Chemotherapy Flashcards
Alkylating Agents
cell cycle NON-specific
cross-link DNA (prevent replication)
inhibit protein synthesis
different groups same mechanism of action: (cyclophosphamide, chlorambucil, melphalan, lomustine)
class cross-resistance except Lomustine
other drugs: procarbazine, cisplatin, carboplatin
Cyclophosphamide: class/MOA
alkylating agent: cross-link DNA (prevent replication),
inhibit protein synthesis.
hepatic activation, renal excretion
Cyclophosphamide: uses
lymphoma, hemangiosarcoma, soft-tissue sarcomas
Cyclophosphamide: adverse effects/toxicity
bladder toxicity. (SIADHS) Syndrome of Inappropriate ADH secretion (hyponatremia)
Chlorambucil: class/MOA
alkylating agent: cross-link DNA (prevent replication), inhibit protein synthesis.
renal excretion
Chlorambucil: uses
substitute for Cytoxan
chronic lymphocytic leukemia
feline GI (small cell) lymphoma
Chlorambucil: adverse effects/toxicity
mild myelosuppression, GI
Melphalan: class/MOA
alkylating agent: cross-link DNA (prevent replication), inhibit protein synthesis.
Melphalan: uses
multiple myeloma, lymphoma rescue
Melphalan: adverse effects/toxicity
myelosuppression (thrombocytopenia), GI
Lomustine: class/MOA
alkylating agent. cross-link DNA (prevent replication), inhibit protein synthesis.
Lomustine: uses
part of LOPP protocol for lymphoma. highly lipid soluble and low molecular weight, crosses BBB
Lomustine: adverse effects/toxicity
myelosuppressive and possibly (irreversibly) hepatic toxic
Procarbazine (Matulane): class/MOA
alkylating agent. cross-like DNA (prevent replication), inhibit protein synthesis.
Procarbazine (Matulane): uses
LOPP/MOPP rescue protocol for lymphoma
Cisplatin: class/MOA
alkylating agent. highly protein bound.
Cisplatin: uses
osteosarcoma, squamous cell carcinoma. can be used intralesional. aka: Platinol
Cisplatin: adverse effects/toxicity
nephrotoxic, nausea, fatal pulmonary edema in cats
Carboplatin (aka paraplatin): class
alkylating agent.
Carboplatin (aka paraplatin): adverse effects/toxicity
myelosuppression (monitor platelets). safe for cats! fewer GI side effects!
Antimetabolites
cell cycle phase SPECIFIC (S-phase)
purine and/or pyrimidine analogues
inserted into DNA–>nonfunctional
drugs: methotrexate, cytosine arabinoside, 5-fluorouracil
Methotrexate: class/MOA
antimetabolite. dihydrofolate reductase antagonist. (product of reduction required for purine precursors)
Methotrexate: uses
Lymphoma, CNS tumors, osteosarcoma
Methotrexate: toxicity
GI and myelosuppression. reversible with leucovorin (Wellcovorin-reduced folate)
Cytosine Arabinoside: class/MOA
antimetabolite. pyrimidine analogue, disrupts DNA, S phase arrest
Cytosine Arabinoside: uses
renal lymphoma, lymphoma rescue, CNS tumors
Antibiotics
cell cycle phase NONspecific. Drugs: Doxorubicin, Actinomycin D, Mitoxantrone. Anthracyclines: derived from Streptomyces, mechanisms are free radical damage and inhibition of topoisomerase II
Doxorubicin: class/MOA
Antibiotic. inhibit topoisomerase II, cell cycle nonspecific.
Doxorubicin: Adverse effects/toxicity
anaphylaxis, vesicant (causes blistering), cardiotoxicity. May turn urine orange/red
Doxorubicin: uses
lymphoma, osteosaroma, hemangiosarcoma
Mitoxantrone: Class/MOA
antibiotic. inhibit topoisomerase II, cell cycle phase nonspecific.
Mitoxantrone: uses
LSA rescue, transitional cell carcinoma, thymomas
Mitoxantrone: adverse effects/toxicity
myelosuppression, GI, may turn urine blue/green
Actinomycin D: class/MOA
antibiotic. inhibit topoisomerase II, cell cycle phase nonspecific.
Actinomycin D: uses
lymphoma rescue, (non-cardiotoxic substitute for Doxorubicin)
Actinomycin D: adverse effects/toxcicity
myelosuppression, GI
Plant Alkaloids
Bind to microtubules of the mitotic spindle. cell cycle phase SPECIFIC (M phase). Drugs that prevent assembly: Vincristine, Vinblastine
Vincristine: class/MOA
Plant alkaloid. prevents mitotic spindle assembly, M phase arrest
Vincristine: uses
lymphoma (combo protocols), transmissible venereal tumor, thrombocytopenia
Vincristine: adverse effects/toxcitiy
vesicant, myelosuppression, peripheral neuropathy
Vinblastine: class/MOA
plant alkaloid. prevent mitotic spindle assembly, M phase arrest.
Vinblastine: uses
mast cell tumor, substitute for vincristine if neuropathy suspected
Vinblastine: adverse effects/toxicity
vesicant, myelosuppression (more than vincristine)
Prednisone: class/MOA
hormone. immunosuppressant steroid, inhibits DNA synthesis. Lympholytic.
Prednisone: uses
Lymphoma, mast cell tumor, insulinoma, intracranial neoplasia. DON’T USE WITH NSAIDS.
Prednisone: adverse effects/toxicity
polyuria, polydipsia, polyphagia, panting, GI ulceration
L-asparaginase: class/MOA
enzyme. cell cycle phase NONspecific. (maximum activity in G1 phase). Degrades asparagine.
L-asparaginase: uses
lymphoma
L-asparaginase: adverse effects/toxicity
anaphylaxis, panreatitis. alone not myelosuppressive, but potential vincristine-induced myelosuppression
Toceranib: class/MOA
Targeted therapy, targets RT-Kinases (KIT)
Toceranib: uses
mast cell tumor
Toceranib: adverse effects/toxicity
effects on bone marrow, GIT, skin and renal
Masitinib: class/MOA
Targeted therapy, targets RT-Kinases (PDGF)
Masitinib: uses
mast cell tumor
Masitinib: adverse effects/toxicity
effects on bone marrow, GIT, skin, renal
Rabacfosadine (Tanovea CA-1): class/MOA
Targeted therapy. Inhibits DNA polymerases responsible for replication.
Rabacfosadine (Tanovea-CA-1): uses
First FDA conditionally approved treatment for canine Lymphoma.
Rabacfosadine (Tanovea-CA-1): adverse effects/toxicity
decreased white blood cell count, diarrhea, vomiting, decreased appetite, weight loss, skin problems, serious and sometimes fatal respiratory complications. (pulmonary fibrosis) (DON’T use in West Highland White Terriers, caution in other terriers)
