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AU14 Pharmacology > Exam 4; Cancer Chemotherapy > Flashcards

Exam 4; Cancer Chemotherapy Flashcards

1
Q

What is the definition of neoplasia

A

uncontrolled growth of cells

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2
Q

What are three treatments of neoplasias

A

surgery
radiation
pharmacologic agents

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3
Q

Non-specific cancer agents act on what

A

all cell phases of replication and resting

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4
Q

Cell specific cancer agents act on what

A

all cell that are replicating rapidly

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5
Q

Cell specific cancer agents act on more defined sites like what

A

antimetabolites
mitotic spindle inhibitors
enzyme inhibitors

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6
Q

What is the broad scope of cell cycle non-specific agents

A

alkylating agents

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7
Q

What is the mechanism behind the alkylating non-specific agents

A

adding an alkyl group to DNA, causing DNA cross linking and inhibits cell replication and RNA synthesis

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8
Q

What is the mechanism behind cyclophosphamide

A

pro-drug given orally or IV

when it kits the cell/DNA it stops the cell from working

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9
Q

What type of drug is lomustine

A

pro-drug given IV; alkylating agent

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10
Q

What are some side effects of cisplatin

A

renal damage and ototoxicity

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11
Q

What type of drug is cisplatin

A

alkylating agent

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12
Q

What is the mechanism behind doxorubicin

A

inserts itself into DNA and blocks DNA and RNA synthesis

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13
Q

Doxorubicin and other rubicin’s produce these

A

free radicals; can break DNA strands

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14
Q

Doxorubicin can cause this to occur

A

heart muscle degeneration (due to the free radicals)

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15
Q

How is doxorubicin given

A

IV

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16
Q

What is the mechanism behind dactinomycin

A

intercalates with DNA and interferes with mRNA synthesis

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17
Q

What is the mechanism behind bleomycin

A

intercalates with DNA and causes DNA strand breakage

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18
Q

What can result from bleomycin

A

pulmonary fibrosis

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19
Q

What is the mechanism behind cell cycle specific agents

A

block the specific enzymatic pathways in DNA synthesis; inhibit cell synthesis; ENZYME INHIBITORS

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20
Q

What is the mechanism behind methotrexate

A

inhibits dihydrofolate reductase

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21
Q

Methotrexate can cause this to happen

A

myelosuppression (bone marrow)

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22
Q

What can be used to treat the side effect caused by methotrexate

A

giving leucovorin, which is a THFA analog; which can resume normal cells but not malignant

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23
Q

What is the mechanism behind 5-flurouracil

A

it inhibits thymidylate synthase; inhibit thymidine synthesis

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24
Q

What is the mechanism behind cytarabine

A

inhibits DNA polymerase

25
Q

What type of drugs are 5-flurouracil and cytarabine

A

pyrimidine analogs

26
Q

What is the mechanism behind 6-mercaptopurine

A

its converted to an analog that inhibits several enzymes needed for purine synthesis

27
Q

What type of drugs are the pyrimidine and purine analogs

A

pro-drugs

28
Q

What is the mechanism behind vincristine and vinblastine

A

binds to microtubules and blocks cell mitosis; given IV

29
Q

What is the mechanism behind paclitaxel and the other “taxel’s”

A

forms abnormal microtubules

30
Q

What is the mechanism behind Eribulin

A

inhibits microtubule and prevents mitosis; causing apoptosis

31
Q

What is the mechanism behind ixabepilone

A

binds microtubules

32
Q

What is the mechanism behind etoposide

A

inhibits topoisomerase II causing un-repairable DNA breaks

33
Q

What is the mechanism behind topotecan (and irinotecan)

A

topoisomerase I inhibitor

34
Q

What is the mechanism behind flutamide and the other “lutamides”

A

blocks the androgen receptor

35
Q

What is the mechanism behind abiraterone

A

it inhibits the enzyme 17-hydroxylase lyase (CYP17)

inhibit androgen synthesis

36
Q

What is the mechanism behind leuprolide

A

receptor activator; stimulates the GnRH receptor

37
Q

What is the mechanism behind tamoxifen (and fluvestrant)

A

blocks the estrogen receptor

38
Q

What are two side effects of tamoxifen

A

retinal changes

increased cataract formation

39
Q

What is the mechanism behind anastrozole

A

inhibits the enzyme aromatase, which is responsible for converting testosterone to estrogen

40
Q

What is the mechanism behind prednisone

A

inhibits the immune system functions, therefore used to treat neoplasia of the immune system such as leukemias and lymphocytes

41
Q

Most of the new cancer drugs target this

A

kinase; they are KINASE INHIBITORS

42
Q

How can you distinguish the kinase inhibitors from the other drugs

A

they end in “-nib”

43
Q

What is the mechanism behind imitinib

A

protein kinase inhibitor, it inhibits the kinase responsible for inhibiting apoptosis (therefore letting apoptosis happen)

44
Q

What is imitinib used to treat

A

chronic myelogenous leukemia (CML)

45
Q

What is the route of imitinib administration

A

orally, and has relatively few side effects (edema is possible)

46
Q

What kind of side effects to the -nib drugs have

A

relatively few, since they are so specific

47
Q

What is the mechanism behind bortezomib and carfilzomib

A

they inhibit proteasome which allow the buildup of proteins, killing the cell

48
Q

What condition is treated with bortezomib and carfilzomib

A

multiple myeloma; overproduction of bone marrow cells

49
Q

How are monoclonal antibodies more and less specific at the same time

A

more specific in that they can target any molecule

less specific in that you can’t predict the impact

50
Q

What is the mechanism behind trastuzumab

A

directed against a kinase; VesHER2 (human epidermal growth factor receptor)

51
Q

What is the mechanism behind bevacizumab

A 
blocks VEGF (vascular endothelial growth factor)
preventing the growth factor from binding to its receptor
52
Q

How does bevacizumab destroy the tumor

A

tumors only grow if there is a blood supply, VEGF (of which is blocked by bevacizumab) allows the growth of blood vessels in tumors

53
Q

What is the mechanism behind rituximab

A

MAB vs CD20, a receptor that allows the binding and control of immune cells

54
Q

What conditions does rituximab treat

A

chronic lymphocytic leukemia

RA

55
Q

What are six problems with the use of traditional DNA binding agents to treat neoplasia

A

not all cancer cells divide rapidly
normal cells are affected by neoplastic agents
not all cancer cells will be killed by the drug
cancer cells can become resistant to the drug
drugs may not enter the CNS
the alkylating agent themselves may cause neoplasia

56
Q

True or False

a combination of cancer drugs is less effective than one targeted drug

A

False, the combo may be more effecting

57
Q

What are five successes of disease with cancer therapy

A 
chroiocarcinoma
ALL
Hodgkin's
testicular
osteosarcoma
58
Q

What are four cancers that have improved survival rates due to new drugs

A

breast
ovarian
colon
multiple myeloma

AU14 Pharmacology (29 decks)

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