Heme/Onc Pharm

Question 1

Can be used to prevent mast cell degranulation

Answer 1

Cromolyn sodium Pharmacology Heme/Onc

Question 1

Treatment of lead poisoning

Answer 1

Dimercaprol and EDTA, succimer in kids Pharmacology Heme/Onc

Question 2

Heparin (mechanism, use, toxicity)

Answer 2

Activates antithrombin, which inactivates thrombin and Xa; used for immediate coagulation and in pregnant women; some patients develop antibodies to platelet factor 4 (HIT) Pharmacology Heme/Onc

Question 3

Enoxaparin, dalteparin (mechanism, use, toxicity)

Answer 3

Same actions as heparin, but has a longer half-life, does not have to be monitored as closely, and has a reduced risk of HIT Pharmacology Heme/Onc

Question 4

Warfarin (mechanism, use, toxicity)

Answer 4

Inactivated gamma-carboxylation of factors II, VII, IX, X, C, and S; used for long-term and non-immediate anticoagulation; can cause tissue necrosis, teratogenic Pharmacology Heme/Onc

Question 5

Alteplase, reteplase, tenecteplase (mechanism, use, toxicity)

Answer 5

Converts plasminogen to plasmin; used as a thrombolytic Pharmacology Heme/Onc

Question 6

Aspirin (mechanism, use, toxicity)

Answer 6

Irreversibly inhibits COX-1 and COX-2; anti-platelet and anti-inflammatory; gastric ulcers, tinnitus, Reye’s syndrome in childhood viral infections Pharmacology Heme/Onc

Question 7

Clopidogrel, ticlodipine, prasugrel, ticagrelor (mechanism, use, toxicity)

Answer 7

Irreversibly blocks ADP receptors on platelets, preventing degranulation; used for acure coronary syndrome; ticlodipine causes neutropenia Pharmacology Heme/Onc

Question 8

Cilostazol, dipyridamole (mechanism, use, toxicity)

Answer 8

Phosphodiesterase inhibitor, increases cAMP and decreases ADP, preventing platelet degranulation; nausea, headache, facial flushing, hypotension Pharmacology Heme/Onc

Question 9

Abciximab, eptifibatide, tirofiban (mechanism, use, toxicity)

Answer 9

GPIIb/IIIa inhibitors, preventing platelet aggregation; bleeding, thrombocytopenia Pharmacology Heme/Onc

Question 10

Methotrexate (mechanism, use, toxicity)

Answer 10

Inhibits dihydrofolate reductase, inhibiting DNA synthesis; myelosuppression, macrovesicular fatty change in liver Pharmacology Heme/Onc

Question 11

5-fluorouracil (mechanism, use, toxicity)

Answer 11

Pyrimidine analog that is activated and inhibits thymidylate synthase, inhibiting DNA synthesis; myelosuppression, photosensitivity Pharmacology Heme/Onc

Question 12

Cytarabine (mechanism, use, toxicity)

Answer 12

Pyrimidine analog that inhibits DNA polymerase; leukopenia, thrombocytopenia, megaloblastic anemia Pharmacology Heme/Onc

Question 13

Azathioprine, 6-mercaptopurine, 6-thioguanine (mechanism, use, toxicity)

Answer 13

Purine analogs that are activated by HGPRT and inhibit purine synthesis; toxicity is increased with allopurinol, causes bone marrow, GI, and liver toxicity Pharmacology Heme/Onc

Question 14

Dactinomycin (actinomycin D) (mechanism, use, toxicity)

Answer 14

DNA intercalator; used for childhood tumors; myelosuppression Pharmacology Heme/Onc

Question 15

Doxorubicin (Adriamycin), daunorubicin (mechanism, use, toxicity)

Answer 15

Generates free radicals that cause DNA strand breaks; dilated cardiomyopathy, myelosuppression, alopecia Pharmacology Heme/Onc

Question 16

Bleomycin (mechanism, use, toxicity)

Answer 16

Generates free radicals that cause DNA strand breaks; pulmonary fibrosis with minimal myelosuppression Pharmacology Heme/Onc

Question 17

Cyclophosphamide, ifosfamide (mechanism, use, toxicity)

Answer 17

Crosslinks DNA (must be activated by liver); myelosuppression, hemhorragic cystitis (can be minimized with mesna) Pharmacology Heme/Onc

Question 18

Carmustine, lomustine, semustine, streptozocin (mechanism, use, toxicity)

Answer 18

Used to treat CNS tumors Pharmacology Heme/Onc

Question 19

Busulfan (mechanism, use, toxicity)

Answer 19

Alkylates DNA; pulmonary fibrosis, hyperpigmentation Pharmacology Heme/Onc

Question 20

Vincristine, vinblastine (mechanism, use, toxicity)

Answer 20

Block microtubule polymerization; vincristine causes neurotoxicity, vinblastine causes bone marro suppression Pharmacology Heme/Onc

Question 21

Paclitaxel (mechanism, use, toxicity)

Answer 21

Blocks microtubule breakdown; myelosuppression Pharmacology Heme/Onc

Question 22

Cisplatin, carboplatin (mechanism, use, toxicity)

Answer 22

Crosslinks DNA; nephrotoxicity (minimize with chloride diuresis, amifostine), acoustic n. damage Pharmacology Heme/Onc

Question 23

Etoposide, teniposide (mechanism, use, toxicity)

Answer 23

Inhibits topoisomerase II; myelosuppression, GI upset, alopecia Pharmacology Heme/Onc

Question 24

Hydroxyurea (mechanism, use, toxicity)

Answer 24

Inhibits ribonucleotide reductase; used in cancers and HbSS disease; bone marrow suppression Pharmacology Heme/Onc

Question 25

Prednisone (mechanism, use, toxicity)

Answer 25

Unknown but may trigger apoptosis in dividing cells; Cushingoid symptoms Pharmacology Heme/Onc

Question 26

Tamoxifen, raloxifene (mechanism, use, toxicity)

Answer 26

Prevents estrogen receptor binding; used in breast cancer and prevention of osteoporosis; tamoxifen increases the risk of endometrial cancer due to agonist effects Pharmacology Heme/Onc

Question 27

Trastuzumab (mechanism, use, toxicity)

Answer 27

Antibody against HER-2 receptor; cardiotoxicity Pharmacology Heme/Onc

Question 28

Imatinib (mechanism, use, toxicity)

Answer 28

Antibody against bcr-abl tyrosine kinase Pharmacology Heme/Onc

Question 29

Rituximab (mechanism, use, toxicity)

Answer 29

Antibody against CD20; used to treat non-Hodgkin’s lymphoma and rheumatoid arthritis Pharmacology Heme/Onc

Question 30

Vemurafenib (mechanism, use, toxicity)

Answer 30

B-raf kinase inhibitor (V600 mutation); used in metastatic melanoma Pharmacology Heme/Onc

Question 31

Bevacizumab (mechanism, use, toxicity)

Answer 31

Antibody against VEGF Pharmacology Heme/Onc