCNS).

A

CCS → halt the M phase

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3
Q

Vinblastine is the most _______ (AE); Vincristine is the most ______(AE)

A
  • myelosuppressive
  • neurotoxic

(mn: Vinblastine BLASTS the bones; Vincristine CRISps the nerves”)

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4
Q

Mechanism of resistance to the mitotic inhibitors is via P-glycoprotein. Which mechanisms are specific to vinka alkaloids? “-taxanes”?

A

vinka: increase Rx efflux

“-taxanes”: mutate B-tubulin

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5
Q

The mitotic inhibitors halt M phase by targeting microtubules, how are the vinka alkaloids and the taxanes different in their MOA?

A
  • vinka: inhibits tubulin polymerization
  • taxanes: promote b-tubulin formation

(mn: “No Assemblies allowed in the vineyard; Taxes are Stable.”)

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6
Q

Which Taxane targets solid tumors? Which target non-small cell, head, neck, ovarian, bladder and breast?

A
  • paclitaxel
  • docetaxel
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7
Q

_______ (vinka alkaloid) targets lymphoma (hodgkins & NHL), breast and testicular cancer.

A

vinblastine

(most myelosuppressive)

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8
Q

_______ (vinka alkaloid) targets ALL, Hodgkin, leukemia & Wilms tumor?

A

Vincristine

(most neurotoxic)

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9
Q

Vinorelbine targets ______ (cancer)

A

solid tumors

(non-small cell lung, breast)

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10
Q

AE of the Taxanes (2)

A
  1. Myelosuppression
  2. hypersensitivity reaction (pre-treat w/corticosteroids & antihistamines)

(Docetaxel → neurotoxicity)

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11
Q

List the 2 sub-classes of the Topoisomerase Inhibitors (reduce supercoiling of DNA)

A
  1. Camptothecins
  2. Podophyllotoxins

(inhibiting the S phase)

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12
Q

What is the difference in the MOA between the Camptothecins and the Podophyllotoxins?

A
  • camptothecin inhibits topoisomerase I
  • podophyllotoxin inhibits topoisomerase II

(both cause strand to break from ⇣ supercoiling)

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13
Q

Which camptothecin treats metastatic colorectal cancer? Which treats ovarian?

A
  • Irinotecan: colorectal
  • Topotecan: ovarian
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14
Q

Which camptothecin has severe diarrhea as an adverse effect in addition to N/V & alopecia?

A

Irinotecan

(tx: metastatic colorectal CA)

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15
Q

Which of the topoisomerase inhibitors needs a dosage adjustment for renal dysfunction?

A

Etoposide (podophyllotoxin sub-class)

(tx: Lung CA & Lymphomas)

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16
Q

Which podophyllotoxin (sub-class of topoisomerase inhibitors) treats Lung CA & lymphoma? Which treats Acute Leukemia?

A
  • Etoposide: Lung & Lymphoma
  • Teniposide: Acute Leukemia
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17
Q

Which of the Antitumor ABX is CCS?

A

Bleomycin

(the other antitumor ABX are CCNS)

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18
Q

List the 3 anthracyclines (sub-class of antitumor ABX)

A
  1. Doxorubicin
  2. Daunorubicin
  3. Mitoxantrone
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19
Q

Doxorubicin & Mitoxantrone target solid tumors, specifically _____.

A

breast cancer

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20
Q

Which anthracyclines both treat AML?

A
  1. Daunorubicin
  2. Mitoxantrone
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21
Q

Doxorubicin treats breast cancer and _____.

(mitoxantrone tx breast CA also)

A

leukemia/lymphoma

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22
Q

Mitoxantrone treats breast CA, and ______(4).

A
  1. prostate
  2. AML
  3. NHL
  4. GE
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23
Q

Which antitumor ABX treats HL, testicular, head, neck and skin CA?

A

Bleomycin

(AE: pulmonary fibrosis & mucocutaneous rxn)

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24
Q

Which 3 Antitumor ABX impair topoisomerase II & generate free radicals to inhibit RNA & DNA synthesis?

A
  1. Doxorubicin
  2. Mitoxantrone
  3. Daunorubicin

(anthracyclines)

25
Q

_______ MOA = reaction w/O2→ superoxide hydroxyl radical

A

bleomycin

(tx: HL, testicular, head, neck & skin CA)

26
Q

Mechanism of resistance to bleomycin

A
  1. increase bleomycin hydrolase
  2. ⇡ DNA repair
27
Q

Side effect of ______ is red urine

A

mitoxantrone

(least cardiotoxic)

28
Q

Mucocutaneous reaction and pulmonary fibrosis are side effects of _______

A

bleomycin

(similar to Hand-foot syndrome - AE of Capecitabine)

29
Q

_______ is the MC acute dose-limiting toxicity of the anthracyclines (subclass of topoisomerase inhibitors)

A

Myelosuppression

30
Q

Prednisone is converted to prednisolone by _______.

31
Q

Prednisone is used to treat ______(2 types CA)

A
  1. Acute leukemia (ALL)
  2. Lymphoma (HL & NHL)
32
Q

______ causes lymphocytopenia & decreases lymphoid mass.

A

Prednisone

33
Q

Which hormonal agent is a SERM (selective estrogen receptor modulator) which inhibits RNA synthesis

34
Q

Menopausal sx & endometrial cancer are potential AE of _____. Hot flashes & arthralgia are side effects of ______-

A
  • tamoxifen
  • aromatase inhibitors (anastrozole, letrozole, exemestane)

(tx: breast CA)

35
Q

Which 2 hormonal agents subclasses treat breast cancer?

A
  1. Estrogen receptor Antagonist (SERM)
  2. Aromatase
36
Q

List the 3 Aromatase inhibitors used to treat breast cancer.

(block conversion of testosterone→estrogen)

A
  1. Anastrozole
  2. Letrozole
  3. Exemestane
37
Q

List the 3 Androgen receptor antagonists (DHT)

A
  1. Flutamide
  2. Bicalutamide
  3. Enzalutamide
38
Q

List the 2 GnRH agonists

39
Q

Which 2 subclasses of hormonal agents treat prostate cancer?

A
  1. GnRH agonists
  2. Androgen receptor (DHT) antagonists
40
Q

________ treats resistant prostate cancer (metastatic castration)

A

Enzalutamide

41
Q

______ (subclass of hormonal agents) cause a surge in LH & FSH followed by inhibition.

A

GnRH agonists

42
Q

Impotence and gynecomastia are side effects of _____ (subclass of hormonal agents)

A

GnRH agonists

43
Q

List the 2 protease inhibitors (chemo Rx)

A
  1. Bortezomib
  2. Carfilzomib

(“-zomib”)

44
Q

Bortezomib & Carfilzomib inhibit _____ → apoptosis

A

Proteasome

45
Q

_______ treats Multiple Myeloma

A

Bortezomib & Carfilzomib

(“Bart proteasomal inhibitor zombie”)

46
Q

Which 2 classes of chemo Rx causes peripheral neuropathy, thrombocytopenia and heart failure?

A
  1. Proteasome inhibitors (bortezomib & carfilzomib)
  2. Taxanes

(Vincristine (Vinka alkaloid), also)

47
Q

Which 2 chemo medications are contraindicated which CYP3A4 inhibitors (including grapefruit juice)?

A
  1. Nilotinib
  2. Proteasome inhibitors (Bortezomib, Carfilzomib)
48
Q

List 4 monoclonal Ab used to treat cancer

A
  1. Bevacizumab
  2. Cetuximab
  3. Rituximab
  4. Trastuzumab
49
Q

_____ (mAb) treats CLL & lymphoma

50
Q

_______ is an Anti-CD20 mAb and may cause a hypersensitivity reaction.

A

Rituximab

(causes complement activation)

51
Q

_______ is a HER2 growth receptor inhibitor → ADCC. Side effect: CHF.

A

Trastuzumab

52
Q

______ is mAb that treats metastatic colorectal cancer and is a VEGF inhibitor.

A

Bevacizumab

53
Q

Bevacizumab side effects (5)

A
  1. delayed wound healing
  2. thrombosis
  3. GI perforation
  4. proteinuria
  5. HTN
54
Q

_____ is used to treat metastatic colorectal cancer, and cancers of the head/neck. Acneiform rash is an indication of efficacy.

A

Cetuximab

(MOA: epidermal growth factor inhibitor)

55
Q

Cetuximab is a ______ inhibitor

A

epidermal growth factor

56
Q

______ is a side effect of the monoclonal Ab class of chemo Rxs.

A

tumor lysis syndrome → cytokine release causes fever/chills and hypotension

(may be fatal if w/o intervention)

57
Q

_______ is a tyrosine kinase inhibitor and is a second line therapy for CML.

58
Q

_______ is contraindicated in patients who have a long QT, hypomagnesemia, or hypoK+ or who drink grapefruit juice.

A

Nilotinib

(Grapefruit juice = CYP3A4 inhibitor)

59
Q

Nilotinib may cause CHF, QT prolongation or ______.

A

pancreatitis

Blood & Lymph (29 decks)

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