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Pharmacology > Exam 3: Cancer > Flashcards

Exam 3: Cancer Flashcards

1
Q

What are the common toxicites that cancer chemotherapy has on rapidly growing cells?

A
  • Bone marrow destruction
  • Stomatitis, dysphasia, diarrhea
  • Alopecia
  • nephrotoxic
  • teratogenic
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2
Q

What are the alkylating agents for cancer chemotherapy?

A
  • Cyclophosphamide
  • Cisplatin
  • Carmustine
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3
Q

What are the antimetabolites for cancer chemotherapy?

A
  • Methotrexate
  • 6 mercaptopurine
  • 5 Fluorouracil
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4
Q

What are the antibiotics for cancer chemotherapy?

A
  • Doxorubicin Hydrochloride

- Belomycin Sulfate

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5
Q

What are the plant alkaloids for cancer chemotherapy?

A

-Vincristine sulfate
Vinblastine Sulfate
-Paclitaxel

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6
Q

What are the tyrosine kinase inhibitors for cancer chemotherapy?

A

Imatinib

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7
Q

What are the growth factor receptor inhibitors for cancer chemotherapy?

A
  • Erlotinib
  • Cetuximab
  • Bevacizumab
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8
Q

What are the non-specific cell cycle drugs?

A

The alkylating agents and doxorubicin

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9
Q

What is the MOA of Alkylating agents?

A
  • Not cell cycle specific

- Alkylate DNA causing miscoding, breakage, and crosslinking

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10
Q

What is the common toxicity associated with alkylating agents?

A

Vesicant- bulla tend to develop at injection sites

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11
Q

What is Cyclophosphamide used for?

A

Broad spectrum of uses- breast, ovarian, non-Hodgkins.

-Form

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12
Q

What is the toxicity associated with Cyclophosphamide and how do you combat this?

A

It forms acrolein which causes hemorrhagic cystitis. This is prevented/treated with MESNA and hydration

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13
Q

What is carmustine used for?

A

It is able to cross the BBB so used for brain cancer, also Hodgkins and non Hodgkin’s lymphoma

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14
Q

What is cisplatin used for?

A

-Broad spectrum-testicular, NSC and SC lung cancer, esophageal, ovarian, bladder

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15
Q

What are the side effects of cisplatin and how can this be combated?

A
  • Renal toxicity: reduced with amifostine

- Acoustic nerve damage, permanent. Sodium thiosulfate may be able to reduce this.

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16
Q

What is the MOA of doxorubicin?

A

Intercalated into DNA and destroys it

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17
Q

What is doxorubicin used for?

A

-One of the most important anti cancer drugs, widely used for lymphomas, leukemia’s, sarcoma, breast, thyroids, etc.

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18
Q

What is the main toxicity associated with doxorubicin?

A

Cardiotoxic- generates free radicals which can be toxic. Toxicity is increased by iron so used with iron chelator

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19
Q

What drugs affect the S phase?

A

The antimetabolites

20
Q

What drug affects the M phase?

A

Paclitaxel, vincristine, and vinblastine

21
Q

What drugs affect G2-M phase?

A

Bleomycin

22
Q

What is the MOA of methotrexate?

A

Inhibits dihydrofolate reductase

23
Q

What is can be given with methotrexate as a rescue?

A

Leucovorin to decrease toxicity from folate deficiency.

Given AFTER methotrexate

24
Q

What are the common side effects of methotrexate?

A

Mucositis, thrombocytopenia, nephrotoxicity, and diarrhea.

**hepatotoxicity when used long term has an immunosuppressive.

25
Q

What is the MOA fo Mercaptopurine?

A

Converted by HGPRT to a ribonucleotide and inhibits DNA and RNA synthesis

26
Q

How does resistance against 6 mercaptopurine develop?

A

Levels of HGPRT decrease

27
Q

What is the important relationship between 6 mercaptopurine and allopurinol?

A

Azathioprine is metabolized to 6 mercaptopurine which is metabolized by xanthine oxidase. Allopurinol inhibits xanthine oxidase metabolism. If a patient is taking allopurinol, dose of azathioprine must be reduced significantly because it can result in fatal blood dyscrasias

28
Q

What drug is often given with 6 mercaptopurine and why?

A

Leukovorin used as a “rescue” to decrease toxicity to other cell types. Given after 6-MP

29
Q

What is the MOA of 5-fluorouracil?

A

Inhibits thymidylate synthetase- blocks DNA synthesis

30
Q

What happens when 5-fluorouracil is given with Leukovorin?

A

The response to 5-FU is increased. Leukovorin should be given prior to 5-FU administration.

-Leukovorin is converted to 5-MTHF which ultimately ends up enhancing thymidylate synthase inhibition

31
Q

What are the common adverse side effects with 5-FU?

A

Oral and GI ulceration

32
Q

What is the MOA of bleomycin?

A

Cell cycle specific at G2 and M.

-Binds directly to DNA

33
Q

What are the adverse effects of Bleomycin?

A
  • Myleosuppresion
  • Pulmonary fibrosis
  • Hypersensitivty
34
Q

What is the MOA of Vincristine/Vinblastine?

A
  • binds to tubulin interfering with microtubules leading to cell cycle arrest in metaphase.
  • Axonal transport required microtubules so they are neurotoxic!
35
Q

What are the toxicities associated with vincristine and vinblastine?

A

Vincristine: Neurotoxicity and low myleosuppresion

Vinblastine:
More myelosuppresion and less nephrotoxicity

36
Q

What is the MOA of Paclitaxel?

A

-Binds to beta tubulin and promotes assembly of microtubules and stabilizes their formation by inhibiting depolymerization. They are extremely stable and non-functional.

37
Q

What are the adverse effects of paclitaxel?

A
  • Myelosuppresion
  • anemia
  • peripheral neuropathy
38
Q

What is the MOA of Imatinib?

A

-Inhibitor of BCR-Abl fusion tyrosine kinase protein (only works if patient has this mutation, so test for it)

39
Q

What cancer is the BCR-ABL mutation common in?

A

Chronic myelogenous leukemia

40
Q

What are the most common side effects seen with Imatinib?

A

Fluid retention (ankle and periorbital edema), nausea, vomiting, malaise, and lethargy

41
Q

What is the MOA of cetuximab?

A

Monoclonal antibody that binds to EGF receptor to inhibit tyrosine kinase activity resulting in growth inhibition and apoptosis

42
Q

What is the MOA of Erlotinib?

A

Blocks ATP binding to EGF receptor to inhibiti the tyrosine kinase activity resulting in growth inhibition and apoptosis.

43
Q

What should you do before prescribing an epidermal growth factor inhibitor?

A

Test for the EGFR expression and mutations

44
Q

What is the MOA of Bevacizumab?

A
  • Angiogenesis inhibitor

- Recombinant humanized monoclonal antibody that binds to VEGF and prevents binding to VEGF receptor

45
Q

What are the risks associated with Bevacizumab?

A

Bleeding and thromboembolism

Pharmacology (25 decks)

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