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Drugs > Hematology > Flashcards

Hematology Flashcards

1
Q

<p>Heparin</p>

A

<p>1) immediate anticoag for PE, ACS, MI, DVT (pregnancy safe)

2) Anti-thrombin: antithrombin cofactor --> decr thrombin* + decr factor Xa
3) toxicity: bleeding, HIT, osteoporosis, Rx interactions; protamine sulfate antidote (pos charge molec that binds neg charge heparin)
4) short 1/2 life</p>

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2
Q

<p>Enoxaparin</p>

A

<p>1) immediate anticoag for PE, ACS, MI, DVT (pregnancy safe)

2) LMWH antithrombin: act more on factor Xa
3) toxicity but less risk than heparin: bleeding, HIT, osteoporosis, Rx interactions; no antidote
4) compared to heparin: better bioavail, 2~4x longer 1/2 life; sub-Q; no need to monitor</p>

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3
Q

<p>Dalteparin</p>

A

<p>1) immediate anticoag for PE, ACS, MI, DVT (pregnancy safe)

2) LMWH antithrombin: act more on factor Xa
3) toxicity but less risk than heparin: bleeding, HIT, osteoporosis, Rx interactions; no antidote
4) compared to heparin: better bioavail, 2~4x longer 1/2 life; sub-Q; no need to monitor</p>

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3
Q

Mineral/Vitamin: Folic Acid

A

1) Use: PND, traumatic cardiac hemolytic anemia, folate defiency (alcoholism)
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

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4
Q

<p>Lepirudin</p>

A

<p>1) immediate anticoag for pts w/ HIT

2) antithrombin
3) N/A
4) deriv of hirudin (leeches)</p>

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5
Q

<p>Bivalirudin</p>

A

<p>1) immediate anticoag for pts w/ HIT

2) antithrombin
3) N/A
4) deriv of hirudin (leeches)</p>

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5
Q

Desferrioxamine (Deferoozamine or Desferal)

A

1) Use: Thalasemias, or other disease with regular blood transfusions - helps avoid iron overload (causes cirrhosis, CHF, DM)
2) Class/MOA: IRON CHELATOR (NOT ORAL!)
3) Side effects/ADEs:
4) Fun Facts

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6
Q

<p>Warfarin (Coumadin)</p>

A

<p>1) chronic anticoag: post STEMI, VTE prophylaxis, prevent stroke in afib (teratogenic)

2) antiplt: interfere w/ nl syn + carboyxlation of vit-K clotting factors (1972: X, IX, VII, II) + proteins C, S
3) bleeding, teratogenic, skin/tissue necrosis*, Rx interactions; give vit K for OD, give FFP for severe OD
4) cyt P450 met; incr PT (extrinsic path); long 1/2 life; follow PT/INR; PO</p>

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7
Q

<p>Alteplase (tPA)</p>

A

<p>1) early MI, early ischemic stroke, direct thrombolysis of severe PE

2) thrombolytic: aid plasminogen --> plasmin to cleave thrombin + fibrin clots
3) bleeding (contraindicate in active bleed, intracranial bleed hx, recent sx, known bleed diathese, severe HTN); tx toxicity w/ aminocaproic acid (inhibits fibrinolysis)
4) incr PT, PTT; no change in plt ct</p>

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7
Q

Epoeitin

A

1) Use: anemia
2) Class/MOA: GROWTH FACTOR EPO = increases RBC
3) Side effects/ADEs:
4) Fun Facts

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8
Q

<p>Reteplase (rPA)</p>

A

<p>1) early MI, early ischemic stroke, direct thrombolysis of severe PE

2) thrombolytic: aid plasminogen --> plasmin to cleave thrombin + fibrin clots
3) bleeding (contraindicate in active bleed, intracranial bleed hx, recent sx, known bleed diathese, severe HTN); tx toxicity w/ aminocaproic acid (inhibits fibrinolysis)
4) incr PT, PTT; no change in plt ct</p>

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9
Q

<p>Tenecteplase (TNK-tPA)</p>

A

<p>1) early MI, early ischemic stroke, direct thrombolysis of severe PE

2) thrombolytic: aid plasminogen --> plasmin to cleave thrombin + fibrin clots
3) bleeding (contraindicate in active bleed, intracranial bleed hx, recent sx, known bleed diathese, severe HTN); tx toxicity w/ aminocaproic acid (inhibits fibrinolysis)
4) incr PT, PTT; no change in plt ct</p>

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9
Q

IL-11 (Oprelvekin, Neumega) Rx: thrombocytopenia

A

1) Use: GROWTH FACTOR thrombocytopenia
2) Class/MOA: stimulates the growth of primative MEGAKARYOCYTE progenitors - increase megakaryocytes, increase peripheral platelets
3) Side effects/ADEs: fatigue, headache, CVE
4) Fun Facts:

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10
Q

<p>Aspirin (ASA)</p>

A

<p>1) antipyretic, analgesic, anti-infl, anti-plt (decr aggregation)

2) irreversibly inhibits COX-1 (and -2) via covalent acetylation --> decr TxA2 + prostaglandins
3) gastric ulcer, tinnitus (CN VIII); chronic use: acute renal failure, interstitial nephritis, upper GI bleed; Reye's syn in kids w/ viral infct; OD: respir alkalosis + met acidosis
4) plts can't syn new COX so effect lasts until new plts made; incr bleeding time; no effect on PT, PTT</p>

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10
Q

Growth Factor: Romiplostim (Nplade) - Thrombopoeitin analog - Rx for chronic ITP

A

1) Use: GROWTH FACTOR thrombocytopenia
2) Class/MOA: same as IL-12: stimulates growth of primative megakarycytic progenitors, increasing megakaryocytes, increasing platelets
3) Side effects/ADEs: fatigue, headache, CVE
4) Fun Facts

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11
Q

<p>Clopidogrel</p>

A

<p>1) ACS, coronary stenting, decr incidence + recurr of thrombotic stroke

2) ADP R inhibitor: inhibit plt aggregation by irreversibly blocking ADP R; inhibit fibrinogen binding via Gp IIb/IIIa
3) N/A
4) N/A</p>

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12
Q

<p>Ticlopidine</p>

A

<p>1) ACS, coronary stenting, decr incidence + recurr of thrombotic stroke

2) ADP R inhibitor: inhibit plt aggregation by irreversibly blocking ADP R; inhibit fibrinogen binding via Gp IIb/IIIa
3) neutropenia (unique)
4) N/A</p>

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12
Q

Ticlopidine, Clopidogrel (Plavix)

A

1) Use: PLATELET INHIBITOR
2) Class/MOA: Inhibit platelet aggregation by irreversibly blocking ADP RECEPTORS | inhibit fibrinogen binding by preventing glycoprotein Iib/I

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13
Q

<p>Prasugrel</p>

A

<p>1) ACS, coronary stenting, decr incidence + recurr of thrombotic stroke

2) ADP R inhibitor: inhibit plt aggregation by irreversibly blocking ADP R; inhibit fibrinogen binding via Gp IIb/IIIa
3) N/A
4) N/A</p>

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14
Q

<p>Ticagrelor</p>

A

<p>1) ACS, coronary stenting, decr incidence + recurr of thrombotic stroke

2) ADP R inhibitor: inhibit plt aggregation by irreversibly blocking ADP R; inhibit fibrinogen binding via Gp IIb/IIIa
3) N/A
4) N/A</p>

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14
Q

Dipyridamole

A

1) Use: PLATELET INHIBITOR
2) Class/MOA: increase cAMP = decrease ADENOSINE uptake/cyclic nucleotide PDE = decreased aggregation
3) Side effects/ADEs: serious bleeding risk
4) Fun Facts

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15
Q

<p>Cilostazol</p>

A

<p>1) intermittent claudication, coronary vasodilation, prevent stroke/TIAs (w/ ASA), angina prophylaxis

2) PDE III inhibitor --> incr cAMP in plts --> inhibit plt aggregation; vasodilator
3) nausea, HA, facial flush, hypotension, ab pain
4) N/A</p>

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15
Q

Heparin

A

1) Use: immediate ANTICOAG for PE, stroke, ACS, MI, DVT | used during pregnancy | follow PTT
2) Class/MOA: INHIBITS THROMBIN ACTION | cofactor for activation of ANTI-THROMBIN, decrease thrombin and Xa, short 1/2 life
3) Side effects/ADEs: Bleeding, thrombocytopenai (HIT),

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16
Q

<p>Dipyridamole</p>

A

<p>1) intermittent claudication, coronary vasodilation, prevent stroke/TIAs (w/ ASA), angina prophylaxis

2) PDE III inhibitor --> incr cAMP in plts --> inhibit plt aggregation; vasodilator
3) nausea, HA, facial flush, hypotension, ab pain
4) N/A</p>

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17
Q

<p>Abciximab</p>

A

<p>1) ACS, PTCA

2) Gp IIb/IIIa inhibitor: bind R on activated plts --> prevent aggregation
3) bleeding, thrombocytopenia
4) made from monoclonal ab Fab fragments (unique)</p>

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17
Q

Lepirudin, Bilirudin

A

1) Use:
2) Class/MOA: Hirudin derivatives; directly INHIBITS THROMBIN
3) Side effects/ADEs:
4) Fun Facts: used as an alternative to heparin for anticoagulating patients with HIT

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18
Q

<p>Eptifibatide</p>

A

<p>1) ACS, PTCA

2) Gp IIb/IIIa inhibitor: bind R on activated plts --> prevent aggregation
3) bleeding, thrombocytopenia
4) N/A</p>

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19
Q

<p>Tirofiban</p>

A

<p>1) ACS, PTCA

2) Gp IIb/IIIa inhibitor: bind R on activated plts --> prevent aggregation
3) bleeding, thrombocytopenia
4) N/A</p>

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19
Q

Warfarin

A

1) Use: Chronic anticoagulation | not used in pregnat women | follow PT/INR values
2) Class/MOA: interfears with normal synthesis of K depedent clotting factors through blocking | INHIBIT THROMBIN GENERATION
3) Side effects/ADEs: bleeding, teratogenic,

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20
Q

Mineral/Vitamin: Ferrous Sulfate

A

1) Use: Iron defiecnt anemia
2) Class/MOA:
3) Side effects/ADEs: Constipation
4) Fun Facts

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21
Q

Mineral/Vitamin: Iron dextran = Iron sucrose

A

1) Use: FE Deficency Anemia
2) Class/MOA:
3) Side effects/ADEs: anaphalazis
4) Fun Facts

21
Q

Protamine Sulfate

A

1) Use: REVERSES HEPRIN
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

23
Q

Mineral/Vitamin: Vitamin B12

A

1) Use: Pernicious Anemia
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

23
Q

Vitamin K

A

1) Use: REVERSES Warfarin
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

25
Q

Deferasirox (EXJADE)

A

1) Use: Thalasemias, or other disease with regular blood transfusions - helps avoid iron overload (causes cirrhosis, CHF, DM)
2) Class/MOA: Iron Cheltors ORAL
3) Side effects/ADEs:
4) Fun Facts

25
Q

Aminocaproid Acid (AMICAR)

A

TREATMENT OF BLEEDING all anti fibrinolytic - a drug to stop a clot from breaking down

27
Q

Filgrastim (G-CSF; Neupogen); Sargramostim (GM-CSF; Leukine); Peg-Filgrastim (Neulasta)

A

1) Use: GROWTH FACTOR any chemo that causes neutropenia; meylosuppressive therapy
2) Class/MOA: stimulates proliferation, matruation and efficacy of NEUTROPHILS via JAK/STAT tyrosine kinase pathway
3) Side effects/ADEs:
4) Fun Facts: same as G-CSF

27
Q

Busulfan

A

1) Use: CML - ablate bone marrow before BM transplant
2) Class/MOA: ANTINEOPLASTIC AGENT | ALYKATING AGENT | lkylates DNA
3) Side effects/ADEs: Pulmonary fibrosis, hyperpigmentation
4) Fun Facts

29
Q

Nitrosoureas (BCNU - Carmustine) & (CCNU - Lomustine)

A

1) Use: Brain tumors (including glioblastoma multifome)
2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Require bioactivation | cross BBB = CNS
3) Side effects/ADEs: CNS tocicity (dizziness, ataxia)
4) Fun Facts

30
Q

Asprinin

A

1) Use: PLATELET INHIBITOR
2) Class/MOA: Actylates and irreversibly inhibits COX-1 and COX-2 to prevent conversion of arachadonic acid to thromboxane A2
3) Side effects/ADEs: increase BT, no effect on PT, PTT | Gastric ulcertation, bleeding, hyperventilation, Reye’s Syndr

31
Q

Methotrexate - Leucivorin (Folinic Acid)

A

1) Use: Cancers (leukemias, lymphomas, choriocarcinoma, sarcoma) non-neoplastics (abortion, ectopic pregancy, RA, psoriasis)
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | FOLIC ACID ANALOG that inhibits dihydroredutase = decrease in dTMP = decrea

32
Q

Abciximab (Rheopro), Eptidibatide (Integrilin) and Tirofibiban (Aggrastat)

A

1) Use: PLATELET INHIBITOR
2) Class/MOA: Monoclonal antibody that binds to the GLYCOPROTEIN RECEPTOR Ib/IIIa on activated platelets, preventing aggregation
3) Side effects/ADEs: bleeding, thrombocytop

33
Q

5-Flurouracil

A

1) Use: Colon cancer and other solid tumors, basal cell carcinoma (topical), synergy with MTX
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANALOG | bioactivated to 5F-dUMP, which covalently complexes folic acid | this complex inhibits

35
Q

Enoxaparin (LMWH, Lovenox)

A

1) Use: Anticoagulation
2) Class/MOA: Cofactor for activation of ANTITHROMBIN and Xa (work better on Xa), better bioavailibilty and 2-4 times longer 1/2 life - can be administered subQ and without lab monitoring
3) Side effects/ADEs: can’t reverse esily

35
Q

Cytarabine (Ara-C)

A

1) Use: AML, ALL, high grade non-Hodgkin’s lymphoma
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANTAGONIST inhibition of DNA polymerase
3) Side effects/ADEs: Leukopenia, thrombocytopenia, megaloblastic anemia
4) Fun Facts

37
Q

Argatroban

A

1) Use: HIT, patient with kidney dysfunction
2) Class/MOA: directly INHIBITS THROMBIN
3) Side effects/ADEs: falsely elevates INR levels
4) Fun Facts: irreversible

38
Q

Bleomycin

A

1) Use: Testicular cancer, HD
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL AGENT | Induces free radical formation; which causes BREAKS IN DNA strands
3) Side effects/ADEs: Pulomonary firbosis, skin changes, minimal myelosupression
4) Fun Facts

39
Q

Alteplase (tPA)

A

1) Use: CVA, acute MI, PE
2) Class/MOA: converts plasminogen to plasmin and helps cleave fibrin mesh TPA
3) Side effects/ADEs: bleeding
4) Fun Facts

40
Q

Etoposide

A

1) Use: Small Cell Cardinoma of the lung and prostate, testicular Carcinoma
2) Class/MOA: ANTINEOPLASTIC AGENT: NATURAL PRODUCT: Inhibits TOPOisomerase II = increase in DNA degradation
3) Side effects/ADEs: myelosupression, GI irritation, alopecia
4) F

41
Q

DDAVP (Desmopressin)

A

1) Use: vWF disease
2) Class/MOA: RELEASES vWF stored in endothelium
3) Side effects/ADEs:
4) Fun Facts

42
Q

Hydroxurea

A

1) Use: Melanoma, CML, sickle cell
2) Class/MOA: ANTINEOPLASTIC AGENT Inhibits RIBONUCULOTIDE REDUCTASE = decrease in DNA synthesis
3) Side effects/ADEs: BM supression, GI upset
4) Fun Facts

43
Q

Novo VII

A

1) Use: potent means to stop bleeding!
2) Class/MOA: BASICALLY FACTOR VII | binds activated platelets and catalysex X-> Xa, which turns activated factor II -> Iia (thrombin)
3) Side effects/ADEs: thrombosis
4) Fun Facts

45
Q

Cyclophoasphamide, Ifosphasmide

A

1) Use: NHL, breast/ovarian carcinomas | immunosupressant
2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Covalently links X-link (intrastrand) DNA at guanine N-7 | requires bioactivation by the liver
3) Side effects/ADEs: Myelosupression, hemor

45
Q

Anastrolzole

A

1) Use: postmenopausal women with breast cancer
2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONES : AROMATASE INHIBITOR
3) Side effects/ADEs:
4) Fun Facts

47
Q

Bendamustine

A

1) Use: Refractory CLL, low NHL
2) Class/MOA: ANTINEOPLASTIC AGENT | Alkylating agent - Nitrogen Mustard
3) Side effects/ADEs: NO allopecia, liver irritation, fatigue, rash
4) Fun Facts

47
Q

Fulvestrant

A

1) Use: advanced breast cancer
2) Class/MOA: ANTINEOPLASTIC AGENT | HORMONES | binds E receptor, accelerates destruction
3) Side effects/ADEs: E withdrawl, muscle wasting and gynecomastia
4) Fun Facts

49
Q

Cisplatin (& mesna), Carboplatin

A

1) Use: Testicular, bladder, ovary and lung carcinomas
2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Cross-link DNA
3) Side effects/ADEs: Nephrotoxicity and acoustic nerve damage
4) Fun Facts

50
Q

Rituximab (Rituxan)

A

1) Use: NHL, RA (with MTX)
2) Class/MOA: ANTINEOPLASTIC AGENT: MONOCLONAL ANTIBODY TO CD-20, which is found on most B-cell neoplasms
3) Side effects/ADEs:
4) Fun Facts

51
Q

6-mercaptopurine and 6-thioguanine

A

1) Use: Leukemias, lymphomas (not CLL or HD)
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PURINE ANALOG | Purine analog = decreased de novo purine syntehsis | activated by HGPRTas
3) Side effects/ADEs: BM, GI, Liver | metabolized by xanthene ox

52
Q

Gemtuzumab Ogozamiin (Mylotarg)

A

Anti-CD33

53
Q

5-azacitidine

A

1) Use: MDS
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANALOG, also restore function of tumor supressor gene
3) Side effects/ADEs:
4) Fun Facts

55
Q

Dactinomycin (Antinomycin D)

A

1) Use: Wilms tumor, Ewig’s sarcoma, rahbdo, childhood tumors (kids ACT out!)
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Intercalates in DNA
3) Side effects/ADEs: Myelosupression
4) Fun Facts

55
Q

Bevacizumab (Avastin)

A

1) Use: Mets lung, colon, breast, renal cell, glioblastoma
2) Class/MOA: ANTINEOPLASTIC AGENT radioimmunotherapy, binds VEGF & prevents interaction with its R - decreased endothelial cell prolifeation and decreased new blood vessel formation
3) Side e

56
Q

Doxorubicin (Adriamycin), Daunorubicin

A

1) Use: HD, myelomas, sarcomas and solid tumors
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Generates free radicles | noncovalently intercalates in DNA = BREAKS IN DNA = decreased replicatoin
3) Side effects/ADEs: cardiotoxicity; myelosupress

58
Q

Vincristine, Vinblastine

A

1) Use: HD, Wilms, Choriocarcinoma
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Alkaloids that BIND TO TUBULIN in M-phase and block polyermization of MICROTUBULES so that mitotic spindle can’t form
3) Side effects/ADEs: neurotoxicity | Blast’s

60
Q

Paclitaxel

A

1) Use: Ovarian and breast carcinomas
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT hyperstablizes polymerized microtubules in M phase so that MITOTIC SPINDLE spindle can’t break down (anaphase can’t occur)
3) Side effects/ADEs: myelosuppresion

62
Q

Thalidomide and Lenolidamide

A

1) Use: MM
2) Class/MOA: ANTINEOPLASTIC AGENT | SUPRESS ANGIONEOGENESIS, immunomodulate, pro-apoptottic?
3) Side effects/ADEs: Birth defects
4) Fun Facts

63
Q

Tamoxifin, Raloxifene

A

1) Use: Breast cancer & osteoporosis
2) Class/MOA: SERM - receptor antagonists in the breast, and antagonist in bone | block the binding of estogren to estrogen receptor positive cells
3) Side effects/ADEs: T: increase risk of endometrial carcinoma via

65
Q

Flutamide

A

1) Use: prostate carcinoma
2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONES a nonsteroidal competitive inhibitor of androgens at the testosterone inhibitor
3) Side effects/ADEs:
4) Fun Facts

67
Q

Leuprolide

A

1) Use: Infertility, prostate cancer, uterine fibrosis
2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONE: GnRH analog with agonist properties when used in pulsatile fasion; antagonist properties wihen used in continous fashion
3) Side effects/ADEs: antiandrog

68
Q

Ketoconazole

A

1) Use: PCOS to prevent hirtuism,
2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONE inhibits STEROID syntehsis (inhibits desmolase)
3) Side effects/ADEs: Gynecomastia and amenorrhea
4) Fun Facts

70
Q

Ibritumomab Tiuxetan (Zevalin)

A

1) Use: HD
2) Class/MOA: ANTINEOPLASTIC AGENT | MONOCLONAL ANTIBODY
3) Side effects/ADEs: infusion reactions
4) Fun Facts

72
Q

Trastuxumab (Herceptin)

A

1) Use: Metastatic breast cancer
2) Class/MOA: monoclonal Ab against HER-2 (erb-B2) helps kill breast cancer cells that overexpress HER-2, possibly through antibody dependent cytotoxicity
3) Side effects/ADEs: Cardiotoxicity
4) Fun Facts

73
Q

Cetuzimab (Erbitux)

A

1) Use: Metestatic Breast Cancer
2) Class/MOA: ANTINEOPLASTIC AGENT MONOCLONAL ANTIBODY TO HER-2 (erb-B2) | helps kill breast cancer cells that overexpress HER-2 possibly through antibody-dependent cytotoxicity
3) Side effects/ADEs: cardiotoxicity
4) F

75
Q

Erlotinib (Tarceva)

A

1) Use:
2) Class/MOA: ANTINEOPLASTIC AGENT small molecule, inhibits EGFR - TK1 inhibitor, preents posphorylation, prevents phosphorylation of tyrosine kinase
3) Side effects/ADEs: Skin rash, fatigue, Diarrhea $$$
4) Fun Facts

76
Q

Bortexomib (Velcade)

A

1) Use: MM
2) Class/MOA: ANTINEOPLASTIC AGENT Small molecule, PROTEASE inhibitor - decrased NFKB activation (cells explode because they ant breakdown proteins they contain
3) Side effects/ADEs: Neruropathy, htormbocytopenia, fever, diarrhea, $$$$
4) Fun

77
Q

Imatinib (Gleevec)

A

1) Use: CML, GI stromal tumors
2) Class/MOA: ANTINEOPLASTIC AGENT PHILDELPHIA CHRphilidelphia chromosome bcr-abl tyrosine kinase inhibitor
3) Side effects/ADEs: fluid retention
4) Fun Facts

Drugs (11 decks)

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