Flood 42 Classification and Side effects: Table 42-1;42-2 Flashcards
Identify 3 vinka alkalods
- Vinblastine
- Vincristine
- Vinorelbine
Name 3 analogs of Antimetabolites and associated drugs
- Pyrimidine anlogues: 5-Fluorouracil, cytarabine, Gemcitabine
- Folate analogues: Methotraxate
- Purine analogues: Premetrexed, Mercaptopurine, Thioguanine, Fludaribine, Pentostatin, Cladribine, Hydroxyurea
What 3 drugs are antitumor antibiotics
- Belomycin
- Doxorubicin
- Epirubicin
Doxirubicin and Epirubicin are Anthracyclines
Doxirubicin and Epirubicin are
Anthracyclines
Name the 2 topoisomerase inhibitors
- Topoisomerase I: Irinotecan, topotecan
- Topoisomerase II: Etopside
Irinotecan, topotecan and etopside have what in common?
All are Topoisonerase inhibitors
- Topoisomerase I: Irinotecan, topotecan
- Topoisomerase II: Etopside
Vinca Alkaloids (Vincristine, vinorelbine) are classified as?
Tubulin binding drugs
Taxoids ( docetaxel, paclitaxel) are classified as?
Tubulin binding drugs
Name 6 types of drugs that are classified under signal transduction modifiers.
- Antiestrogens
- Antiandrogens
- Monoclonal antibodies
- Aromatase inhibitors
- Gonadotropin-releasing drugs
- Progestins
Name 3 antiestrogens
- Tamoxifen
- Toremifene
- Raloxifene**
Name 3 antiandrogens
- Flutamide
- Bicalutamide
- nilutamide
Name 2 monoclonal antibodies
- Rituximab
- Trastuzumab
Name 3 Aromatase inhibitors
- Letrozole
- Anastrazole
- Aminoglutethimide
Name 2 Gonadotropin-releasing drugs
- Leuprolide
- Buserelin
Name 1 Progestins
- megestrol acetate
What is the mechanism of action of Alkylating agents
Impair cell function by forming covalent bonds on important molecules in proteins, DNA and RNA. Classified by their chemical structure and mechanism of covalent bonding.
These drugs impair cell function by forming covalent bonds on important molecules in proteins DNA and RNA. They are classified by their chemical structure and mechanism of covalent bonding.
Alkylating agents
These drugs are structural analogs of naturally occurring metabolites involved in DNA and RNA synthesis.
Antimetabolites
These drugs either substitute for metabolite that is normally incorporated into DNA or RNA or compete for the catalytic site of a key enzyme.
Antimetabolites
What is the MOA of antimetabolites
They are structural analogs of naturally occurring metabolites involved in DNA and RNA synthesis. They either substitute for metabolite that is normally incorporated into DNA or RNA or compete for the catalytic site of a key enzyme.
These drugs work by Intercalating DNA at specific sequences, creating free radicals, which cause strand breakage.
Antitumor antibiotics
These drugs are products of fungus having streptomyces. They also have the MOA of topoisomerase I and II.
Anthracyclines (doxorubicin, epi_rubicin)_
Classified under antitumor antibiotics
These drugs control the 3D structure of DNA. They inhibit enzymes responsible for the uncoling of DNA during replication.
Topoisomerase inhibitors
What is responsible for the uncoling of DNA during replication?
Topoisomerase I and II
These drugs bind to tubulin and prevent the formation of the microtubule which is important during mitosis but also for cell shape, intracellular transport and axonal function.
Vinca Alkaloids
Classified under tubulin-binding drugs
Impaired formation of microbubles by vinka alkaloids will result in?
- inhibited mitosis
- Ipaired cell shape
- Impaired intracellular transport and axonal function.
This signal transduction modifier drug will bind to specific antigens on tumor cells and thereby modify cell proliferation.
Monoclonal antibodies (Rituximab, Transtuzumab)
These drugs work by inhibiting a hormone responsible for the conversion of androgens into estrogens
Aromatase inhibitors (Aminoglutethimide, anastrazole, letrozole)
What is the mechanism of action of signal trusduction modifiers
Are hormonal treatments of cancer that results in disruption of the normal growth factor receptor interactions which lead to cell proliferation and is effective in cancer cells where mutations have resulted in uncontrolled cell proliferation utilizing activated signaling pathways.
All chemotherapeutics can cause mylosupression except?
- Temozolomide
- Antitumor antibiotics; bleomycin
- Signal transduction modulators
These chemotherapeutics can cause cardiomyopathy
- Epirubicin
- Doxorubicin
Name four group of drugs that are classified as alkylating drugs
Alkylating drugs include :
- nitrogen mustards
- alkyl sulfonates
- nitrosoureas
- triazenes.
Name 2 side effects commonly found with all chemotherapeutics
- Nausea and Vomiting
This drug can cause alopecia and mucositis and is commonly used to treat Hodgkin desease and hodgkin lymphoma
Mechlorethamine
It can also cause mylosuppression
What are the side effects of cyclophosphamide
- Mylosuppression
- Mucositis
- Alopecia
- Hemorhagic cystitis
- Seizures
- Renal failure
- Cardiac failure
- Inapropriate secretion of vasopressin (ADH)
- Skin pigmentation
What are the indications of Cylclophosphamide
- Acute lymphocytic leukemia
- Chronic lymphocytic leukemia
- Lymphomas
- Myelomas
- Neuroblastoma
- Breast, ovarian, cervical and testicular cancer
- Lung cancer
- Wilms tumor
- Sarcoma
What are the major side effects of Melphalan
Myelosupression
Pulmonary fibrosis is possible
N/V is NOT common
What are the indications of Chlorambucil
- Hodgkin disease
- Non-Hodgkin lymphoma
- Macroglobulinemia
What are the side effects of Chlorambucil
- Myelosupression
- Seconary leukemias
- Pulmonary fibrosis is possible
- CNS stimulation with large doses
What are the indications of Busulfan
- Acute myelogenous leukemias
- Chronic myelogenous leukemias
What are the side effects of Busulfan
- Myelosupression
- Thrombocytopenia
- Hyperurecemia from extensive purine catabolism accompanying the rapid cellular destruction and renal damage from precipitation of urates
Nitroureas are mustard gas-related compounds used as an alkylating agent in chemotherapy. Name four
- Carmustine
- Lomustine
- Semustine
- Streptozocine
What are the indications of Carmustine
- Hodgkins disease
- Non-Hodgkin lymphoma
- Astrocytoma
- Myeloma
- Melanoma
- Nitrourea with widest clinical use due to ability to cross bbb
What are the side effects of Carmustine
- Myelosupression
- Hepatitis
- Interstitial pulmonary fibrosis and pneumonitis
- Renal failure
- Flushing
- 20-30% will get pulmonary toxicity and 24% of those will die as a result.
- 6 wk delayed onset of leukopenia and thrombocytopenia
What are the indications of Lomustine
- Hodgkin desease
- Non-Hodgkin lymphoma
- Astrocytoma
- Small cell lung cancer
This nitrourea is a methylated analogue or another nitrourea and is indicated for colon cancer
Semustine
Side effects of Lomustine and semustin are?
Delayed myelosupression manifesting as leukopenia and thrombocytopenia
What are the indications of Streptozocin
Insulinoma
Carcinoid tumor
Has a unique affinity for Beta cells of the islets of Langerhans and has proved useful in the treatment of pancreatic islet cell carcinoma and malignant carcinoid
What are the side effects of Streptozocin
- Myelosupression
- Hepatitis
- Renal failure
What are the side effects of mitomycin
- Myelosuppression- delayed thrombocytopenia and Leukopenia
- Mucositis
- Cardiac failure
- Interstitial fibrosis 3-12% - synagysticaly with O2 and radiation
- Hemolytic Uremic syndrome
What are the indications of Mitomycin
- Head and neck
- breast cancer
- Lung
- Gastric
- Colon
- Rectal
- Cervical cancer
What is the dose limiting effect of cisplatin
Renal toxicity
What are the indications of Cisplatin
- Head and neck
- Thyroid
- Lung
- Ovarian
- Endometrial
- Cervical
- testicular
- Neuroblastoma
- Osteogenic Sarcoma
What are the side effects of Cisplatin
- Myelosupression- transient leukopenia and thrombocytopenia
- Peropheral neuropathy, parasthesia, loss of position sense- note baseline
- Allergic reactions
- Renal toxicity- low GFR and renal tubular dysfunction can begin as early as 3-5 days after initiating treatment.
- Electrolyte abnormalities (Hypocalcemia, hypomagnesemia, hypophosphatemia)
- Allergic reactions: Facial edema, bronchoconstriction, tachy, hypotension may occur minutes after injection.
What are the indications of methotrexate
- Head and neck, Breast, lung ca
- Acute lymphocytic leukemia
- Non-Hodgkins lymphoma
- Osteogenic sarcoma
What are the side effects of methotrexate
- Myelosuppression
- Mucositis
- Pneumonitis
- Hepatic fibrosis
- Renal toxicity in high doses
- Interferes with embryogenesis
- Hemorrhagic enteritis and death from intestinal perforation
What are the side effects of Fluorouracil (5-FU)
- Myelosuppression
- Mucositis
- Alopecia
- Pigmentation
- Chest pain
What are the side effects of Cytarabine
- Myelosuppression
- Mucositis
- Hepatitis
What are the side effects of Gemcitabine
- Myelosuppression
- Flulike symptoms
What are the side effects of Mercaptopurine
- Myelosuppression
- Anorexia
- Jaundice
What are the side effects of thioguanine
- Myelosupression
- Anorexia
What are the side effects of Fludarabine
- Myelosuppression
- Optic neuritis
- Peripheral neuropathy
- Seizures
- Coma
- Depression of CD4 cells
Pentostatin
- Myelosuppression
- Depletion of T cell
- Hepatitis
What are the side effects of Cladribine
- Myelosuppression
- Tumor lysis syndrome
- Asthenia
What are the side effects of hydroxyurea
- Myelosupression
- Dermatologic changes
What are the side effects of doxorubicin
- Myelosupression
- Cardiomyopathy
- Mucositis
What are the side effects of Epirubicin
- Myelosuppression
- Cardiomyopathy
- Alopecia
- Mucositis
- Phlebitis
What are the side effects of mitoxantrone
- Myelosupression
- Mucositis
What are the side effects of Etoposide
- Myelosupression
- Systemic hypotension
- Hepatitis
- Mucositis
What are the side effects of Teniposide
- Myelosupression
- Systemic hypotension
What are the side effects of Dactinomycin
- Mucositis
- Chelitis
- Glositis
- Alopecia
- Cutaneous erythema
What are the side effects of captothecins: Irinotecan & topotecan
- Myelosupression
- Alopecia
What are the side effects of bleomycin
- Interstitial pulmonary fibrosis
- Allergic reactions
- Skin pigmentation
What are the side effects of Vinka alkalods: Vinblastine, Vincristine, Vinorelbine
- Myelosupression
- Peripheral neuropathy
What are the side effects of Taxanes: Paclitaxel and docetaxel
- Myelosupression
- Peripheral neuropathy
- Allergic reactions
- Alopecia totalis
Docetaxel also causes cardiac dysrythmias and capilary leakage
What are the common side effects of antiestrogens: Tamoxifen, toremifene, raloxifene
Venous thrombosis
Hot flushes
- Tamoxifen can also cause weight gain, amenorrhea, hypercalcemia and endometrial cancer
What is the indication for antiestrogens
breast cancer
What are the side effects of antiandrogens: Flutamide, Bicalutamide and Nulutaide
Gynacomastia
Hot flushes
Nilutamide also causes delayed visual adaptation to dark
What is the indication for antiandrogens
Prostate cancer
What are the side effects of Rituximab
- Infusion related chills, rash and fever
- Non-infusion related myalgias, angioedema, bronchospasm abc cardiac dysrythmias.
- Myelosupression
What are the side effects of Trastuzumab
Fever and Chills
What are the side effects of Anastrazole
- Asthenia
- Headache
- Hot flushes
What are the side effects of letrozole
- Headache
- Heartburn
What are the indications of aromatase inhibitors (Anastrazole, Aminoglutethimide, Letrozole)
Breast cancer
What are the side effects of gonadotropin-releasing drugs: Leuprolide, Buserelin
- Impotence
- Hot flushes
- Pain at site bony metastases
What are the side effects of progestins: Megestrol acetate
Weight gain