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Hematology > Chemotherapy drugs > Flashcards

Chemotherapy drugs Flashcards

1
Q

Alkylating drugs (including platinum)

A

Cyclophosphamide, Ifosfamide, cisplatin, carboplatin, oxaliplatin

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2
Q

Mechanism of alkylating drug class

A

Cell cycle NON specific. Causes cross linking of base pairs

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3
Q

Toxicities from typical alkylating agents?

A
  1. Myelosuppression
  2. Nausea/vomitting
  3. Secondary malignancies
  4. Infertility/impaired fertility
  5. Hemorrhagic cystis
    - Ifosfamide produces more acrolein than cyclophosphamide. So need to give Mesna to prevent renal issues
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4
Q

Toxicities from atypical alkylating agents (platinum compounds)

A
  1. Peripheral neuropathies
    - Oxaliplatin: cold sensitivity
  2. Nephrotoxic (cisplatin)
    - Prevention with forced diuresis, mannitol.
    - Increased creatinine 3-6 days after administartion
    - Magnesium wasting
  3. Nausea/vomiting (cisplatin)
  4. Thrombocytopenia (carboplatin)
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5
Q

Roles of methotrexate? Toxicities?

A

Works as a folate antagonist inhibiting DHFR. Toxicity: Mucositis, myelosuppression

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6
Q

Role of 5-fluorouracil? Toxicities?

A

Works as a pyrimidine analogue by inhibiting thymidylate synthase. Toxicities: Continuous infusion leads to GI symptoms (mucositis, diarrhea). Bolus dose leads to myelosuppression

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7
Q

Role of Capecitbatine? Toxicities?

A

Works as a pyrimidine analogue. Toxicities: Hand-foot syndrome

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8
Q

Role of cytarabine (Ara-C)? Toxicities?

A

Works as a pyrimidine antagonist. Continuous infusion and high dose. Toxicities with high dose: Cerebellar toxicity (increased incidence with renal dysfunction, cr>2), conjunctivities

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9
Q

Role of 6-mercaptopurine? Toxicities?

A

Works as a purine antagonist. Toxicities: Not mentioned??

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10
Q

Types of microtubule targeting agents?

A
  1. Vincas
  2. Taxanes
  3. Topoisomerase I inhibs
  4. Topoisomerase II inhibts
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11
Q

Mechanism of vincas? Examples? Toxicities?

A

Mechanism: M-phase Microtubular destruction
Examples: Vincristine, vinblastine
Toxicities: Cumulative neurotoxicities, variable myelsuppresion (vinblastine>vincristine), FATAL IF GIVEN INTRATHECALLY

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12
Q

Mechanism of Taxanes? Examples? Toxicities?

A

Mechanism: M-phase Microtubular stabilization
Examples: Abraxane (paclitaxel protein-bound particles) paclitaxel, docetaxel
Toxicities: Myelosuppresion, peripheral neuropathies, hypersensitivity. Cremaphor diluent in paclitaxel>Tween80 in docetaxel

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13
Q

Mechanism of Topoisomere I inhibitors? Examples? Toxicities?

A

Mechanism: Inhibits enzyme responsible for relaxing supercoiled DNA, preventing transcription
Examples: Topetecan, irinotecan
Toxicities: Myelosuppresion, Diarrhea (early onset is self-limiting-give atropine, late onset is life threatening-give as much loperamide as you need)

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14
Q

Mechanism of Topoisomere II inhibitors? Examples? Toxicities?

A

Mechanism: Inhibits enzyme responsible for recoiling DNA after transcription
Examples: Etoposide
Toxicities: Myelosuppresion, secondary malignancies (AML11q23), dose dependent mucositis

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15
Q

Mechanism of Anthracyclines? Examples? Toxicities?

A

Mechanism: Intercalates DNA and inhibits topoisomerase. Secondary mechiansm includes free radical damage and perhaps some alkylation
Examples: Doxorubicin (most solid tumors), daunorubicin (acute leukemias), idarubicin, epirubicin (breast cancer)
Toxicities: All cause cumulative, dose-dependent biventricular heart failure. Extravasation. Myelosuppresion, mucositis

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16
Q

What are 2 Differentiating agents? Toxicities?

A
  1. All trans retinoic acid
  2. Arsenic trioxicde
    Toxicities: Cardiotoxicity with electrolyte abnormalities (Arsenic) Differentiation syndrome
17
Q

Examples of antitumor antibiotics? Toxicities?

A

Examples: Bleomycin and Proteasome inhibitor (Bortezomib)
Toxicities: Pulmonary toxicity (Bleomycin); Proteasome inhibitor: Fatigue, weakness, malaise, neuropathy, thrombocytopenia

18
Q

Mechanism of immunomodulating agents (atypical therapeutics) (Imids)? Examples? Toxicities?

A

Mechanism: Antiangiogenesis through inhibition of VEGF
Example: Thalidomide and lenalidomide
Toxicities: Neuropathy, thromboembolism

19
Q

Mechanism of biologic response modifiers? Examples? Toxicities?

A

Mechanism: Modulation of host immune system to enchance recognition and antineoplastic effects
Examples: Interferon and IL-2
Toxicities: Flu-like symptoms, depression/psychiatric symptoms

20
Q

Example of hormonal therapy anti-estrogens (2)

A

Tamoxifen and fulvestrant (used for Breast cancer)

21
Q

Example of hormonal therapy aromatase inhibitors (3)

A

Anastrozole, letrozole, and Exemestane (irreversible) (used for Breast cancer)

22
Q

Example of hormonal therapy for antiandrogens (3)

A

Flutamide, Bicalutamide, Nilutamide (used for prostate cancer)

23
Q

Example of hormonal thearpy LHRH agonists (2)

A

Leuprolide, Goserelin (Used for tumor “flare and prostate cancer)

24
Q

Example of hormonal thearpy GnRH anatognists (1)

A

Degarelix (Used for prostate cancer)

25
Q

Example of hormonal therapy CYP17 inhibitors (1)

A

Abiraterone (androgen biosynthesis inhibitor) (Used for prostate cancer)

26
Q

Order of monoclonal antibodies from murine to human

A

Murine (100%): Muromonab
Chimeric (33%): Cetuximab, rituximab
Humanized (10%): Bevacizumab, trastuzumab
Human (0%): Panitumumab

27
Q

Mechanism of bevacizumab and associated toxicities

A

Mechanism: Monoclonal antibody directed against VEGF-R
Toxicties: Proteinuria, GI perforation

28
Q

Mechanism of Cetuximab and associated toxicities

A

Mechanism: Monoclonal antibody directed against EGFR
Toxicities: Severe hypersensitivity reactions, acneiform rash (correlates with survival)

29
Q

Mechanism of Imatinib and toxicities

A

Mechanism: Protein tyrosine kinase inhibitor that inhibits the Bcr-Abl tyrosine kinase gene. This inhibits proliferation and induces apoptosis in Bcr-Abl positive cell lines
Toxicties: Acneiform rash (more associated with EGFR directed therapies)

30
Q

Mechanism of ipilimumab and toxicities

A

Mechaniasm: Monoclonal antibody that blocks CTLA-4. CTLA-4 typically tones down the immune system. So this drug therefore helps T-cells remain active.
Toxicities: Rash, diarrhea, liver toxicity, hypophysitis

Hematology (6 decks)

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