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Pharmacology > Heme and Cancer > Flashcards

Heme and Cancer Flashcards

1
Q

Warfarin MOA

A

Inhibits epoxide reductase interfering with y-carboxylation of vit-k dependent factors

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2
Q

Lab to follow for Warfarin

A

PT (extrinsic pathway)

INR

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3
Q

Lab to follow for Haparin

A

PTT

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4
Q

What anticoagulant do you not want to give HIT pts and Why?

A

Warfarin

it causes warfarin skin necrosis

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5
Q

First line treatment for lead poisoning

A

Dimercaprol and EDTA

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6
Q

used for chelation in lead poisoning in kids

A

succimer

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7
Q

SS cell treatment

A

Hydroxyrea increase fetal Hb

BM transplant

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8
Q

Treatment for acute intermittent porphyria

A

Glucose and Heme

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9
Q

How does heme treat acute intermittent porphyria

A

It inhbits the synthesis of more porphyria

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10
Q

Treatment for vWF and the mechanism by which it does so

A

Desmopressin (DDAVP)- induces weibel palabel bodies in the endothelium cells to secrete more vWF

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11
Q

What is given in a warfarin overdose

A

FFP

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12
Q

What is used to treat coagulation factor deficiences involving fibrinogen and VIII

A

Cryoprecipitate

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13
Q

Hairy cell leukemia treatment and MOA

A

Cladribine (2-CDA) and adenosine deaminase inhibitor and adenosine accumulation is toxic to B-cells

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14
Q

Imatinib MOA and use

A

blocks excessive tyrosine kinase

CML–chronic myelogenous leukemia

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15
Q

Heparin MOA

A

Co-factor for the activation of antithrombin

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16
Q

Heparin ultimately reduces

A

Factor 10a and thrombin

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17
Q

Which anticoagulant is safe for preg?

A

Heparin

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18
Q

Heparin is used for

A

Immediate PE
Acute coronary syndrome
MI
DVT

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19
Q

Heparin toxicities

A

Bleeding
thrombocytopenia(HIT)
osteoporosis
Drug interactions

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20
Q

Drug and its MOA used for Heparin antidote

A

Protamine sulfate

+ charged so bind negatively charged heparin

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21
Q

List the low molecular weight haparins

A

Enoxaparin

dalteparin

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22
Q

What is different about the low mol weight heparins

A

act more on factor 10a
better bioavailability
greater t1/2

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23
Q

What is the alternative in pts with HIT

They are derivatives of

A

Lepirudin
bivalirudin
hirudin–leeches anticoagulant

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24
Q

What factors are affected by Warfarin

A

2,7,9,10, S, and C

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25
Q

Warfarin uses

A

chronic anticoagulation after STEMI

Afib stroke prevention

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26
Q

Warfarin toxcity

A

Bleeding
TERATOGEN
Skin/tissue necrosis(esp with C and S deficiency)
Drug interaction

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27
Q

For mere reversal of warfarin overdose give

For severe reversal of warfarin overdose give

A

Vit k

FFP

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28
Q

What do the thrombolytics do

A

Aid conversion of plasminogen to plasmin to thrombin and fibrin clots

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29
Q

List the thrombolytics

A

Alteplase(tPA)
reteplase(rPA)
tenecteplase(TNK-tPA)

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30
Q

The Thrombolytics are used for

A

Early MI
Early ischemic stroke
Severe PE thrombolysis

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31
Q

Thrombolystics toxicity and antidote

A

Bleeding

aminocaproic acid

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32
Q

Aminocaproic acid inhibits

A

fibrinolysis

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33
Q

Thrombolytics are contraindicated in

A

H/O intracranial bleed
recent surg
knwn diatheses
severe HTN

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34
Q

ASA MOA

A

IRREVERSIBLY inhibtis COX-1 and COX-2 by covalent acetylation so TXA2 and prostaglandins are decreased

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35
Q

ASA increases

A

bleeding time only

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36
Q

ASA toxicity

A

Gastric ulceration
tinnitus
Chronic use==upper GI bleeding,nephritis, interstitial nephritis
Reye’s syndrome

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37
Q

ASA overdose causes

A

Repiratory alkalosis

metabolic acidosis

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38
Q

clopidogrel
ticlopidine
ticagrelor

A

IRREVERSIBLY block ADP receptors inhibiting IIb/IIIa binding to fibrinogen and thus plt aggregation

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39
Q

ADP receptor inhibitors

and use

A

Clopidogrel, ticlopidine, ticagrelor

Acute coraonary syndrome
coronary stenting
reduce recurrence of thrombotic stroke

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40
Q

ADP receptor inhibitor tocixity

A

ticlopidine cause Neutropenia

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41
Q

Cilostazol and dipyridamole uses

A

Intermittent claudication
coronary vasodilatio
prevention of stroke of TIA
Angina prophylaxis

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42
Q

Cilostazol and dupyridamole MOA

A

Phosphodiesterase III inhibitors that increase cAMP in PLT inhibiting aggragation.
Also VD

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43
Q

Abciximab, eptifibatide, tirofiban MOA

A

Bind GPIIb/IIa receptor on PLT and prevent aggregation

44
Q

GIIb/IIIa recepto inhibitors clinical use

A

Acute coronary syndromes

percutaneous translumunal coronary angioplasty

45
Q

GIIb/IIIa receptor inhibitors toxicity

A

bleeding

thrombocytopenia

46
Q

cilostazol and dipyridamole toxicity

A 
Nausea
HA
flushing
hypoTN
Abd pain
47
Q

List the antimetabolites and their general MOA

A

Methotrexate
5-flourouracil
cytarabine
azathioprine

48
Q

Methotrexate MOA

A

A folic acid analog that inhibits dihydrofolate reductase= decrease DNA and protein syn

49
Q

MTx clinical use

A 
CA: Leukemia, lymphoma, choriocarcinoma, sarcoma
abortion
ectopic preg
RA
psoriaris
50
Q

MTX toxicity

A

Myelosuppression
macrovesicular fatty change in liver
Mucositis
teratogen

51
Q

5-FU MOA

A

Pyrmidine analog that is converted to 5f-dUMP inhibiting thymidylate synthesis—-decrease DNA and protein synthesis

52
Q

5-FU use

A

Colon cancer

basal cell carcinoma

53
Q

5-fluorouracil toxicity

A

myelosuppression

photsensitivity

54
Q

Myeosuppression associated with MTX and 5-FU overdose can be rescued by

A

Leucovorin

55
Q

Cytarabine MOA

A

Pyrimidine analog the inhibits DNA polymerase

56
Q

cytarabine (arabinofuranosyl cytidine) toxicity

A

Leukopenia
thombocytopenia
megaloblastic anemia

57
Q

cytarabine clinical use

A

leukemia and lymphomas

58
Q

Azathioprine MOA

A

purine analog that is activated by HGPRT to decrease de novo purine synthesis

59
Q

Azathioprine toxicity

A

BM, GI and liver stuff

60
Q

List the antitumor antibodies

A

Bleomycin
Dactinomycin
Doxorubicin

61
Q

Dactinomycin MOA and uses

A

Intercalates in DNA
Wilms’s tumor
Ewing’s sarcoma
rhabdomyosarcoma

62
Q

Dactinomycin toxicity

A

Myelosuppression

63
Q

Doxorubicin MOA

A

Generates free redicals—breaks in DNA

64
Q

Doxorubicin toxicity

A

Dilated cardiomyopathy
myelosuppression
alopecia

65
Q

This drug will prevent doxorubicin cardiomyopathy

A

dexrazoxane

66
Q

Bleomycin MOA

A

Induces free radical formation causing breaks in DNA

67
Q

Bleomycin clinical use

A

Testicular cancer

Hodgkin’s lymphoma

68
Q

bleomycin toxicity

A

Pulmonary fibrosis

skin changes

69
Q

List the alkylating agents and their general MOA

A 
Cyclophospahmide
ifosfamide
nitrosoureas
busulfan
Alkylate and damage DNA
70
Q

Cyclophophamide and ifosfamde MOA

A

Covalently X-Link DNA at guanine N-7

71
Q

cyclophosphamide and ifosfamide toxicity

A 
myelosuppression
hemorrhagic cystitis( mesna prevents)
72
Q

List the nitrosoureas

A

Carmustine
lomustine
semustine
streptozocin

73
Q

the ntirosourease uses

A

alkylating agent for Brain tumors like glioblastoma multiform

74
Q

Whats special about the nitrosoureas and list toxicity

A

Can cross the BBB

CNS toxicity like diziness and ataxia

75
Q

Busulfan MAO and use

A

Alkylates DNA
CML
Ablation of bone marrow b/f transplant

76
Q

Busulfan toxicity

A

Pulmonary fibrosis

hyperpigmentation

77
Q

Microtubule inhibitors

A

Vincristine
vinblasitn
Paclitaxel

78
Q

Vincristine and vinbalstine MOA

A

Alkaloids that bind to tubulin in M phase blocking polymerization of microtubles

79
Q

Vincristine and vinblastine use

A

Solid tumor, leukemias and lymphomas

80
Q

vincritine toxicity

A

neurotoxicity:
areflexia
peripheral neuritis
paralytic ileus

81
Q

Vinblastine toxicity

A

Blast the bone marrow

82
Q

Paclitaxel MOA

A

hyperstabilizes polymerized microtubules in M phase so that mitotic spindle cannot break down

83
Q

Paclitaxel clinical use

A

Ovarian and breast carcinomas

84
Q

Paclitaxel toxicity

A

Myelosuppression

hypersensitivity

85
Q

Cisplatin and carboplastin MOA

A

cross link DNA

86
Q

cisplastin and carboplastin use

A 
carcinomas:
Testicular
bladder
ovary
lung
87
Q

cisplastin and carboplastin toxicity

A

Nephrotoxicity (give amifostine)
acoustic nerve damage
chloride diuresis

88
Q

Etoposide and teniposide MOA

A

inhibits topoisomerase II and thus increases DNA degradation

89
Q

Etoposide and teniposide use and toxicity

A

solid tumor, leukemia, lymphocytes
myelosuppression
GI irritation
alopecia

90
Q

Hydroxyurea MOA

A

Inhibits ribonucleotide reductase decreasing synthesis

91
Q

hydroxyurea use

A

Melanoma
CML
sickle cell

92
Q

How does hydroxyurea work for SS

A

it increases fetal Hb

93
Q

Hyrdoxyurea toxicity

A

BM supression

GI upset

94
Q

Prednisone/predinosolone MOA for CA cells

A

May trigger apotosis

95
Q

Tamoxifen and raloxifene MOA

A

Blocks the binding of estrogen to estrogen receptors. Agonist in bones
Antagonist in breast

96
Q

Tamoxifen and reloxifene use

A

Breast CA prevention and treatment

Osteoporosis prevention

97
Q

Tamoxifen toxicity

A

Agonist in endometrium–cancer

hot flashes

98
Q

Trastuzumab MOa

A

Monoclonal Ab against HER-2 for HER-2 expressing BCA

99
Q

Trastuzumab toxicity

A

cardiotoxicity

100
Q

Imatinib (Gleevec) MOA

A

9, 22 abl-bcr tyrosine kinase inhibitor

101
Q

Imatinib use and toxicity

A

CML and GI stromal tumors

Fluid retention

102
Q

Rituximab MOA

A

Monoclonal AB against CD20

103
Q

rituximab MOA

A

Nonhodgkin’s lyphoma

in combo with methotrexate for RA

104
Q

Vemurafenib MOA

A

inhibit the forms of B-Raf kinase with the V600E mutation

105
Q

Vemurafenib use

A

Metastatic melanoma

106
Q

Bevacizumab MOA

A

monoclonal AB against VEGF to inhibit angiogenesis

107
Q

Bevacizumab clinicla use

A

solid tumors

Pharmacology (13 decks)

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