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Drugs- Basic High Yield Stuff for Boards > Heme Onc Drugs- GOOD > Flashcards

Heme Onc Drugs- GOOD Flashcards

1
Q

Heparin antidote? Effective for the LMWH?

A

Protamine sulfate; only works for HEPARIN, not its LMW derivatives

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2
Q

HIT: what the pathology?

A

IgG against heparin bound platelet factor 4

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3
Q

Bivalirudin:
MOA
Important use

A

Direct thrombin inhibitor (blocks factor II)
*note, this comes from LEECHES 😳
Oral alternative for heparin in cases of HIT

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4
Q 
Warfarin: 
Blocks what clotting factors? 
Site of action? 
Alters what bleeding test? 
Actual relevant polymorphism? 
Used in preggos?
A

II, VII, IX, X + proteins C/S (vitamin K dependent factors)
Prevents factor synthesis in LIVER
Effects EXTRINSIC PATH –> PT altered
Crosses placenta. Don’t use it in preggos ya dummy!!!!
VKORC1 morphisms effect metabolism!

**The (ex) (P)residen(T) went to (war)farin in the year 1(0)972
(Factors = 10,9,7,2

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5
Q

Two ways to reverse warfarin?

A

Slowly: give vitamin K
Rapidly: need to give patients frozen plasma to replace factors

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6
Q

Apixaban, rivaroxaban
MOA
Use
Reversal agent

A

Api(Xa)ban, Rivaro(Xa)ban both inhibit factor Xa!!!
Prophylactic against DVT/PE/STROKE, only
Oral and no monitoring needed.
No antidote.

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7
Q

Drugs ending in –plase:
MOA
Increase what bleeding tests?
Use?

A
  • Convert plasminogen to plasmin to cleave fibrin meshwork in clogs
  • will increase both PT & PTT
  • Treats actual PRESENT CLOTS, i.e. MI/stroke/PE etc.
  • NOT NOT prophylactic!!
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8
Q

Ticlopidine and drugs with –grel

  • MOA
  • use
  • ADR or ticlopidine
A

ADP-Ri –> block GPAII/III
Used in coronary syndrome and coronary stenting
Ticlopidine causes neutropenia so USE CLOPIDIGREL more often.

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9
Q

Cilostazol, Dipyridamole
MOA
Use and one unique use of dipyridamole?

A

PDE3i = ^^^cAMP = platelet inhibition
Vasodilators and prevent clotting
*dipyridamole used in stress test

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10
Q

Abciximab, eptifibatide:
MOA
Use

A

direct GPII/III inhibitors
(–grel drugs block ADP and therefore II/III)
Used in angioplasty/unstable angina

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11
Q

What are the “antimetabolite” chemo drugs? (5)

A

5 FU
methotrexate
Cytaribine; Cladribine
6-MP/ azathioprine(prodrug)

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12
Q

Of the anti-metabolites, which are purine analogs (3)

A

6MP, it’s prodrug (azathioprine), and Cladribine

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13
Q

Cytarabine specific MOA:

A

Pyrimidine analog

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14
Q

5FU inhibits what enzyme

A

Thymidylate synthase

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15
Q

Methotrexate inhibits what enzyme?

A

Dihydrofolate Reductase

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16
Q

Drugs that have increased toxicity when combined with allopurinol/febuxostat?

A

The purine analogs, because they are broken down by xanthine oxidase

(6MP, Cladribine, azathioprine)

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17
Q

Antimetabolite used to treat ectopic pregnancy/ abort pregnancy/treat choriocarcinoma?

A

Methotrexate

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18
Q

Antimetabolite used to treat hairy cell.

By the way. Who gets HCL and what’s the tap like? What’s it stain + for?

A

Cladribine treats HCL.

Old men. Dry T(r)AP–> stain TRAP +

19
Q

Which antimetabolite should be combined with leucovorin?

A

5FU and methotrexate because they are inhibitors of folic acid synthesis.

20
Q

Antimetabolites effect what part of the cell cycle?

A

S phase

21
Q

What chemo drugs are also antibiotics?

A

The ones that end in –cin

  • bleomycin
  • doxorubicin
  • daunorubicin
  • dactinomycin
22
Q

Doxo/daunorubicin/dactinomycin MOA

A

Intercalate in DNA and cause strand breaks

23
Q

Bleomycin MOA? WHAT DOES IT CAUSEEEEE?

A

Generates free radicals that cause DNA strand breaks!!!
NOTORIOUS FOR PULM FIBROSIS.INSTEAD OF ASKING DRUG THEY WILL PROB ASK MOA CAUSE THE NAME IS TOO EASY.

You remember pulm fibrosis by chemo tox man or remember that the lung has two loves/kinda looks like a “B” for bleomycin. Or anyway you want BUT JUST REMEMBER.

24
Q

Antitumor abx used to treat kiddos?

A

Dactinomycin
(The kids are ACTIN’ out!)
Treats stuff like Wilms tumor, Ewing’s sarcoma, rhabdo, etc

25
Q

Busalfan, the phosphamides, and nitrosureas are in what class of chemo drugs?

A

Alkylators (Cross Link DNA)

26
Q

What does cyclophosphamide cause and how do you prevent it?

A

Hemorrhagic cystitis. Prevent with Mesna (toxin binding agent)

27
Q

What does busulfan cause?

How might you distinguish this from another drug?

A

Pulm fibrosis, like bleo.
Bleo is used more often, especially in testicular cancer and hodgkins which are pretty common.

If you do see busulfan used, it’s usually before a bone marrow transplant.

28
Q

Which drugs are microtubule inhibitors?

A

Taxols and vincristine/vinblastine

29
Q

What’s the difference between vin– drugs and taxols?

A

Taxols hyperstabilize microtubles to prevent mitotic spindle breakdown in M phase

Vin–drugs prevent the spindle from ever forming.

30
Q

Which of the microtubule inhibitors treat female cancers?

A

TAXOLS CAUSE THEY ARE LIKE TACOS (at least that’s what my iPad continuously corrects the word to) AND ALL GIRLS LOVE TACOS.

Taxols treat breast/ovarian cancer.

31
Q

What salient ADR do the vin– drugs cause?

A

Peripheral neuropathy

32
Q

How do cisplatin and carboplatin work?

A

Cross link DNA just like the other C drug (cyclphosphamide)

33
Q

Etoposide and teniposide MOA

A

Block topoisomerase II

34
Q

Irinotecan, topotecan block?

A

Topoisomerase II

35
Q

Hydroxyurea:

What other non cancer condition does it treat and how?

A

Sickle Cell; increases HbF

*also note: S phase specific; inhibits DNA syn; but it’s use in Sickle cell seems to be a more popular topic.

36
Q

BeVacizumAB MOA?

A

VEGF Ab

37
Q

(E)rlotin(ib) MOA and one weird ADR

A

EGFR TKi
(Like the treatment of non small cell lung cancer with EGFR mutations that we learned about! (eGFR) Good Females Rarely smoke)
–causes acne like rash

38
Q

C(E)tixim(AB) MOA

A

EGFR Ab

39
Q

IMANTINIB*
MOA AND USE!

I HAVE HAD THIS QUESTION TWICE ALREADY. KNOW IT. LEARN IT. LOVE IT. EAT. IT. SLEEP. IT. JUST LEARN IT.

A

TKi. Treats CML. BCR-ABL 9,22.

40
Q

Rituximab MOA

A

CD20 antibody against B cells!!

41
Q

Tamoxifen, raloxifene MOA

A

–fens = FEmales!!
Selective estrogen receptor modulators.
Treats breast cancer/ prevents osteoporosis

42
Q

Trastuzumab MOA/ use?

A

Her-2-Neu Ab.

trazTWOzumab treats her TWO neu positive breast cancer

43
Q

Vemurifenib MOA?

A

Inhibits BRAF oncogene

44
Q

Heparin blocks what clotting factors?
Safe for preggos?
Effects which clotting path (intrinsic or extrinsic)?
Effects what tests (bleeding time, PT, PTT)?

A

II (thrombin), Xa
Doesn’t cross placenta, safe for preggos
Blocks intrinsic path –> alters PTT

Drugs- Basic High Yield Stuff for Boards (20 decks)

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