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Heme Onc Pharm Flashcards

1
Q

heparin MOA

A

activates antithrombin III and decreases thrombin and factor Xa

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2
Q

how do you follow heparin values in the lab

A

PTT

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3
Q

Do you use warfarin or heparin for DVT prevention during pregnancy?

A

heparin

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4
Q

antidote for heparin

A

protamine sulfate

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5
Q

LMWH vs. unfractionated heparin in terms of half life

A

LMWH halflife is much longer

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6
Q

LMWH moa

A

act more on Xa than thrombin

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7
Q

what is heparin induced thrombocytopenia?

A

IgG antibodies against heparin-bound platelet factor 4 –> complex activates platelets –> can cause both thrombosis and thrombocytopenia

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8
Q

How do you treat heparin-induced thrombocytopenia?

A

direct thrombin inhibitors (argatroban bivalirudin dabigatran)

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9
Q

how do you track warfarin effect?

A

PT INR (want INR to be between 2-3)

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10
Q

how is warfarin administered vs. heparin?

A

warfarin = oral heparin is subq or IV

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11
Q

apixaban MOA

A

bind to and directly inhibit factor Xa

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12
Q

rivoroxaban moa

A

bind to and directly inhibit factor Xa

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13
Q

alteplase MOA

A

directly or indirectly aid conversion of plasminogen to plasmin which cleaves thrombin and fibrin clots

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14
Q

reteplase MOA

A

directly or indirectly aid conversion of plasminogen to plasmin which cleaves thrombin and fibrin clots

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15
Q

stretokinase MOA

A

directly or indirectly aid conversion of plasminogen to plasmin which cleaves thrombin and fibrin clots

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16
Q

tenecteplase moa

A

directly or indirectly aid conversion of plasminogen to plasmin which cleaves thrombin and fibrin clots

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17
Q

how do thrombolytics (such as fibrinolytics) change lab values?

A

increase PT and PTT by decreasing fibrin (common pathway)

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18
Q

how do you treat thrombolytics (alteplase reteplase…) overdose/toxicity?

A

aminocaproic acid FFP or cryoprecipitate)

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19
Q

how does aspirin irreversibily inhibit COX-1 and COX-2

A

covalent acetylation

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20
Q

how does aspirin affect pt and ptt

A

doesn’t!

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21
Q

clopidoral MOA

A

inhibits platelet aggregation by irreversibly blocking ADP receptor on platelets - prevents expression of gp IIb/IIIa on platelet surface

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22
Q

prasugrel MOA

A

inhibits platelet aggregation by irreversibly blocking ADP receptor on platelets - prevents expression of gp IIb/IIIa on platelet surface

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23
Q

ticlopidine MOA

A

inhibits platelet aggregation by irreversibly blocking ADP receptor on platelets - prevents expression of gp IIb/IIIa on platelet surface

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24
Q

ticlopidine toxicity

A

neutropenia (presents with fever and mouth ulcers)

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25
cilostazol MOA
phosphodiesterase III inhibitor --> increases cAMP in platelets
26
dipyridamole moa
phosphodiesterase III inhibitor --> increases cAMP in platelets resulting inhibition of platelet aggregation. Also vasodilates. 
27
Abciximab MOA
binds to gp IIb/IIIa on activated platelets preventing aggregation. made of monoclonal antibody Fab fragments
28
eptifibatide MOA
binds to gp IIb/IIIa on activated platelets preventing aggregation. made of monoclonal antibody Fab fragments
29
tirofiban MOA
binds to gp IIb/IIIa on activated platelets preventing aggregation. made of monoclonal antibody Fab fragments
30
azathioprine works during what cell cycle phase
s
31
cladribine works during what cell cycle phase
s phase
32
6 MP works during what cell cycle phase
s phase
33
azathioprine/6 MP/6-TG are activated by what enzyme
HGPRT
34
azathioprine MOA
purine (thiol) analog - decrease de novo purine synthesis 
35
6 MP MOA
purine (thiol) analog (decrease de novo purine synthesis)
36
6 -TG moa
purine (thiol) analog (decrease de novo purine synthesis)
37
azathioprine and 6 MP are metabolized by what enzyme 
xanthine oxidase
38
azathioprine/6 MP are affected how by allopurinol?
increased toxicity (allopurinol blocks XO)
39
cladribine MOA
purine analog that is resistant to adenosine deaminase (purine degradation pathway) - increased intracellular adenosine concentration) - kills cell 
40
cladribine is used for what use
hairy cell leukemia
41
cytarabine MOA
pyrimidine analog - inhibits DNA polymerase 
42
5 FU MOA
pyrimidine analog --> bioactivated to dUMP which covalently complexes with folic acid which then inhibits thymidylate snythase (decreases dtmp --> decreasea DNA synthesis)
43
methotrexate MOA
folic acid analog that inhibits DHF reductase --> dtmp --> dna synthesis 
44
leucovorin is used to rescue side effects of what drug
methotrexate
45
bleomycin MOA
induces free radical formation (breaks DNA strands)
46
bleomycin toxicity
pulmonary fibrosis
47
dactinomycin moa
intercalates in dna 
48
doxorubin MOA
generates free radicals and intercalate in dna (breaks in dna) --> decreased replication 
49
doxorubicin toxicity
cardiotoxicity (dilated cardiomyopathy)
50
What is used to prevent cardiotoxicity in doxorubicin?
dexrazoxane (iron chelating agent)
51
busulfan mOA
cross-links DNA
52
busulfan toxicity
pulmonary fibrosis
53
cyclophosphamide MOA
cross links DNA
54
carmustine MOA
cross links DNA
55
lomustine MOA
cross links DNA
56
semustine
cross links DNA
57
stretozocin MOA
cross links DNA
58
what causes hemorrhagic cystitis 
cyclophosphamide
59
hemorrhagic cystitis related to cyclophosphamide can be reversed using
mesna
60
paclitaxel MOA
hyperstabilizes microtubules in M phase such that spindle cannot seperate (no anaphase)
61
vincristine vinblastine MOA
vinca alkaloids that bind beta-tubulin and inhibit its polymerization into microtubules 
62
vincristine/vinblastine cell cycle phase
m phase
63
vinblastine toxicity
bone marrow supression
64
vincristine side effects
neurotoxicity (peripheral neuropathy)
65
cisplatin/carboplatin MOA
cross-links DNA using ROS
66
cisplatin/carbopalatin toxicity
ototoxicity and nephrotoxicity
67
how can u stop nephrotoxity with carboplatin/cisplatin
amifostine (free radical scavenger) and chloride (saline) diuresis - cisplatin stays in non-reactive state when there is a higher chloride concentration
68
etoposide mOA
topoisomerase II inhibitor
69
irinotecan/topotecan
topoisomerase 1 inhibitor
70
hydroxyurea moa
inhibitors ribonucleotide reductase (increases HbF)
71
bevacizumab moa
monoclonal antibody against VEGF
72
erlotinib moa
EGFR tyrosine kinase inhibitor
73
imatinib moa
tyrosine kinase inhibitor of BCR-ABL 
74
rituximab moa
monoclonal antibody against CD20
75
tamoxifen/raloxifene moa
selective estrogen receptor modulator - receptor antagonist in breast receptor agonist in bone. blocks binding of estrogen to ER positive cells
76
tamoxifen toxicity
agonist in endometrium so increases risk of endometrial cancer
77
does raloxifene increase risk of endometrial cancer
estrogen receptor antagonist in endometrial tissue so no increased risk of endometrial cancer
78
trastuzumab moa
monoclonal antibody against her2/neu (c-erb-b2) - tyrosine kinase receptor
79
trastuzumab side effects
cardiotoxicity
80
vemurafenib moa
small molecule inhibtor of braf oncogene positive melaonoma 
81
5 fu and 6 mp toxicity
myelosuppression
82
methotrexate toxicity
myelosupression
83
dense granules in platelets contain what
ADP, ca+2
84
alpha granules in platelets contain what
vWF and fibrinogen

heme onc (2 decks)

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