Chemotherapy II Alkylating Agents

Question 1

What is the action of alkylating agents?

Answer 1

Covalent binding to DNA by alkylating N-7 of guanine that is cell cycle non-specific

Question 2

What is required for cyclophosphamide function?

Answer 2

Activation via a P450 oxidase enzyme

Question 3

Cyclophosphamide Indications

Answer 3

• Breast Cancer

- Non-Hodgkin Lymphoma

Question 4

Cyclophosphamide SE

Answer 4

• Nausea
• Vomiting
• Hair loss
• Myelosppressoin
• Hematuria

Question 5

What is the difference between ifosfamide and cyclophosphamide?

Answer 5

Ifosfamide has 20% of the alkylating effect that cyclophosphamide does

Question 6

Ifosfamide SE

Answer 6

• Hematuria
• Myelosuppression
• Hair loss

Question 7

What must be coadministered with ifosfamide and why?

Answer 7

Coadminister with mesna which is a uroprotectant to prevent hematuria which occurs much more regularly with ifosfamide

Question 8

Ifosfamide Indications

Answer 8

• Testicular Cancer

- Soft Tissue Sarcoma

Question 9

Temozolomide MOA

Answer 9

Methylates the DNA and inhibits DNA function and DNA synthesis

Question 10

Temozolomide SE

Answer 10

• Nausea
• Vomiting
• Hair loss

Question 11

What is required for long term use of temozolomide?

Answer 11

Prophylaxis for pneumocystis carinii pneumonia

Question 12

Temozolomide Indications

Answer 12

Primary brain tumors like glioblastoma

Question 13

Cisplatin MOA

Answer 13

Binds covalently to DNA to produce cytotoxic interstrand and intrastrand crosslinks

Question 14

Cisplatin SE

Answer 14

• Intense nausea and vomiting
• Renal toxicity is dose limiting
• Hearing loss
• Hypomagnesemia

Question 15

What is given with cisplatin to prevent kidney damage?

Answer 15

Mannitol with saline hydration

Question 16

Cisplatin Indications

Answer 16

• Testicular cancer (CURATIVE)
• Bladder cancer
• Head and neck cancer
• Ovarian cancer
• Small cell and non small cell lung cancer

Question 17

What is the difference between cisplatin and carboplatin?

Answer 17

Carboplatin is not renal toxic and doses are instead limited by the myelosuppression

Question 18

What cancer is very sensitive to cisplatin?

Answer 18

Testicular Cancer

Question 19

What is the dose limiting toxicity for cisplatin?

Answer 19

Renal toxicity

Question 20

Oxaliplatin Indications

Answer 20

Colorectal cancer

Question 21

Oxaliplatin SE

Answer 21

• Acute cold induced neuropathy

- Chronic sensory neuropathy

Question 22

Vincristine MOA

Answer 22

Prevents polymerization of tubular

Question 23

What phase of the cell cycle is vincristine specific for?

Answer 23

M-phase

Question 24

Vincristine SE

Answer 24

Neuropathy

Question 25

Vincristine Indications

Answer 25

• Non-Hodgkin’s lymphoma
• Acute lymphoblastic leukemia
• Lymphoma

Question 26

Paclitaxel MOA

Answer 26

Prevents tubulin disassembly

Question 27

What phase of the cell cycle is paclitaxel specific for?

Answer 27

M-phase

Question 28

Paclitaxel SE

Answer 28

• Myelosuppression
• Hair loss
• Nausea/vomiting
• Peripheral sensory neuropathy
• Myalgia

Question 29

How is paclitaxel metabolized?

Answer 29

Predominantly hepatic metabolism

Question 30

Paclitaxel Indications

Answer 30

Ovarian, gastroesophageal, breast and non-small cell lung cancers

Question 31

Etoposide MOA

Answer 31

Targets topoisomerase II and produces DNA double strand breaks

Question 32

What cell cycle phase is etoposide specific for?

Answer 32

G1-S phase

Question 33

Etoposide SE

Answer 33

• Nausea/vomiting
• Hair loss
• Myelosuppression
• Can cause leukemia

Question 34

Etoposide Indications

Answer 34

• Testicular cancer
• Lung cancer
• Lymphoma