Dasgupta Flashcards
1
Q
MOPP
A
Hodgkin’s disease
2
Q
ABVD
A
Hodgkin’s disease
3
Q
CHOP
A
Non-Hodgkin’s Lymphoma
4
Q
CMF
A
Breast
5
Q
CAF
A
Breast
6
Q
PACE
A
Small cell lung cancer
7
Q
VIP
A
Germ cell
8
Q
BIP
A
Cervical
9
Q
M-BACOD
A
Lymphomas
10
Q
BEP
A
Ovarian
11
Q
CVD
A
Pheochromocytoma
12
Q
PEB
A
Testicular
13
Q
G1 phase of cell cycle
A
Cell contents other than chromosomes are duplicated
14
Q
S phase of cell cycle
A
DNA is replicated
15
Q
G2 phase of cell cycle
A
Preparing for division (proteins produced, spindle apparatus forms)
16
Q
M phase of cell cycle
A
Cell division
17
Q
G0 phase of cell cycle
A
Resting cell
18
Q
Alkylating agents: MOA
A
Add methyl (other alkyl group) to guanine residue of DNA causing cross-bridging between DNA nucleotides
19
Q
Alkylating agent causing cross-linking between 2 DNA strands vs cross-linking between 2 residues on 1 DNA strand
A
Cross-linking between 2 strands = GOOD
Cross-linking of 2 residues on 1 strand results in increased ability to develop mutations that lead to resistance (due to DNA repair causing fragmentation)
20
Q
Name 3 main alkylating agents
A
- Mustragen (mechlorethamine)
- Cyclophosphamide
- Chlorambucil
These are the other ones:
- Estramustine phosphate
- Busulfan
- Nitrosureas (streptozocin, procarbazine, dacarbazine)
21
Q
Unique property of mustragen (mechlorethamine)
A
NOT excreted
22
Q
What disease is mustragen commonly used to treat
A
Hodgkin’s disease (along with other chemotherapy agents)
23
Q
Unique property of cyclophosphamide
A
Must be activated by p450
24
Q
2 Unique toxicities of cyclophosphamide
A
- Hemorrhagic cystitis
- SIADH (water intoxication)
25
What 3 diseases is cyclophosphamide used to treat
1. Burkitt's lymphoma
2. Acute lymphocytic leukemia
3. Other lymphomas/leukemias
26
Drug that is generally administered to decrease side effect of hemorrhagic cystitis
MESNA (Mercaptoethanesulfonate)
27
How does MESNA work?
Reacts with acrolein (toxic by product of cyclophosphamide metabolism) in urine and detoxifies it
28
Estramustine phosphate route of administration and unique therapeutic effects
- Can be given orally
| - Anti-mitotic effect in addition to alkylating effect
29
Unique toxicity with busulfan
Pulmonary fibrosis and hyper-pigmentation of the skin
30
Unique toxicity with nitrosureas
Pulmonary fibrosis and nephrotoxicity
31
What alkylating agent is given as a first line therapy for brain tumors? Why?
Nitrosureas due to being lipophilic
32
What should patients taking procarbazine avoid?
- MAOInhibitors
- Alcohol
*cause rapid increase in BP
33
Dacarbazine: MOA
Methylates DNA and RNA
34
Cisplatin: MOA
Intrastrand crossling by binding to guanine
35
What element is contained in cisplatin
Platinum
36
What is the hallmark side effect involving platinum drugs
NEPHROTOXICITY
37
What is generally administered with all chemotherapeutic agents? Why?
- Normal saline for hydration
| - Eliminate toxic metabolites and flush out the chemotherapy quickly
38
Are alkylating agents CCS or CCNS?
CCNS
39
Are platinum containing agents CCS or CCNS?
CCNS
40
2 major drugs in the anthracycline category
1. Doxorubicin
| 2. Daunorubicin
41
Antracycline: MOA
- Intercalation of 2 strands of DNA, inhibiting topoisomerase
- Cause single and double strand DNA breaks
- Histone eviction
42
Are anthracyclines CCS or CCNS?
CCNS
43
Unique toxicity with anthracyclines
Cardiotoxicity
44
What drug can be administered with anthracyclines to reduce there unique toxic side effect
Dexrazoxane
45
What drug has a similar mechanism of action to doxorubicin but has decreased incidence of cardiotoxicity
Mitoxantrone
| *Note if cardiotoxicity is seen with this drug however, it is SEVERE
46
Main 2 drugs in the topoisomerase II inhibitor category
- Etoposide
| - Tenopside
47
Topoisomerase II active agent: MOA
Forms an inhibitory complex with DNA-topoisomerase II
48
Main cancers that topoisomerase II inhibitors are used in
- Testicular
| - Small-cell lung cancer
49
Are topoisomerase II inhibitors CCS or CCNS?
CCS = S and G2 phase
50
Camptothecin Analog: MOA
Inhibitors of topoisomerase I
51
3 main drugs in the camptothecin analog family
1. Camptothecin
2. Topotecan
3. Irinotecan
52
Why is irinotecan different from the other 2 drugs in the camptothecin analogs
It is a prodrug, activated by TISSUE CARBOXYESTERASES
53
Tissue carboxyesterases are produced in high levels in what type of cancer
Carcinoma
54
Unique side effect of camptothecin analogs
Severe Diarrhea
55
Are camptotheicn analogs CCS or CCNS?
CCS = S phase
56
2 major chemotherapeutic antibiotics
1. Bleomycins
| 2. Dactinomycin (Actinomycin D)
57
Main use of Bleomycins
- Testicular carcinoma (high cure rate)
| - Lymphomas
58
Is bleomycin CCNS or CCS?
CCS = G2 phase
59
Unique toxicity associated with bleomycin use
Pulmonary fibrosis and pneumonitis
60
Bleomycin: MOA
Bind to reduced iron (Fe2+) leading to free radical production
61
Dactinomycin: MOA
- Intercalates between purine-pyrimidine base pairs preventing transcription
- Also causes SS breaks
62
Is dactinomycin CCS or CCNS?
CCNS
63
Dactinomycin unique property
Most potent anti-tumor agent known
64
Unique toxicity: Dactinomycin
- Oral and GI ulceration
| - Stomatitis
65
3 Major uses of dactinomycin
- Methotrexate resistant tumors
- Wilm's tumor
- Rhabdomyosarcoma
66
Definition of Antimetabolites
Compounds that mimic endogenous biochemicals required for DNA/RNA synthesis
67
2 Folic acid antimetabolite
- Methotrexate
| - Pemetrexed
68
3 Pyrimidine antimetabolite
- 5-Fluorouracil
- Cytarabine
- Gemcitabine
69
Purine antimetabolite
6-mercaptopurine
70
Folic acid analog: MOA
Inhibit DHFR
71
Pemetrexed is what type of chemotherapeutic agent and what is special about this drug when compared to the others in its class
Folic acid analog, it inhibits TYMIDYLATE SYNTHASE as well as DHFR
*Thymidylate synthase is used in purine synthesis
72
How does inhibiting DHFR result in cell death
Inability to form purines and pyrimidines
73
Main therapeutic use of methotrexate and pemetrexed
Coriocarcinoma
74
What other uses do methotrexate and pemetrexed have
- Chemotherapy maintenance in ALL children, less active in adult
- Combination therapy
75
Unique toxicity: Folic acid analogs
- Oral and GI ulceration
- Hepatotoxicity
- Pulmonary toxicity
76
Are folic acid analogs CCS or CCNS
CCS = S phase
77
What is leucovorin
A "rescue regimen" given 24-36 hours after high-dose methotrexate
78
What does leucovorin do?
Minimizes toxic effects of folate depletion
79
T/F Leucovorin diminishes the anti-tumor activity or methotrexate
False
80
5-Fluorouracil: MOA
- Inhibit tymidylate synthase
| - Incorporate directly into DNA/RNA
81
Cytarabine: MOA
- Inhibit DNA polymerase
| - Incorporate directly into DNA
82
Is 5-fluorouracil CCS or CCNS
CCNS
83
Is cytarabine CCS or CCNS
CCS = S phase
84
Is gemcitabine CCS or CCNS
CCNS
85
Unique toxicity: Pyrimidine analogs
Oral and GI ulceration
86
6-Mercaptopurine: MOA
Inhibition of purine precursor formation
87
Is 6-Mercaptopurine CCS or CCNS
CCS = S phase
88
What drug inhibits the metabolism of 6-mercaptopurine?
Allopurinol
| *Commonly given to Diabetics suffering gout
89
If a patient is taking allopurinol and you want to start 6-mercaptopurine as a chemotherapeutic agent, what must you do?
Decrease the dose of 6-mercaptopurine
90
Adenosine Deaminase inhibitors: MOA
Inhibits adenosine deaminase (key enzyme needed in DNA synthesis)
91
Main cancers where adenosine deaminase inhibitors are used
Hairy cell leukemia
| *Other leukemias and lymphomas
92
What are the 2 categories of tubular-binding agents
- Vinca alkaloids
| - Yew alkaloids
93
3 vinca alkaloids
- Vincristine
- Vinblastine
- Vinorelbine
94
2 yew alkaloids
- Paclitaxel (Taxol)
| - Docetaxel
95
Vinca alkaloids: MOA
- Bind to tubulin
| - Block Polymerization
96
Yew alkaloid: MOA
Prevent microtubule DEPOLYMERIZATION
97
Unique toxicity: Vinca alkaloids
- Peripheral neuropathy
- SIADH
- Hair loss
98
Unique toxicity: Yew alkaloids
Peripheral neuropathy
99
Are tubular binding agents CCS or CCNS
CCS = M phase
100
Interferon: MOA
Inhibit tumor by increasing activity of host immune system
101
Are interferons CCS or CCNS
CCNS
102
Prednisone: MOA
- Anti-inflammatory properties
| - Induce apoptosis
103
Cancer type where prednisone is used
Hodgkin's lymphoma and leukemias
104
Progestins: MOA
Bind cancer cells expressing progesterone receptor
105
2 Anti-estrogen drugs
1. Tamoxifen
| 2. Toremefine
106
Anti-estrogen: MOA
Binds estrogen receptor expressed on certain cancer cells
107
Anti-androgen: MOA
Blocks androgen induced growth
108
What drug is often combined with anti-androgen drugs and why
-Leuprolide
109
Leuprolide
Inhibits testosterone production by blocking LH release
110
Total androgen ablation
Blockage of production and binding of androgens by administering drug combinations
111
How can antibodies be used as a chemotherapeutic regimen
Block cell surface receptors which promote tumor growth (or prevent angiogenesis)
112
Main 3 antibody chemotherapuetic agents
1. Bevuczimab
2. Denusomab
3. Trastuzumab
113
Bevuczimab: MOA
Blocks VEGF preventing angiogenesis
114
Denusomab: MOA
Blocks RANK-RANK-lingand in bone
115
Trastuzumab: MOA
Blocks Her2/c-Neu
116
Main 3 "targeted inhibitors" of cancer growth
1. Imatinib
2. Erlotinib/Gefitinib
3. Crizotinib
117
Imatinib: MOA
Block Bcr-Abl kinase
118
Erlotinib/Gefitinib: MOA
Blocks EGFR signaling
119
Crizotinib: MOA
Blocks ALK-1 kinase
120
Is Bcl-2 a pro- or anti- apoptotic protein
Anti-apoptotic
121
Venetoclax: MOA
Binds Bcl-2 and inhibits its expression
122
Main cancer type where anti-apoptotic chemotherapies are used
Leukemias
123
What category of chemotherapeutics do Vorinostat and Romidepsin fall under
HDAC (histone deacetylase) inhibitors
124
HDAC inhibitors: MOA
Prevent histone de-acetylation, thereby preventing replication
125
PARP-1 normal function
Rescue cells by base excision repair
126
How is PARP-1 expression changed in most cancer cells?
Increased, thereby aiding in survival
127
What 1 drug is a PARP-1 Inhibitor
Olaparib
