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Pharmacy School Fall P3 > Final Exam study > Flashcards

Final Exam study Flashcards

1
Q

What origin is a carcinoma?

A

malignant neoplasm of squamous epithelial cell origin

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2
Q

What origin is a adenocarcinoma?

A

malignant neoplasm of gland tissue

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3
Q

What origin is a sarcoma?

A

malignant neoplasm derived from glandular tissue such as bone, muscle, fat

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4
Q

What type of classification is BRCA 1/2?

A

-tumor suppressors
-mutation increases risk for cancer
-are susceptible to PARP inhibitors due to synthetic lethality
ex. Olaparib

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5
Q

What are the parts of the cell cycle?

A

G0/G1 - accumulates building blocks for division
S- cell replicates its DNA
G2 - cell assembles machinery for the chromosomes to seperate/ cell double checks chromosomes
M- mitosis

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6
Q

What type of chemotherapies work in the G1 phase?

A

kinase inhibitors, hormone inhibitors, CDK4/6 inhibitors

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7
Q

What type of Chemotherapies work in the S phase?

A

anti-metabolites, anti-folates, topo I inhibitors

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8
Q

What type of chemotherapies work in the G2 phase?

A

Topo II inhibitors

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9
Q

What type of chemotherapies work in the M phase?

A

microtubule inhibitors

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10
Q

What chemotherapies are non-cell cycle specific?

A

alkylators, intercalaters

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11
Q

What are two well-known tumor suppressors?

A

TP53, p16

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12
Q

What are two well-known oncogenes?

A

KRAS, P13K

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13
Q

What are the mechanisms of drug resistance?

A

-increased transport of drugs out of the cell through efflux pumps (often via PgP or MRP) *most common reason to resistance for multiple chemotherapies at once
-reduced transport into the cell
-decreased activation of prodrug
-increased detoxification of drug molecule (increased metabolism of drug)
-changes in drug target or function
-physiological changes such as cancer cells refuging into the blood brain barrier, massive stromalization (area becomes fibrous), cell cycle slowing
-increased anti-apoptopic proteins in cancer cells or increased repair of dna damage due to chemotherapies

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14
Q

What enzyme converts androstenedione to estrone?

A

CYP19 (Aromatase)

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15
Q

What endocrine therapies can be used for pre-menopausal women?

A

tamoxifen
leuprolide, goserelin

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16
Q

What endocrine therapies can be used for post-menopausal women?

A

tamoxifen
fulvestrant
anastrozole, letrozole, exemestane

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17
Q

What medications can be used in hormonal therapy for prostate cancer?

A

leuprolide, goselerin, triptorelin (GnRH analogs)
degarelix, relugolix (GnRH antagonists)
Abiraterone (CYP17 antagonist)
Enzalutamide, apalutamide, darolutamide (AR antagonists)

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18
Q

What is a diagnostic molecular pathway?

A

genomic DNA gets tested for mutation and if positive then will go on therapy for that

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19
Q

What are the different types of kinase inhibitors?

A

Type I-binds to active site of kinase
type II- binds to inactive site of kinase
type III- allosterically bind to kinase

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20
Q

What are some examples of Type I tyrosine kinase inhibitors?

A

EGFR inhibitors (afatinib, neratinib, gefitinib, erlotinib)

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21
Q

What medication is given when a patient acquires a T790M mutation to gefitinib?

A

Osimertinib

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22
Q

What kinase inhibitors are indicated with a BCR-Abl translocation?

A

Imatinib, Ponatinib (indicated after T315I mutation)

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23
Q

What is a prognostic molecular pathology?

A

helps to predict recurrence and can prevent overtreatment but does not drive indications for specific therapy

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24
Q

What are the anti-metabolite chemotherapies?

A

5-Fluorouracil (+ leucovorate for increasing efficacy)
cytarabine (+ tetrahydrouridine)
6-Mercaptopurine
Methotrexate

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25
Q

What rescues from a 5-FU overdose?

A

Thymidine

26
Q

What are alkylating agents?

A

generate reactive electrophilic intermediates that react with nucleophilic groups on DNA/protein
-create cross-linkages that are inter- and intra- strand linkages

27
Q

What side effects are of note in patients treated with alkylating agents?

A

increased risk of second malignancies

28
Q

What chemotherapies are considered alkylating agents?

A

cyclophosphamide, Mitomycin C, chlorambucil

29
Q

What chemotherapies are considered platinum therapies?

A

Cisplatin, carboplatin, oxaliplatin

30
Q

What is the difference between alkylating and platinum agents?

A

alkylating agents - have alkyl groups; form intra- and inter- strand crosslinks
platinum agents- cause intra strand crosslinks

31
Q

What side effects are of note with cisplatin?

A

-nephrotoxicity
-not myelosuppressive

32
Q

What cell phase do Topo I inhibitors work in?

A

S phase specific

33
Q

What are some examples of chemotherapies that are Topo I inhibitors?

A

Topotecan, Irinotecan

34
Q

What are some examples of chemotherapies that are Topo II inhibitors?

A

Doxorubicin (also an intercalator), Etoposide (G2/M specific)
Bleomycin

35
Q

What medication mediates Doxorubicin toxicity?

A

Dexrazoxane

36
Q

What are the microtubule inhibitors?

A

Vincristine, paclitaxel

37
Q

Are Taxanes microtubule stabilizers or destabilizers?

A

microtubule stabilizers
-prevents microtubule breakdown

38
Q

Are vinca alkaloids microtubule stabilizers or destabilizers?

A

microtubule destabilizers
-prevents microtubule assembly

39
Q

What are the major side effects of vincristine?

A

peripheral neuropathy, neurotoxicty

40
Q

What are the major side effects of paclitaxel?

A

myelosuppression

41
Q

What immunotherapies bind to the EGF receptor?

A

Cetuximab, panitumumab

42
Q

What is the nomenclature with monoclonal antibodies?

A

chimeric =-xi
mouse= -o
humanized = -zu
fully human = -u

43
Q

What medications are VEGF inhibitors?

A

Bevacizumab

44
Q

What are some examples of BiTE therapies?

A

Blinatumomab -binds CD3 and CD19

45
Q

What T cell therapy targets CTLA-4?

A

ipilimumab

46
Q

What medications are DNA methylating agents?

A

Azacitibine

47
Q

What medications are proteasome inhibitors?

A

borteZOMIB

48
Q

What is the MOA of venetoclax?

A

inhibits BCL-2 (an anti-apoptotic protein)
-1st FDA approved small molecule that inhibits a protein-protein interation

49
Q

What medications are indicated for anticipatory N/V?

A

Lorazepam 0.5-1 mg po

50
Q

What medications are indicated for delayed N/V?

A

dexamethasone, NK-1 antagonist, olanzapine

51
Q

What is included in a moderately emetogenic regimen?

A

steroid, 5-HT3 antagonist +/- either olanzapine or aprepitant
-can be 2 or 3 drugs

51
Q

What is included in a highly emetogenic regimen?

A

NK-1 antagonist, Steroid (Dexamethasone) , 5-HT3 antagonist, Olanzapine

51
Q

What is the most emetogenic chemotherapy agent?

A

Cisplatin

52
Q

What adverse effects are there for 5-HT3 antagonists?

A

headache, constipation

53
Q

What NK-1 antagonist side effects are there?

A

hiccups

54
Q

What side effects are there with olanzapine?

A

sedation

55
Q

What medication do you use for neutropenic fever?

A

colony stimulating factors
-filgrastim or pegfilgrastim

56
Q

What is the corrected calcium equation?

A

serum calcium + 0.8(4- serum albumin)

57
Q

What is first line therapy for hypercalcemia?

A

mild HCM - hydration, zolendronic acid or pamidronate
moderate HCM- zolendronic acid
severe HCM- hydration, zolendronic acid, calcitonin if refractory

58
Q

What are the treatment options for treatment refractory HCM?

A

denosumab

59
Q

What clinical pearl is related to dosing for SRE?

A

renal adjustment dosing is needed for pamidronate, zolendronic acid

60
Q
A

Pharmacy School Fall P3 (25 decks)

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