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Step 1 > Copy of HEME ONC Drugs - Rides > Flashcards

Copy of HEME ONC Drugs - Rides Flashcards

1
Q

Mineral/Vitamin: Ferrous Sulfate

A

1) Use: Iron defiecnt anemia
2) Class/MOA:
3) Side effects/ADEs: Constipation
4) Fun Facts

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2
Q

Mineral/Vitamin: Iron dextran = Iron sucrose

A

1) Use: FE Deficency Anemia
2) Class/MOA:
3) Side effects/ADEs: anaphalazis
4) Fun Facts

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3
Q

Mineral/Vitamin: Folic Acid

A

1) Use: PND, traumatic cardiac hemolytic anemia, folate defiency (alcoholism)
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

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4
Q

Mineral/Vitamin: Vitamin B12

A

1) Use: Pernicious Anemia
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

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5
Q

Desferrioxamine (Deferoozamine or Desferal)

A

1) Use: Thalasemias, or other disease with regular blood transfusions - helps avoid iron overload (causes cirrhosis, CHF, DM)
2) Class/MOA: IRON CHELATOR (NOT ORAL!)
3) Side effects/ADEs:
4) Fun Facts

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6
Q

Deferasirox (EXJADE)

A

1) Use: Thalasemias, or other disease with regular blood transfusions - helps avoid iron overload (causes cirrhosis, CHF, DM)
2) Class/MOA: Iron Cheltors ORAL
3) Side effects/ADEs:
4) Fun Facts

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7
Q

Epoeitin

A

1) Use: anemia
2) Class/MOA: GROWTH FACTOR EPO = increases RBC
3) Side effects/ADEs:
4) Fun Facts

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8
Q

Filgrastim (G-CSF; Neupogen); Sargramostim (GM-CSF; Leukine); Peg-Filgrastim (Neulasta)

A

1) Use: GROWTH FACTOR any chemo that causes neutropenia; meylosuppressive therapy
2) Class/MOA: stimulates proliferation, matruation and efficacy of NEUTROPHILS via JAK/STAT tyrosine kinase pathway
3) Side effects/ADEs:
4) Fun Facts: same as G-CSF

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9
Q

IL-11 (Oprelvekin, Neumega) Rx: thrombocytopenia

A

1) Use: GROWTH FACTOR thrombocytopenia
2) Class/MOA: stimulates the growth of primative MEGAKARYOCYTE progenitors - increase megakaryocytes, increase peripheral platelets
3) Side effects/ADEs: fatigue, headache, CVE
4) Fun Facts:

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10
Q

Growth Factor: Romiplostim (Nplade) - Thrombopoeitin analog - Rx for chronic ITP

A

1) Use: GROWTH FACTOR thrombocytopenia
2) Class/MOA: same as IL-12: stimulates growth of primative megakarycytic progenitors, increasing megakaryocytes, increasing platelets
3) Side effects/ADEs: fatigue, headache, CVE
4) Fun Facts

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11
Q

Asprinin

A

1) Use: PLATELET INHIBITOR (dec aggregation), antipyretic, analgesic, antiinflamm
2) Class/MOA: covalently Actylates and irreversibly inhibits COX-1 and COX-2 to prevent conversion of arachadonic acid to thromboxane A2. Platelets cannot synth new enzyme (effects last until new platelets produced-inc bleeding time, dec prostaglandins. No change in pt or ptt)
3) Side effects/ADEs: Gastric ulcertation, tinnitus (cn viii). chronic use–> acute renal failure, interstitial nephritis, upper GI bleeding, hyperventilation (od–> resp alk + met acidosis), Reye’s Syndr (in kids w/ viral infect)

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12
Q

Ticlopidine, Clopidogrel (Plavix), prasurgrel, ticagrelor

A

1) Use: PLATELET INHIBITOR, ACS, coronary stenting, dec incidence/recurrence of thrombotic stroke
2) Class/MOA: Inhibit platelet aggregation by irreversibly blocking ADP RECEPTORS | inhibit fibrinogen binding by preventing glycoprotein Iib/Iiia from binding to fibrinogen
3) neutropenia (ticlopidine)

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13
Q

Abciximab (Rheopro), Eptidibatide (Integrilin) and Tirofibiban (Aggrastat)

A

1) Use: PLATELET INHIBITOR; ACS, per cutaneous trains luminal coronary angioplasty
2) Class/MOA: Monoclonal antibody that binds to the GLYCOPROTEIN RECEPTOR Ib/IIIa on activated platelets, preventing aggregation
3) Side effects/ADEs: bleeding, thrombocytopenia
Abciximab=made from monoclonal Ab Fab fragments

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14
Q

Dipyridamole, cilostazol

A

1) Use: PLATELET INHIBITOR ; intermittent clay dictation, coronary vasodilation, prevention of stroke/tias (+aspirin), angina prophylaxis
2) Class/MOA: pde iii inhib; increase cAMP in platelets = decrease ADENOSINE uptake/cyclic nucleotide PDE = decreased aggregation; vasodilator
3) Side effects/ADEs: serious bleeding risk, nausea, headache, facial flushing, hypotension, abd pain
4) Fun Facts

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15
Q

Heparin

A

1) Use: immediate ANTICOAG for PE, stroke, ACS, MI, DVT | used during pregnancy (does not cross placenta)| follow PTT
2) Class/MOA: INHIBITS THROMBIN ACTION | cofactor for activation of ANTI-THROMBIN, decrease thrombin (iia) and Xa, short 1/2 life
3) Side effects/ADEs: Bleeding, thrombocytopenai (HIT), osteoporosis, drug-drug interactions.
Protamine sulfate=antidote (+ charged molecule to bind - charged, large, acidic polymer heparin)
Iv, sQ

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16
Q

Enoxaparin (LMWH, Lovenox), dalteparin

A

1) Use: Anticoagulation
2) Class/MOA: Cofactor for activation of ANTITHROMBIN and Xa (work better on Xa), better bioavailibilty and 2-4 times longer 1/2 life - can be administered subQ and without lab monitoring
3) Side effects/ADEs: can’t reverse esily

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17
Q

Lepirudin, Bilirudin

A

1) Use:
2) Class/MOA: Hirudin derivatives; directly INHIBITS THROMBIN
3) Side effects/ADEs:
4) Fun Facts: used as an alternative to heparin for anticoagulating patients with HIT

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18
Q

Argatroban

A

1) Use: HIT, patient with kidney dysfunction
2) Class/MOA: directly INHIBITS THROMBIN
3) Side effects/ADEs: falsely elevates INR levels
4) Fun Facts: irreversible

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19
Q

Warfarin

A

1) Use: Chronic anticoagulation (post-stemi, dvt prophylaxis, stroke prevention in a fib) | not used in pregnat women (can cross placenta–>bone deformities, abortion, ophthalmologic abnormalities)| follow PT/INR values (affects extrinsic (7)); long 1/2 life
2) Class/MOA: interfears with normal synthesis and gamma carboxylation of K dependent clotting factors through blocking epoxied reductase| INHIBIT THROMBIN GENERATION
3) Side effects/ADEs: skin/tissue necrosis, drug-drug interactions
Metabolized by cyp450.
Reversal=vit k + FFp
Small lipid soluble molecule
Oral

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20
Q

Alteplase (tPA), retrplase (rPA), tenecteplase (TNK-tPA)

A

1) Use: early CVA, acute early MI, direct thrombolysis of severe PE
2) Class/MOA: thrombolytics; directly or indirectly converts plasminogen to plasmin, which cleaves thrombin & fibrin clots. Inc pt & ptt, no change in platelet count.
3) Side effects/ADEs: bleeding (contraindicated in pts with active bleeding, hx of intracranial bleeding, recent surgery, known bleeding disorder, severe hypotension)
Tx tox w: aminocaproic acid (fibrinolysis inhib)
4) Fun Facts

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21
Q

Protamine Sulfate

A

1) Use: REVERSES HEPRIN
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

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22
Q

DDAVP (Desmopressin)

A

1) Use: vWF disease
2) Class/MOA: RELEASES vWF stored in endothelium
3) Side effects/ADEs:
4) Fun Facts

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23
Q

Vitamin K

A

1) Use: REVERSES Warfarin
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

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24
Q

Novo VII

A

1) Use: potent means to stop bleeding!
2) Class/MOA: BASICALLY FACTOR VII | binds activated platelets and catalysex X-> Xa, which turns activated factor II -> Iia (thrombin)
3) Side effects/ADEs: thrombosis
4) Fun Facts

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25
Q

Aminocaproid Acid (AMICAR)

A

TREATMENT OF BLEEDING all anti fibrinolytic - a drug to stop a clot from breaking down

26
Q

Cyclophoasphamide, Ifosphasmide

A

1) Use: NHL, breast/ovarian carcinomas, solid tumors, leukemias, some brain cancer| immunosupressant
2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Covalently links X-link (interstrand) DNA at guanine N-7 | requires bioactivation by the liver
3) Side effects/ADEs: Myelosupression, hemorrhagic cystitis, partially prevented with Mesna (think group of Mesna binds toxic metabolite)

27
Q

Busulfan

A

1) Use: CML - ablate bone marrow before BM transplant
2) Class/MOA: ANTINEOPLASTIC AGENT | ALYKATING AGENT | alkylates DNA
3) Side effects/ADEs: Pulmonary fibrosis, hyperpigmentation
4) Fun Facts

28
Q

Bendamustine

A

1) Use: Refractory CLL, low NHL
2) Class/MOA: ANTINEOPLASTIC AGENT | Alkylating agent - Nitrogen Mustard
3) Side effects/ADEs: NO allopecia, liver irritation, fatigue, rash
4) Fun Facts

29
Q

Nitrosoureas (BCNU - Carmustine) & (CCNU - Lomustine), semustine, streptozocin

A

1) Use: Brain tumors (including glioblastoma multifome)
2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Require bioactivation | cross BBB –> CNS
3) Side effects/ADEs: CNS tocicity (dizziness, ataxia)
4) Fun Facts

30
Q

Cisplatin, Carboplatin

A

1) Use: Testicular, bladder, ovary and lung carcinomas
2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Cross-link DNA
3) Side effects/ADEs: Nephrotoxicity and acoustic nerve damage
4) Fun Facts: prevent nephroxocitiy with amifostine (free radical scavenger) & chloride diuresis

31
Q

Methotrexate (mtx)

A

1) Use: Cancers (leukemias, lymphomas, choriocarcinoma, sarcoma) non-neoplastics (abortion, ectopic pregancy, RA, psoriasis)
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | FOLIC ACID ANALOG that inhibits dihydrofolate reductase–> dec dTMP–> dec DNA & protein synth
3) muesli suppression (reversible w/ leucovorin (folinic acid)); macro vesicular fatty change in liver; mucositis

32
Q

AZathiprine 6-mercaptopurine (6-mp) and 6-thioguanine (6-tg)

A

1) Use: Leukemias, lymphomas (not CLL or HD)
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PURINE (thiol) ANALOG | Purine analog = decreased de novo purine syntehsis | activated by HGPRT
3) Side effects/ADEs: BM, GI, Liver | metabolized by xanthene oxidase; thus inc tox w/ allopurinol

33
Q

5-Flurouracil (5-fu)

A

1) Use: Colon cancer and other solid tumors, basal cell carcinoma (topical), synergy with MTX
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANALOG | bioactivated to 5F-dUMP, which covalently complexes folic acid | this complex inhibits thymidylate synthase–> dec dtMP–> dec DNA & protein synth
3) myelosuppresaion (not reversible w/ leucovorin); photosensitivity
Od tx w/ thymidine

34
Q

5-azacitidine

A

1) Use: MDS
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANALOG, also restore function of tumor supressor gene
3) Side effects/ADEs:
4) Fun Facts

35
Q

Cytarabine (Ara-C=arabinofuranos cytidine)

A

1) Use: AML, ALL, high grade non-Hodgkin’s lymphoma
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANTAGONIST/analog? inhibition of DNA polymerase
3) Side effects/ADEs: Leukopenia, thrombocytopenia, megaloblastic anemia
4) Fun Facts

36
Q

Dactinomycin (Antinomycin D)

A

1) Use: Wilms tumor, Ewig’s sarcoma, rahbdomyosarcoma, childhood tumors (kids ACT out!)
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Intercalates in DNA
3) Side effects/ADEs: Myelosupression
4) Fun Facts

37
Q

Doxorubicin (Adriamycin), Daunorubicin

A

1) Use: HD, myelomas, sarcomas and solid tumors, leukemias, lymphomas
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Generates free radicles | noncovalently intercalates in DNA = BREAKS IN DNA = decreased replicatoin
3) Side effects/ADEs: cardiotoxicity; myelosupression, alopecia; toxic to tissues following extravasation; dexrazoxane (iron cheating agent) used to prevent cardiotoxicity

38
Q

Bleomycin

A

1) Use: Testicular cancer, HD
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL AGENT | Induces free radical formation; which causes BREAKS IN DNA strands
3) Side effects/ADEs: Pulomonary firbosis, skin changes, minimal myelosupression
4) Fun Facts

39
Q

Vincristine, Vinblastine

A

1) Use: HD, Wilms, Choriocarcinoma, solid tumor, leukemia, lymphoma
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Alkaloids that BIND TO TUBULIN in M-phase and block polyermization of MICROTUBULES so that mitotic spindle can’t form
3) Side effects/ADEs: vincristine- neurotoxicity (areflexia, peripheral neuritis)| vinblastine blasts bone marrow (suppression)

40
Q

Etoposide, teniposide

A

1) Use: Small Cell Cardinoma of the lung and prostate, testicular Carcinoma, solid tumors, leukemia, lymphoma
2) Class/MOA: ANTINEOPLASTIC AGENT: NATURAL PRODUCT: Inhibits TOPOisomerase II = increase in DNA degradation
3) Side effects/ADEs: myelosupression, GI irritation, alopecia
4) F

41
Q

Paclitaxel, other taxols

A

1) Use: Ovarian and breast carcinomas
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT hyperstablizes polymerized microtubules in M phase so that MITOTIC SPINDLE spindle can’t break down (anaphase can’t occur)
3) Side effects/ADEs: myelosuppresion & hypersensitivity

42
Q

Hydroxurea

A

1) Use: Melanoma, CML, sickle cell (inc hbf)
2) Class/MOA: ANTINEOPLASTIC AGENT Inhibits RIBONUCULOTIDE REDUCTASE = decrease in DNA synthesis (s phase specific)
3) Side effects/ADEs: BM supression, GI upset
4) Fun Facts

43
Q

Thalidomide and Lenolidamide

A

1) Use: MM
2) Class/MOA: ANTINEOPLASTIC AGENT | SUPRESS ANGIONEOGENESIS, immunomodulate, pro-apoptottic?
3) Side effects/ADEs: Birth defects
4) Fun Facts

44
Q

Tamoxifin, Raloxifene

A

1) Use: Breast cancer (tx & prevention) & osteoporosis prevention
2) Class/MOA: SERM - receptor antagonists in the breast, and agonist in bone | block the binding of estogren to estrogen receptor positive cells
3) Side effects/ADEs: T: partial agonist in endometrium increase risk of endometrial carcinoma; hot flashes; r: endometrial antagonist

45
Q

Anastrolzole

A

1) Use: postmenopausal women with breast cancer
2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONES : AROMATASE INHIBITOR
3) Side effects/ADEs:
4) Fun Facts

46
Q

Flutamide

A

1) Use: prostate carcinoma
2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONES a nonsteroidal competitive inhibitor of androgens at the testosterone inhibitor
3) Side effects/ADEs:
4) Fun Facts

47
Q

Fulvestrant

A

1) Use: advanced breast cancer
2) Class/MOA: ANTINEOPLASTIC AGENT | HORMONES | binds E receptor, accelerates destruction
3) Side effects/ADEs: E withdrawl, muscle wasting and gynecomastia
4) Fun Facts

48
Q

Leuprolide

A

1) Use: Infertility, prostate cancer, uterine fibrosis
2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONE: GnRH analog with agonist properties when used in pulsatile fasion; antagonist properties wihen used in continous fashion
3) Side effects/ADEs: antiandrog

49
Q

Ketoconazole

A

1) Use: PCOS to prevent hirtuism,
2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONE inhibits STEROID syntehsis (inhibits desmolase)
3) Side effects/ADEs: Gynecomastia and amenorrhea
4) Fun Facts

50
Q

Rituximab (Rituxan)

A

1) Use: NHL, RA (with MTX)
2) Class/MOA: ANTINEOPLASTIC AGENT: MONOCLONAL ANTIBODY TO CD-20, which is found on most B-cell neoplasms
3) Side effects/ADEs:
4) Fun Facts

51
Q

Ibritumomab Tiuxetan (Zevalin)

A

1) Use: HD
2) Class/MOA: ANTINEOPLASTIC AGENT | MONOCLONAL ANTIBODY
3) Side effects/ADEs: infusion reactions
4) Fun Facts

52
Q

Gemtuzumab Ogozamiin (Mylotarg)

A

Anti-CD33

53
Q

Trastuxumab (Herceptin)

A

1) Use: her 2 + Metastatic breast cancer
2) Class/MOA: monoclonal Ab against HER-2 (c-erb-B2=tyrosine kinase) helps kill breast cancer cells that overexpress HER-2, possibly through antibody dependent cytotoxicity
3) Side effects/ADEs: Cardiotoxicity
4) Fun Facts

54
Q

Cetuzimab (Erbitux)

A

1) Use: Metestatic Breast Cancer
2) Class/MOA: ANTINEOPLASTIC AGENT MONOCLONAL ANTIBODY TO HER-2 (erb-B2) | helps kill breast cancer cells that overexpress HER-2 possibly through antibody-dependent cytotoxicity
3) Side effects/ADEs: cardiotoxicity
4) F

55
Q

Bevacizumab (Avastin)

A

1) Use: Mets lung, colon, breast, renal cell, glioblastoma (solid tumors)
2) Class/MOA: ANTINEOPLASTIC AGENT radioimmunotherapy, monoclonal ab against VEGF & prevents interaction with its R - decreased endothelial cell prolifeation and decreased new blood vessel formation

56
Q

Erlotinib (Tarceva)

A

1) Use:
2) Class/MOA: ANTINEOPLASTIC AGENT small molecule, inhibits EGFR - TK1 inhibitor, preents posphorylation, prevents phosphorylation of tyrosine kinase
3) Side effects/ADEs: Skin rash, fatigue, Diarrhea $$$
4) Fun Facts

57
Q

Bortexomib (Velcade)

A

1) Use: MM
2) Class/MOA: ANTINEOPLASTIC AGENT Small molecule, PROTEASE inhibitor - decrased NFKB activation (cells explode because they ant breakdown proteins they contain
3) Side effects/ADEs: Neruropathy, htormbocytopenia, fever, diarrhea, $$$$
4) Fun

58
Q

Imatinib (Gleevec)

A

1) Use: CML, GI stromal tumors
2) Class/MOA: ANTINEOPLASTIC AGENT PHILDELPHIA CHRphilidelphia chromosome bcr-abl tyrosine kinase inhibitor
3) Side effects/ADEs: fluid retention
4) Fun Facts

59
Q

Prednisone, predisolone

A

1) used in cll, NHL (part of combo chemo regimine). Immunosuppressant (autoimmune diseases)
2) may trigger apoptosis. May even work in non dividing cells
3) Cushing like symptoms; immunosupppression, cataracts, acne, osteoporosis, HTn, peptic ulcers, hyperglycemia, psychosis

60
Q

Vemurafenib

A

1) metastic melanoma

2) small molecule inhibitor of forms of b-raf kinase w/ v600e mutation

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