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Elliot Step 1 > Heme Onc Drugs > Flashcards

Heme Onc Drugs Flashcards

1
Q

MOA of heparin?

A

Cofactor for actvation of antithrombin; decreases thrombin and decreases factor X

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2
Q

Drug decreases antithrombin?

A

Heparin

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3
Q

Anticoagulant that does not cross placenta?

A

Heparin

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4
Q

Antidote for heparin?

A

Protamine sulfate

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5
Q

Benefit of LMW heparin?

A

Enoxaparin and dalteparin act more on factor 10 and have better bioavailability and longer half life

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6
Q

Heparin induced thrombocytopenia?

A

Development of IgG AB against heparin bound to platelet factor 4–>thrombosis and thrombocytopenia

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7
Q

Alternative to heparin for anti coagulating patients with HIT?

A

Lepirudin and bivalirudin–>anticoagulant used by leeches; inhibits thrombin

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8
Q

Lepirudin and bivalirudin moa?

A

Block thrombin( anticoagulant used by leeches)

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9
Q

Warfarin gamma carboxylates which clotting factors?

A

2,7,9,10, C, S– and CAN cross the placenta

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10
Q

Which pathways does warfarin act on?

A

Extrinsic and PT

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11
Q

Enoxaparin and Dalteparin?

A

LMW heparin– primarily block X

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12
Q

Treatment for severe warfarin overdose?

A

Fresh frozen plasma

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13
Q

Alteplase MOA?

A

Anything that ends in “plase” is a thrombolytic–>increased PT and PTT, no chance in platelet count

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14
Q

Alteplase toxicity?

A

aminocaproid acid– inhibitor of fibrinolysis

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15
Q

MOA of aspirin?

A

Irreversibly inhibits COX by acetylation–>increased bleeding time; decreased TXA2 and dec prostoglandins– NO EFFECT ON PT OR PTT

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16
Q

Overdose of aspirin can lead to?

A

respiratory alkalosis and metabolic acidosis; reyes syndrome

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17
Q

Used in coronary stenting?

A

Clopidogrel (ticlopidine, prasugrel, ticagrelor)

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18
Q

ADP receptor inhibitor that causes neutropenia?

A

Ticlopidine

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19
Q

Inhibits platelet aggregation via increase in cAMP and vasodilators?

A

Cilostazol and dipyridamole

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20
Q

Cilostazol and dipyridamole?

A

Phosphodiesterase III inhibitors– increased cAMP in platelets, thus inhibiting aggregation

THEY ARE ALSO VASODILATORS

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21
Q

Side effects of cilostazol ?

A

Facial flushing, abdominal pain, hypotension

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22
Q

What is abciximab made from?

A

Monoclonal antibody Fab fragments– used in percutaneous transluminal coronary angioplasty

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23
Q

May cause thrombocytopenia (blocks activation of platelets)

A

Abciximab

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24
Q

Vinca alkaloids and taxols block?

A

Mitosis

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25
Q

Bleomycin blocks?

A

G2

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26
Q

DNA intercalators?

A

Dactinomycin and doxorubicin

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27
Q

Vinca alkaloids inhibit?

A

Microtubule formation

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28
Q

Paclitaxel inhibits?

A

microtubule disassembly– taxes the tubules

29
Q

Blocks DHF to THF?

A

Methotrexate– may cause microvesicular changes in the liver

30
Q

Leads to increase in dUMP?

A

5FU inhibits thymidylate synthase which synthesizes dUMP to dTMP

31
Q

Antidote to myelosuppression caused by methotrexate?

A

leucovorin

32
Q

Leucovorin?

A

Antidote to myelosuppresion caused by methotrexate

33
Q

Antidote to 5FU toxicity?

A

Thymidine (5FU may also cause photosensitivity)

34
Q

Antimetabolite that causes photosensitivity?

35
Q

Cytarabine toxicity?

A

panCYTopenia (caused by CYTarabine)– S phase specific

36
Q

Block de novo purine synthesis (purine analogs)

A

Azathioprine, 6 thioguanine, and 6MP– activated by HGPRT

37
Q

Side effects of azathioprine and 6MP

A

Bone marrow, GI, liver, increased toxicity when used with allpurinol

38
Q

Intercalates DNA? Used in Wilms and Ewings?

A

Dactinomycin (actinomycin D)— used for childhood tumors– children ACT out

39
Q

MOA of doxorubicin?

A

Generates free radicals– non covalently intercalates in DNA–>cardiotoxicity (dilated cardiomyopathy); myelosuppresion, alopecia

40
Q

What medication is used with doxorubicin to prevent cardiotoxicity?

A

Dexrazoxane– iron chelating agent

41
Q

May cause pulmonary fibrosis

A

Bleo– has minimal myelosuppresion (amiodorone; busulfan; methotrexate)

42
Q

Covalently crosslink DNA at guanine N-7? and require bioactivation by liver?

A

Cyclophosphamide

43
Q

Hemorrhagic cystitis?

A

Cyclophosphamide (partially prevented with mesna)

44
Q

Alkylating agent that crosses BBB?

A

Nitrosoureas (carmustine, lomustine, semustine, streptozocin)– so obviously they can cause CNS toxicity

45
Q

Used for brain tumors?

A

Nitrosoureas– can cause CNS toxicity

46
Q

Busulfan? MOA? use? toxicity

A

Alkylates DNA– used for CML; pulmonary fibrosis

47
Q

Alkaloids that bind to tubulin in M phase and block polymerization of microtubules?

A

Vincristine and vinblastine

48
Q

Microtubules inhibitor that may cause neurotoxicity; peripheral neuropathy, areflexia)

A

Vincristine

49
Q

Vinblastine SE?

A

Blasts bone marrow– and causes blisters

50
Q

Prevents mitotis spindle from breaking down?

A

Paclitaxel– may lead to hypersensitivity

51
Q

Causes acoustic nerve damage?

A

Cisplatin– also causes nephrotoxicity– use amifostine to prevent nephrotoxicity

52
Q

Amifostine?

A

Used with Cisplatin to prevent nephrotoxicity

53
Q

Inhibits Topo II?

A

Etoposide and teniposide– used for solid tumors

54
Q

Used for testicular, bladder and ovarian cancer?

A

Cisplatin– messes up your DNA

55
Q

Inhibits ribonucleotide reductase–> dec pyrimidine synthesis?

A

Hydroxyurea

56
Q

Prednisone and cancer?

A

May trigger apoptosis

57
Q

Tamoxifen toxicity?

A

Partial agonist in endometrium–> endometrial cancer

58
Q

Raloxifene?

A

Antagonist on breast; agonist on bone; and does not increase endometrial carcinoma

59
Q

Monoclonal antibody against HER2, a tyrosine kinase?

A

Trastuzumab— may cause cardiotoxicity

60
Q

Trastuzumab MOA?

A

Mab against Her2– tyrosine kinase

61
Q

Toxicity of imatinib?

A

Fluid retention

62
Q

Used in GI stromal tumors?

A

Imatinib (c-kit tyrosine kinase)

63
Q

Inhibits BRAF kinase? use?

A

Melanoma– Vemurafenib

64
Q

Vemurafenib?

A

inhibits BRAF kinase– used for metastatic melanoma

65
Q

Mab agst VEGF?

A

Bevacizumab– used in solid tumors

66
Q

Rivaroxabam ?

A

X inhibitor

67
Q

Apixaban?

A

X inhibitor

68
Q

Irinotecan?

A

Inhibits topo I– used in colon cancer

69
Q

Topotecan?

A

Inhibits topo I– used in small lung cell cancer

Elliot Step 1 (32 decks)

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