General Pharm (Chemo/Alkylating&Hormones/Anti-Metabolites) Flashcards
Gompertzian Growth
tumor takes constant amount of time to double its size
Goldie-Coldman Hypothesis
best strategy prevention of tumor resistance is to initiate treatment early and use a combination of drugs with non-overlapping toxicities
Partial response to anti-cancer
reduction of at least 50% in the diameter of all measurable lesions
Stable disease
range from decrease of < 50% to increase of < 25% in diameter product of tumor
Progressive disease
increase of more than 25% in diameter product of any lesion
cell-cycle non-specific
alkylators
platinums
anthracyclines
M-phase
vinca alkaloids
taxanes
S-phase
antimetabolites
vinca alkaloids
vincristine, vinblastin
taxanes
paclitaxel
docetaxel
vomiting center (medulla) receives input from
GI tract, cerebral cortex, vestibular apparatus, chemoreceptor trigger zone (CTZ)
NTs of emetic reflex
dopamine histamine serotonin endorphins ACh GABA Substance P
acute anti-emetics
serotonin antagonists
nk-1 antagonists
corticosteroids
(first 24hr)
delayed anti-emetics
DA antagonists
corticosteroids
nk-1 antagonists
(3-5d post chemo, assoc w/ cisplatin,
cyclophosphamide,
doxorubicin)
anticipatory anti-emetics
benzos
5-HT3 antagonists - anti-emetics
odansetron*
palonosetron*
dolasetron
granisetron
corticosteroid anti-emetics
dexmethasone
atypical antipsychotic - anti-emetics
olanzapine
benzos - anti-emetics
lorazepam
EPO to tx anemia
procrit
darbepoetin
myeloid growth factors to lessen neutropenia
filgrastim (GCSF)
sargamostim (GM-CSF)
pegfilgrastim (long-acting GM-CSF)
alkylating agents
platinum analogues
- cisplatin
- oxaplatin
- carboplatin
Cyclophosphamide
Ifosfamide
Hormonal agents - anti-cancer
Glucocorticoids
Androgens
Anti-hormonal agents
- aromatase inhibitors
- anti-estrogen
- anti-androgen
- LH-RH agonists
platinum analogues
- cisplatin
- oxaplatin
- carboplatin
standard of care w/ ifosfamide admin
MESNA
binds acrolein in urine
acrolein
metabolite of cyclophosphamide and ifosfamide
bladder toxicity
nitrogen mustards
cyclophosphamide
ifosfamide
anti-androgens
flutamide
bicalutimide
nilutamide
LHRH agonists
leuprolide
goserelin
triptorelin
anti-estrogens
tamoxifen
raloxifene
toremifine
fulvestrant
aromatase inhibitors
anastrazole
letrozole
exemestane
glucocorticoids - anti-cancer
prednisone
androgens
dihydrotestosterone
danazol
anti-metabolites
methotrexate
cytarabine
5-FU
gemcitabine
methotrexate reversal agent
leucovorin (colonic acid)
glucarpidase
enzyme that rapidly cleaves methotrexate into non-toxic form
Ara-C
Cytarabine
anti-metabolite
5-FU has synergistic effects w/ _____
5-FU has synergistic effects w/ LEUCOVORIN
3 intrathecal drugs
methotrexate
cytarabine
thiotepa
other antimetabolites
6-mercaptopurine
6-thioguanine
capecitabine
pemetrexed - anti-folate
dopamine antagonists
procholoperazine
metoclopramide
perphenazine
adjuvant
used after deqnitive solid surgery to eradicate micro-metastatic disease
Neoadjuvant
used to reduce tumor burden prior to surgical intervention