Chemotherapy Flashcards
5FU
fluropyrimidine
prodrug, used for T
interferes with FA absorption
SE FA deficiency
Capecitabine
fluropyrimidines
prodrug, used for U
toxic: neutropenia, thrombocytopenia, anemia
SE: bleeding if also no coumadin, hand-foot syndrome, diarrhea
Cytarabine
cytidine analogue
analogue of C
inhibits DNA polymerase
Toxic: cerebellar syndrome, bone suppression, N/V, abd pain, oral ulceration, hepatic dysfunction
Gemcitabine
cytidine analogue
inhibits DNA polymerase and ribonucleotide reductase
Azacytidine, Decitabine
nucleoside analogue
stops progression of myelodysplastic syndrome
reduces transfusion needs
toxic: myelosuppression
Mercaptopurine, Thioguanine
purines
metabolized by TPMT (decrease dose 6-MP)
SE: hepatotoxicity, BM suppression
-If gout txed with allopurinol, reduce merc. dose by 75%
Fludarabine
interferes with DNA polymerase
toxic: myelosuppression, increase infection
Cladribine, Pentostatin
purine nucleoside analogue
clad–> resists deactivation by adenosine deaminase
pent–> inhibits adenosine deaminase; don’t use with fludarabine (toxicity to bone, lung, liver, brain)
SE: myelosuppression, increase risk of infection
Methotrexate, Demetrexed
antifolate
supplement prn with B12 and FA
SE: neutropenia, thrombocytopenia, mucusitis, hepatotoxicity, N/V
RTN with high dose MTX= water, increase pH urine
Vinca alkaloids
mitotic inhibitor–> inhibits microtubule assembly
resistnat cancer develops w/ Pgp
extravasatoin–> apply heat packs
Taxanes
anti-mitotic
interfere with microtubule disassembly (use corticosteroids before use)
SE myelosuppression
*give corticosteroids before using either of the following…
Doxetaxel: increase fluid retention
Paclitaxel: increase neurotoxicity, give anti-histamines before use, don’t give if bilirubin >ULN or SGOT/SGPT 1.5x ULN
Epothilone
used in paclitaxel resistant lines
Ixabepilone used to tx metastatic breast cancer
premedicate with anti-histamines
Estramustine
alkylating agent nor-N2 mustard with estradiol
inhibits microtubule assembly
Camptothecin
inhibit TIase I
toxic: diarrhea (tx with imodium), neutropenia
Etoposide, Teniposide
inhibit TIase II
toxic: myelosuppression, bleeding
Mitoxantrone
intercalalting TIase II, but potential for free radicals less than anthracenes
used in MS
toxic: cardiotoxicity, AML
Anthracene
Doxorubicin, daunorubicin, idarubicin, epirubicin
intercalating TIase inhibitors
generates free radicals
if at risk for cardiomyopathy apply cold pack 15 min before dexrazoxane (apply within 6 hours)
Toxic: AML, fatal CHF if dose>400 (doxo)
Cisplatin
nephrotoxicity, ototoxicity, peripheral neuropathy, emesis, anemia
Carboplatin
limited by hematologic toxicity (less likely than cisplatin for SE)
Oxaliplatin
moderately emetogenic, peripheral neuropathies, unique cold-induced neuropathies
N2 mustards
cyclophosphamide and ifosfamide
tx solid tumors and hematologic malignancies
infuse MENSA to reduce risk of hemorrhagic cystitis
encephalopathy following ifosfamide infusion d/t increase risk of CNS toxicity
Bendamustine
active against dividing cells
tx lymphoid malignancies
Nitrosourea
DNA alkylating agent
BCNU (IV drug impregnated biodegradable wafer following sx) and CCNU
Bleomycin
anti tumor abx
inactivated within cells by enzyme aminohydrolase (low concentration in lungs, skin)
toxic: pulmonary fibrosis
Hydroxurea
inhibits RNA reductase
toxic: clastogenicity, mutagenicity
Asparaginase
depletes supplies and inhibits protein synthesis
tx: acute leukemia
Arsenic Trioxide
induces apoptosis
used for some leukemias
Vorinostat
histone deacetylase inhibitor
used for skin cancer
SE: PE and DVT
Rituximab
CD20
B cell non-Hodgkins lymphoma
SE: transient fever, chills, N, headache, asthenia
Ibritumomab
CD20
non-Hodgkin lymphoma
SE: infusion related rxs, anaphylaxis, thrombocytopenia, neutropenia
Alemtuzumab
CD52
SE: black box opportunistic infections
Cetuximab
EGFR
used alone or in combo for metastatic colon cancer, head and neck cancers
SE: fatigue, GI complaints, abd pain, reports of death/CP arrest
Panitumumab
EGFR ligand
Trastuzumab (Herceptin)
HER-2
tx metastatic breast cancer
risk of cardiac failure (esp with anthracyclins)
Erlotinib
selective EGFR tyrosine kinase inhibitor
SE: rash and diarrhea
Lapatinib
inhibits EGFR and HER-2
SE: diarrhea, rash, hepatotoxicity, increase QT interval
Bevacizumab
prevents activation and promotion of angiogenesis
SE: HTN, bleeding episodes, not recommended 28 days after sx
Sunitinib, Soraferib
inhibits VEGFR-2 and platelet derived GFR
Sun= CHF, Sora= hand-foot syndrome
