Cytotoxic Chemo

Question 1

Mechlorethamine

Answer 1

Alkylating Agent

Cross linking of DNA and alkylation of DNA and/or protein

Question 2

Carmustine

Answer 2

Alkylating Agent

Cross linking of DNA and alkylation of DNA and/or protein

Question 3

Busulfan

Answer 3

Alkylating Agent

Cross linking of DNA and alkylation of DNA. And/or protein

Question 4

Chlorambucil

Answer 4

Alkylating Agent

Cross linking of DNA and alkylation of DNA and/or protein

Question 5

Cisplatin, Carboplatin, Oxaliplatin

Answer 5

Alkylating Agent

Cross linking of DNA and alkylation of DNA and/or protein

Question 6

Cyclophosphamide

Answer 6

Alkylating Agent
Requires metabolic activation
Crosslinking of DNA and alkylation of DNA and/or protein

Question 7

Alkylating Agents resistance

Answer 7

Decreased transportation of drug into cell
Increased activity of DNA repair enzymes
Increased production of substances that bind and deactivates drug

Question 8

Alkylating Agent Toxicities

Answer 8

Leukemogenic
Bone marrow suppression
Toxic to intestinal mucosa
Pulmonary fibrosis
Endothelial damage

Question 9

Methotrexate

Pemetrexed

Answer 9

Antimetabolite
Inhibits dihydrofolate reductase (blocks DNA synthesis)
Toxicity: nephrotoxic

Question 10

Fluorouracil (5-FU)

Capecitabine

Answer 10

Antimetabolite
Inhibit biosynthesis of pyramiding nucleotide, mimic natural
Toxicity: Severe diarrhea

Question 11

Cytarabine

Gemcitabine

Answer 11

Antimetabolite
Inhibits DNA polymerase and DNA elongation
Must be activated
Toxicity: myelosuppression, GI, flu like symptoms

Question 12

Mercaptopurine

Answer 12

Antimetabolite
Inhibits multiple pathways in conversion of inosine monophosphate to adenine and guanine nucleotides
Must be activated
Toxicities: hyperuremia, bone marrow suppression, nausea, vomiting, jaundice

Question 13

Fludarabine phosphate

Answer 13

Antimetabolite

Interrupts DNA synthesis by causing DNA chain termination leading to apoptotic death

Question 14

Vinblastine

Answer 14

Vinca Alkaloid
Inhibit microtubule polymerization
Toxicity: bone marrow suppression, GI, neurological manifestations

Question 15

Vincristine

Answer 15

Vinca Alkaloid
Inhibit microtubule polymerization
Toxicity: little bone marrow suppression, neurological manifestations, severe constipstion

Question 16

Vinorelbine

Answer 16

Vinca Alkaloid
Inhibit microtubule polymerization
Toxicity: granulocytopenia, less neurotoxicity

Question 17

Paclitaxel

Docetaxel

Answer 17

Taxanes
Promote polymerization of microtubule
Toxicity: bone marrow suppression, hypersensitivity reactions

Question 18

Etoposide

Answer 18

Topoisomerase 2 targeting
Inhibit DNA replication, transcription, cause abortive mitosis
Toxicity: leukopenia, nausea, vomiting, stomatitis, diarrhea, alopecia, hepatic toxicity

Question 19

Teniposide

Answer 19

Topoisomerase 2 targeting
Inhibit DNA replication, transcription, cause abortive mitosis
Toxicity: myelosuppression, nausea, vomiting

Question 20

Topotecan

Answer 20

Topoisomerase 1 Target
Entrap TOPO 1 and DNA complex leads to cell death
Toxicity: significant hematologist toxicity, neutropenia, thrombocytopenia, nausea, vomiting

Question 21

Irinotecan

Answer 21

Topoisomerase 1 target
Entrap TOPO 1 and DNA complex leading to cell death
Toxicity: delayed diarrhea, myelosuppression

Question 22

Dactinomycin

Answer 22

Antibiotic
Bind to double helix of DNA. Resulting in a block in transcription of DNA by RNA polymerase (single strand breaks)
Toxicity: anorexia, nausea, vomiting, hematopoietic suppression

Question 23

Doxorubicin

Answer 23

Antibiotic
Intercalate with DNA affecting DNA/RNA synthesis (single and double strand beaks), free radical generation
Toxicity: cardiotoxic

Question 24

Mitoxantrone

Answer 24

Antibiotic
Anthracycline derivative, causes DNA strand breaks via TOPO 2
Toxicity: acute myelosuppression, cardiotoxic

Question 25

Bleomycin

Answer 25

Antibiotic DNA cleaving, oxidative damage leading to single and double strand breaks Toxicity: cutaneous, pulmonary, myelosuppressive