DIT cancer drugs (only on things specific to the drugs)

Question 1

Methotrexate mechanism?

Answer 1

S phase specific antimetabolite

Just like trimethoprim. DHF analog so no THF recharged and available for dUMP to dTMP

Question 2

What is leucovorin?

Answer 2

Folic acid, basically. Used for helping fix myelosuppression from methotrexate

won’t save 5FU

Question 3

5 Flurouracil mechanism?

Answer 3

Pyrimidine analogue.
activated to 5F-dUMP to covaenlty bind folic acid and no thymidylate synthase activity

no dTMP and no DNA

Question 4

Basal cell skin cancer and actinic keratosis treated with what?

Answer 4

5-FU

Question 5

What is uridine?

Answer 5

Rescue for 5FU when myelosuppression

Question 6

What 6-mercaptopurine?

Answer 6

purine analog, obviously. inhibits purine synthesis

Question 7

What is significance of 6 mercaptopurine metabolism?

Answer 7

xanthine oxidase. So more toxicity if patient is on allopurinol

Question 8

What is 6-thioguanine?

Answer 8

works like 6 mercaptopurine except not metabolized by xanthine oxidase

can be given with allopurinol

Question 9

What is cytarabine?

Answer 9

CyTarabine is a pyrimidine analogue (C and T). it inhibits DNA polymerase

(its like acyclovir or rifampin, but for human DNA!)

Question 10

Mechanism of cyclophosphamide?

Answer 10

covalently cross link DNA so cell can’t replicate

Guanine specifically

Question 11

what cancer drug can cause hemorrhagic cystitis? It also causes increased risk of bladder cancer (TCC).

how do you prevent it?w

Answer 11

KNOW THIS

cyclophosphamide b/c acrolein is toxic metabolite

Prevent with mesna

Question 12

What are the nitrosoureas? What is the mechanism?
What is important about them?

What is the mnemonic?

Answer 12

Put nitro in your mustang! (mustines)

Carmstine, lomustine, semustine, streptozocin

alkylating agent. Needs bioactivation. BUT CAN CROSS BBB.

cross links DNA

Question 13

Toxicity of nitrosoureas?

Answer 13

Crosses BBB so CNS tox

Question 14

What is the mechanism of busulfan?

side effect?

Answer 14

X links DNA (alkylating agent again)

Pulmonary fibrosis is side effect (and busulfan tan but whatever)

Question 15

Mechanism of rubicins?

Answer 15

generate free radicals

also intercalate DNA and causes breaks!

Question 16

Side effect of rubicins?

Answer 16

CArdiotoxic (dilated cardiomyopathy) and heart failure

heart muscle susceptible b/c low levels superoxide dismutase. Rubicins make oxidative radicals

Question 17

What is dexrazoxane?

Answer 17

Iron chelating agent that prevents cardiotoxicity of the rubicins?

Question 18

What is mechanism of dactinomycin?

Answer 18

Intercalates DNA

Question 19

What anticancer drug is used in pediatric cancers a lot?

Mnemonic

Answer 19

Dactinomycin

Children ACT out! dACTinomycin

Question 20

Bleomycin mechanism?

Answer 20

Free radical formation which causes DNA to break (BLeo BLasts DNA)

Question 21

Side effect of bleomycin?

Answer 21

Pulmonary fibrosis (same as busulfan, easy to remember b/c start with B’s)

Methotrexate can cause fibrosis too

Question 22

What three anticancer drugs cause pulm fibrosis?

Answer 22

Busulfan, bleomycin and methotrexate

Question 23

What is a adriamycin?

Answer 23

It is a poor named rubicin

Question 24

The platinum containing anti caner drugs work how?

Answer 24

Cross linkDNA. they are the ___platins

Question 25

What cancer drugs have genitourinary association? What is the bonus toxicity?

Answer 25

Platins are for treating testicular, ovarian and bladder cancer But nephrotoxic also ototoxic

Question 26

What drugs are nephrotoxic and ototoxic? 4 categories

Answer 26

Vanco __platins aminoglycosides loop diuretics

Question 27

What does Etoposide and teniposide work on?

Answer 27

Etoposide and Teniposide inhibit topo 2 (which unwinds DNA upstream

Question 28

Step 1 likes testicular cancer (thats fucked up). What is a common regimen for treatment? mnemonic

Answer 28

Eradicate Ball Cancer Etoposide Bleomycin (or Ifosfamide) Cisplatin

Question 29

Mechanism for ironotecan and topotecan?

Answer 29

Inhibit topo1. Diarrhea

Question 30

Vincristine and vinblastine work how? side effect?

Answer 30

Block polymerization of microtubules Neuro toxicity. vinBLASTINE blasts bone marrow

Question 31

Paclitaxel and taxels mechanism?

Answer 31

Hyperstabalize (TAXing to keep them polymerized)

Question 32

Drugs that stabilize microtubules? not all cancer drugs

Answer 32

Microtubules G C very poorly ``` Mebendazole griseofulvan colchicine Vincristine/blastine paclitaxel ``` KNOW!

Question 33

Mechanism of hydroxyurea?

Answer 33

Inhibtis ribonucleotide reductase

Question 34

Prednisone mechanism as anti cancer drug?

Answer 34

May trigger apoptosis especially lymph stuff (makes sense since immunosuppressant)

Question 35

Mnemnoic for side effect of prednisone?

Answer 35

BAM CUSHINGOID ``` Buffalo hump amenorrhea moon facies crazy (psychosis) ulcers skin changes (acne) htn (aldosterone agonism) infection necrosis of femoral head glaucoma/cataracts osteoporosis immunosuppression diabetes ```

Question 36

Tamoxifen mechanism?

Answer 36

SERM estrogen receptor affect Antagonist in breast Agonist in bone and partial agonist in endometrium ER breast cancer Can prevent breast cancer if BRCA increased risk of endometrial carcinoma (b/c overstimulation), but it stimulates less than estrogen, so helps there too. weird

Question 37

Rolixefene mechanism?

Answer 37

SERM Estrogen antagonist in breast and endometrium Agonist in bone. USED FOR OSTEOPOROSIS

Question 38

Mechanism of trastuzumab? Toxicity?

Answer 38

Her2 tyrosinekinase receptor monoclonal antibody for it The trastuzumab trashy whore hurt my heart. CARDIOTOXIC

Question 39

Rituxumab mechanism?

Answer 39

anti CD20 can help with lymphoma, leukemia, RH arthritis..

Question 40

Imatinib mechanism?

Answer 40

nib means inhibitor, not monoclonal antibody It is for BCR-ABL tyrosine kinse in (and if philly chromosome is anywhere else)