Chemotherapy Drugs Flashcards
Drug that acts as a mitotic spindle poison causing depolymerization of microtubles leading to destabilization; comes from periwinkle plant
Vinca Alkaloids
- Vincristine
- Vinblastine
What are the adverse effects of vinca alkaloids?
1) Neuro toxicity (Jaw pain, foot drop, constipation, paralytic ileus)
2) Vincristine cause SIADH
3) Bone marrow hypoplasia
4) Lethal if given IT
5) Vesicant
Drug that catalyzes the hydrolysis of asparagine to aspartic acid resulting in the inhibition of protein synthesis in tumor cells dependent upon aspargine?
1-Asparaginase
Drug that inhibits tyrosine kinase enzyme abl-bcr and induces apoptosis to cells positive for abl-bcr
Imatinib
What is Imatinib used to treat?
Imatinib is used to treat chronic myeloid leukemia which is caused by the translocation of 9:22 abl-bcr
How does Rituximab work?
Rituximab is a monoclonal antibody that is selective for CD20 which is found on B-cells; once activated it causes complement dependent cytotoxicity
Drugs that inhibit topoisomerase II generating free radicals and causing DNA breakage
Antrhacylines
- Daunorubicin
- Doxorubicine (adriamycin)
Toxicity of antrhacylcines (doxurubicin/adriamycin)
1) Dilated Cardiomyopathy and congestive heart failure
2) Severe vesicants (blistering)
3) Myelosuppresion
4) Stomatitis- inflammation of mucous lining in mouth
What drugs bind to tubulin and stabilize mitotic spindles causing inhibition of mitosis?
Taxanes
1) Paciltaxel
2) Docetaxel
What drug forms ternary complex with DNA and topoisomerase II preventing ligation of DNA strands?
Etoposide
How does cyclophosphamide work?
Cyclophosphamide is a classic alkylating agent that alkylates the 7th position nitrogen of guanine in DNA
Drug that inhibits replication by acting as a chain terminator; pyrimidine analog
Cytarabine
Drug that inhibits the conversion of folic acid to tetrahydrofolic acid by acting as a folic acid analog for dihydrofolate reductase; results in defective thymidine synthesis; S phase specific
Methotrexate
Drug that inhibits purine nucleotide synthesis and metabolism; thiopurine analog
6-Mercaptopurine
MOA of Leucovorin
1) Supplies reduced amount of folate that enables for purine synthesis to occur
2) Used for methotrexate toxicity
MOA of Cisplatin
Platinum alkylating compound that causes cross linking of DNA which causes damage
Drug that binds to Ferrous iron and DNA causing single and double free radicals
Bleomycin
What are the toxic effects of bleomycin?
1) Pulmonary fibrosis (think: BLAB)
2) Raynaud’s phenomenon
3) Palmar-plantar erythema
4) Mucositis
What are the toxic effects of rituximab?
1) Infusion related bronchospasm, hypotension
2) Leukopenia
What is apspariginase used to treat?
Acute Lymphoblastic leukemia
What is the treatment for acute promyelocytic leukemia?
Tretinoin
Toxicity of Methotrexate
1) Myelosuppresion (neutropenia in particular)
2) Renal Toxicity
3) Hepatic
4) CNS (seizures, changes in mental status)
5) GI (mucositis in particular)
6) Teratogenic
What drug can have full doses of other chemotherapeutic with it?
Imatinib
What is a side effect of ATRA?
Pseudotumor cerebri
Drug that inhibits thymidylate synthase resulting in decreased DNA and protein synthesis
5-Fluoruracil
What is given for a 5-fluoruracil toxicity
thymidine
MOA of busulfan
Alkylates DNA
Adverse effects of busulfan
1) Pulmonary fibrosis
2) hyperpigmentation
Monoclonal antibody against CD20
Rituximab
bcr-abl tyrosine kinase inhibitor
Imatinib
Monoclonal antibody against HER-2
Trastuzumab
Hemorrhagic cystitis caused by chemotherapeutic drug
Cyclophosphamide
What must you be aware of when treating with chemotherapeutics?
Tumor lysis syndrome
1) Leads to increased amounts of K and Nucleotides
2) Results in arrhythmias and elevated uric acid levels
What drugs can be used to reduce tumor lysis syndrome?
1) Allopurinol (xanthine oxidase inhibitor)
2) Rasburicase (acts like urate oxidase -breaks down uric acid)
Drug selective for HER2
Trastuzumab
Drug selective for IgE
Omalizumab
Drug selective for CD20
Rituximab
Drugs selective for TNF-alpha
1) Infliximab
2) Adalimumab
What do you use to prevent nephrotoxicity when using cisplatin
Amifostine
What drug do you give to prevent hemorrhagic cystitis in pt. receiving cyclophosphamide?
Mesna
- Binds to acrolein
What is the cause of hemorrhagic cystits by cyclophosphamide?
Metabolism of cyclophosphamide to acrolein