chemotherapy

Question 1

log kill hypothesis

Answer 1

chemo kills a constant fraction of cells via first order kinetics

Question 2

growth fraction

Answer 2

ratio of proliferating cells:cells in G0

Question 3

growth fraction and response to chemo

Answer 3

high growth fraction- good response

Question 4

drug of choice for chemo-related nausea/vomiting

Answer 4

5HT3 anatagonist (ondansetron)

Question 5

drugs used for the prevention of neutropenia

Answer 5

filgastrim

sargromastin

Question 6

general MOA of alkylating agents

Answer 6

cause DNA damage

Question 7

alkylating agents (4)

Answer 7

cyclophosphamide
busulfan
nitrosoureas
cisplatin

Question 8

adverse reaction of cyclophosphamide and prevention

Answer 8

metabolite acrolein causes hemorrhagic cystitis, prevent with mesna (donates sulfhydryl groups to neutralize metabolite)

Question 9

2 main adverse reactions of cisplatin/prevention

Answer 9

nephrotoxicity- prevent with amifostin

ototoxicity- due to acoustic nerve damage

Question 10

ADR of procarbazine

Answer 10

disulfuriam-like reaction

Question 11

busulfan is DOC for

Answer 11

CML

Question 12

ADR of busulfan

Answer 12

pulmonary fibrosis

Question 13

chlorambucil is DOC for

Answer 13

CLL

Question 14

nitrosureas are used for-

Answer 14

brain tumors, lipophilic, can cross BBB

Question 15

ADR of nitrosureas

Answer 15

CNS toxicity (dizziness, ataxia)

Question 16

anti-metabolites (4)

Answer 16

methotrexate, 6-MP, 5-FU, cytarabine

Question 17

methotrexate MOA

Answer 17

inhibits dihydrofolate reductase, thereby decreasing synthesis of DNA, RNA and key cellular proteins

Question 18

ADRs of methotrexate (2), reduced by

Answer 18

bone marrow suppression, mucositis
give leucovorin (folinic acid)

Question 19

6-MP MOA

Answer 19

converted by HGPRT to toxic metabolites that affect purine metabolism

Question 20

6-MP drug interaction

Answer 20

allopurinol (6-MP is degraded to inactive metabolites by XO, when XO inhibited, must reduce 6-MP dose)

Question 21

cytarabine MOA

Answer 21

activated by kinases to AraCTP, inhibits DNA polymerase

Question 22

5-FU MOA

Answer 22

converted to 5-FdUMP which competes for dUMP at thymidylate synthethase, leading to thymidineless death of cells

Question 23

5-FU ADR

Answer 23

bone marrow suppression

Question 24

vinka alkaloids MOA

Answer 24

bind B-tubulin, prevent mitotic spindle formation (M phase specific)

Question 25

ADR of vincristine/vinblastine

Answer 25

severe neurotoxicity

Question 26

main difference between vincristine and vinblastine

Answer 26

vincristine spares the bone marrow

Question 27

paciltaxel, docetaxel MOA

Answer 27

stablizes mitotic spindle, preventing disassembly and freezes in M phase (metaphase)

Question 28

topotecan, irinotecan MOA

Answer 28

inhibit topoisomerase I

Question 29

etopiside, teniposide MOA

Answer 29

inhibit topoisomerase II (laste S, early G2)

Question 30

anthracyclines MOA (doxorubicin)-4

Answer 30

intercalate between base pairs
inhibit topoisomerase II
generate free radicals to dec DNA/RNA synthesis
cause strand breaks

Question 31

ADR of dozorubicin

Answer 31

cardia toxicity, acute/chronic

prevent with dexrazoxane

Question 32

MOA of bleomycin (2)

Answer 32

forms complex with iron to cause break in DNA and free radicals

Question 33

ADR of bleomycin

Answer 33

pulmonary fibroisis

Question 34

cell cycle specificity of bleomycin

Answer 34

G2

Question 35

ADR of asparaginase

Answer 35

acute pancreatitis

Question 36

non-specific agents

Answer 36

alkylating agents

Question 37

S specific

Answer 37

anti-metabolites

Question 38

S-G2 specific

Answer 38

topoisomerase inhibitors

Question 39

G2 specific

Answer 39

bleomycin

Question 40

M specific (2)

Answer 40

vinka alkaloids, taxols