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heme & lymph > Fitz - Purine Antimetabolites & S-Phase Agents > Flashcards

Fitz - Purine Antimetabolites & S-Phase Agents Flashcards

1
Q

tx: 6MP

A

maintenance of remission in ALL

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2
Q

tx: 6TG

A

acute nonlymphocytic leukemia (w/ daunorubicin and cytarabine)

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3
Q

tx: fludarabine (2-F-araA)

A

CLL, hair cell leukemia, indolent NHL

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4
Q

tx: cladribine

A

hairy cell, NHL, CLL

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5
Q

DLT: 6MP

A

myelosuppresion, hepatotoxicity (jaundice)

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6
Q

DLT: 6TG

A

myelosuppression, hepatotoxicity (LT use)

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7
Q

DLT: 2-F-araA

A

myelosuppresion, opportunitstic infs, toxic fluroadenine with oral admin

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8
Q

DLT: cladribine

A

myelosuppresion, drug fever

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9
Q

activating enzyme of 6MP

A

HPRT (HPGRT)

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10
Q

inactivating enzymes of 6MP

A

TMPT and XO in the liver

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11
Q

6MP over exposure risk increased in pts taking

A

XO inhibitors - allopurinol and febuxostat

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12
Q

management of tumor lysis syndrome

A

allopurinol

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13
Q

s/s of tumor lysis syndrom

A
  • hyperkalemia
  • hyperphosphatemia
  • hyperuricemia
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14
Q

drug used to manage tumor lysis syndrome via the degradation of uric acis

A

pegloticase

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15
Q

genetic variant of TPMT that has higher than normal TMPT activity

A

high/high (H/H)

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16
Q

risk and benefit of H/H variant TPMT

A
  • benefit = lower tox

- risk = relapse

17
Q

risk and benefit of L/L variant TPMT

A
  • risk = myelosuppresion and secondary malignancy

- benefit = efficacy

18
Q

MOA: 2-F-araA and cladribine

A

inhibition of SNA polymerase and cessation of replication by integration into DNA/RNA

19
Q

pyrimidine antimetabolites that are active in the S phase

A
  • 5FU
  • capecitabine
  • cyrarabine (ara-C)
  • gemcitabine
20
Q

folate antimetabolites that are active in the S phase

A

MTX, pemetrexed

21
Q

purine antimetabolites that are active in the S phase

A
  • 6MP
  • 6TG
  • 2-F-araA
  • cladribine
22
Q

most impt factor for efficacy of cell cycle specific drugs

A

schedule dependent

23
Q

diagnostic threshold of tumor cells

A

10^9 (1 billion)

heme & lymph (11 decks)

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