Condensed pharm

Question 1

Alkylating subgroups

Answer 1

Nitrogen mustards
Nitrosoureas

General- effect all phases, can be seen more in S phase

Question 2

Nitrogen mustards and side effects

Answer 2

Mechlorethamine- Vesicant
Tx: Thiosulfate
Do not give if pregnant

Cyclophosphamide pro drug
Hemorrhagic cycstitis (give fluid and MESNA)
Leukopenia
SIADH (Give lasix)

Question 3

Nitrosoureas action, main drug and its side effect

Answer 3

Alkylates carbomoylate protein and attacks O2, and can cross BBB

Carmustine- can cause pulmonary fibrosis

Question 4

Folic acid analog

Answer 4

Methotrexate
Give with low dose of leukovorin to rescue healthy cells
Can cause renal/neuro toxicity

Question 5

Pyrimidine analogs and side effects

Answer 5

Can cause Uric acid build up from xanthine oxidase

ARA-C is a deoxycytidine and fragments dbl helix via steric hindrance (most effective in S phase)
Commonly given with vinblastine (causes accumulation of cells in S phase)

Question 6

Purine analogs

Answer 6

6-MP
6-TG
Fludarabine
Pentostatin
Cladribine and clofarabine

Question 7

6-MP

Answer 7

Use with allopurinol because it reduces its metabolism and decreases uric acid levels

Question 8

6-TG

Answer 8

Also use with allopurinol

Activatied by HGPRT

Question 9

Pentostatin

Answer 9

FATAL PULMONARY TOXICITY if given with Fludarabine

Question 10

Fludarabine

Answer 10

FATAL PULMONARY TOXICITY if given with Pentostatin

Question 11

Cladribine and Clofarbine

Answer 11

Reduce NAD and ATP

Question 12

Vinca alkaloids side effects and drugs

Answer 12

M Phase specific
Binds tubulin
Disrupts transport=Neurotoxin
Resistance if P-gp gene amplified
Death if given intrathecally
Extreme pain fon extravasastion from Phlebitis

Vincristine
Vinblastine

Question 13

Vincristine

Answer 13

In MOPP regimen

Neuropathy

Question 14

Vinblastine

Answer 14

Give with ARA-C, gets stuck in S phace and ARA-C becomes more effective

Can cause SIADH

Question 15

Topo 2 inhibitors

Answer 15

Binds tubulin, does not effect structure
Prevents re-annealing of cells in S and G2 phases

Etopiside- Mild thrombocytopenia
Teniposide- Longer duration

Question 16

Anthracycline side fx and drugs

Answer 16

All with rubicin in the name

Intercalates between opposite DNA strands, they then break

CARDIOTOXIC: Use with dexrazoxane

Question 17

Doxorubicin

Answer 17

VESICANT with Adriamycin flare streaking
Causes red urine and leukopenia
Cardiotoxitiy-Quinones attached to the anthracycline ring form semiquinones that chelate iron forming an Rx-Fe-DNA complex that reacts with O2

Question 18

Daunorubicin

Answer 18

Like doxorubicin but with a limited spectrum

Question 19

End anthracyclines

Answer 19

Mitoxanthrone

Bleomycin

Question 20

Mitoxantrone

Answer 20

Less toxic than Bleomycin

Question 21

Bleomycin

Answer 21

PULMONARY FIBROSIS and CUTANEOUS problems

Chelates copper and iron

Question 22

L-Asparaginase

Answer 22

Anaphylaxis
Hyperglycemia
Bleeding

Question 23

DNA methylating agents

Answer 23

Azacitidine
Decitabine
Nelarabine

Question 24

Azacitidine

Answer 24

Covalently binds to DNA cytosine methyltransferase

Leads to apoptosis

Question 25

Decitabine

Answer 25

Like azacitidine but also breaks DNA strand

Question 26

Monoclonal IgG antibodies end with mab | All target CD20 except the A one

Answer 26

Alemtuzumab- CD52 | Tositomomab- kills via ionizing radiation

Question 27

Interferons BBW

Answer 27

Aggravating fatal neuropsychiatric, autoimmune, ischemic, and infectious disorders Alpha 2a (inhibits ornithine decarboxylase), peg2a, alpha 2b

Question 28

Aldesleukin

Answer 28

Acts on T cell progenitors to make LAK CAPILLARY LEAK SYNDROME

Question 29

Denileukin difitox

Answer 29

IL2 with Diptheria toxin | CAPILLARY LEAK SYNDROME

Question 30

BCR-ABL protein TK inhibitors

Answer 30

``` t9;22 with Ph chromosome Imitiinab- Nilotinib- Dasatinib- Pronatinib- BBW Ibrutinib- prevents -cell trafficing ```

Question 31

Pronatinib BBW

Answer 31

Thrombosis and hepato toxicity

Question 32

Hydroxyurea

Answer 32

S phase specific

Question 33

Tretinoin

Answer 33

RAR-RXR binding Inhibits proliferation Do not give if pregnant

Question 34

Arsenic trioxide

Answer 34

DNA fragmentation

Question 35

Bortezomib

Answer 35

Inhibits ubiquitin pathway

Question 36

Thalidomide

Answer 36

Inhibits angiogenesis, decreases TNFa and leukocyte migration

Question 37

Lenalidomide

Answer 37

Like thalidomide just not as teratogenic

Question 38

Pomalidomide

Answer 38

Do not give if pregnant.