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USMLE Step 1 > Heme-onc Pharmacology > Flashcards

Heme-onc Pharmacology Flashcards

0
Q

Heparin toxicity

A

Bleeding, duh. Also, HIT.

Use protamine.

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1
Q

Heparin-MOA

A

Cofactor for activation antithrombin. Decreases thrombin, Xa.

Monitor PTT.

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2
Q

Warfarin-MOA

A

Interferes with gamma carboxylation of vit k dependent clotting factors II, VII, IX, X, protein C and protein S.

Extrinsic pathway. Increases PT.

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3
Q

Warfarin-toxicity

A

Bleeding.

Teratogenic (“don’t wage WAR on the baby”)

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4
Q

Thrombolytics (streptokinase, urokinase, tPA=alteplase, APSAC)

A

Aids conversion plasminogen to plasmin.

Plasmin cleaves thrombin and fibrin clots.

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5
Q

Thrombolytics, clinical use

A

Early MI, early CVA

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6
Q

Aspirin, MOA

A

Irreversibly inhibits COX.

Increases bleeding time, no effect on PT, PTT

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7
Q

Aspirin, clinical use

A

Antipyretic, analgesic, anti inflammatory, antiplatelet

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8
Q

Aspirin, toxicity

A

Gastric ulceration, bleeding, hyperventilation, Reye’s syndrome (kids), tinnitus

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9
Q

Clopidogrel, MOA

A

Blocks ADP irreversibly

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10
Q

Clopidogrel, clinical use

A

ACS, coronary stenting

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11
Q

Abciximab, MOA

A

Binds GpIIb/IIIa on platelets, inhibiting aggregation

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12
Q

Abciximab, clinical use

A

ACS, PTCA

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13
Q

Abciximab, toxicity

A

Bleeding, thrombocytopenia

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14
Q

Antimetabolites

A

Act on S phase of cell cycle

Methotrexate
5-FU
6-MP
6-TG
Cytarabine
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15
Q

Methotrexate, MOA

A

Folic acid analog, inhibits dihydrofolate reductase.

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16
Q

Methotrexate, clinical use

A

Cancer-leukemia, lymphomas, choriocarcinomas, sarcomas

Other-abortion, ectopic pregnancy, RA, psoriasis

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17
Q

Methotrexate, toxicity

A

Myelosuppression-reversible with leucovorin

Fatty liver, mucositosis, teratogenic

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18
Q

5-FU (fluorouracil), MOA

A

Pyramiding analog, inhibits thymidylate synthase

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19
Q

5-FU, clinical use

A

Colon cancer and other solid tumors, BCC.

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20
Q

5-FU, toxicity

A

Myelosuppression
Photosensitivity

Tx OD with thymidine

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21
Q

6-mercaptopurine (MP), MOA

A

Purine analog, decreases de novo purine synthesis

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22
Q

6-MP, clinical use

A

Leukemias, lymphomas

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23
Q

6-MP, toxicity

A

Bone marrow, GI, liver.

Metabolized by Xanthine oxidase so increased toxicity if used with allopurinol.

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24
Q

6-thioguanine (TG), MOA

A

Purine analog, decreases de novo purine synthesis

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25
Q

6-TG, clinical use

A

ALL

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26
Q

6-TG, toxicity

A

Bone marrow depression, liver. Can be given with allopurinol.

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27
Q

Cytarabine, MOA

A

Pyrimidine analog

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28
Q

Cytarabine, clinical use

A

AML, ALL, high grade NHL.

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29
Q

Cytarabine, toxicity

A

Leukopenia, thrombocytopenia, megaloblastic anemia

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30
Q

Dactinomycin, MOA

A

DNA intercalating agent

31
Q

Dactinomycin, clinical use

A

Wilms tumor, Ewing’s sarcoma, rhabdomyosarcoma.

I.e. Kids tumors

32
Q

Doxorubicin, daunorubicin, MOA

A

Generates free radicals

Noncovalently intercalates in DNA

33
Q

Doxorubicin, duanorubicin, clinical use

A

Hodgkins

Myelomas, a sarcomas, solid tumors (breast, ovary, lung)

34
Q

Doxorubicin, daunorubicin, toxicity

A

Cardiotoxicity (DCM), myelosuppression, alopecia.

Dexrazoxane used to prevent cardiotoxicity

35
Q

Bleomycin, MOA

A

Induces ROS, which cause strand breaks

36
Q

Bleomycin, clinical use

A

Testicular cancer, Hodgkins

37
Q

Bleomycin, toxicity

A

Pulmonary fibrosis
Skin changes
Minimal myelosuppression

38
Q

Etoposide, MOA

A

Inhibits topoisomerase II

39
Q

Etoposide, clinical use

A

Small cell of lung and prostate, testic carcinoma

40
Q

Etoposide, toxicity

A

Myelosuppression, GI irritation, alopecia

41
Q

Cyclophosphamide, MOA

A

Alkylation agent. Requires bioactivation by liver.

42
Q

Cyclophosphamide, clinical use

A

NHL, breast and ovarian carcinoma. Also, immunosuppression

43
Q

Cyclophosphamide, toxicity

A 
Myelosuppression
Hemorrhagic cystitis (partially prevented it with mesna)
44
Q

Nitrosoureas, MOA

A

Alkylating agent that crosses BBB

45
Q

Nitrosoureas, clinical use

A

Brain tumors

46
Q

Nitrosoureas, toxicity

A

CNS toxicity (dizziness, ataxia)

47
Q

Busulfan, MOA

A

Alkylates DNA

48
Q

Busulfan, clinical use

A

CML. Also to ablate pt’s bone marrow before transplant

49
Q

Busulfan, toxicity

A

Pulmonary fibrosis, hyper pigmentation

50
Q

Vincristine, Vinblastine, MOA

A

Bind to Tubulin in M phase to prevent microtubule polymerization

51
Q

Vincristine, Vinblastine, clinical use

A

Hodgkins, Wilms tumor, choriocarcinoma, ALL

52
Q

Vincristine, vinblastine, toxicity

A

Vincristine-neurotoxicity, paralytic ileus

Vinblastine-bone marrow suppression

53
Q

Paclitaxel, taxols, MOA

A

Prevent mitotic spindle breakdown

54
Q

Paclitaxel, taxols, clinical use

A

Ovarian and breast carcinomas

55
Q

Paclitaxel, taxols, toxicity

A

Myelosuppression, hypersensitivity

56
Q

Cisplatin, carboplatin, MOA

A

Cross link DNA

57
Q

Cisplatin, carboplatin, clinical use

A

Testicular, bladder, ovary, lung carcinoma

58
Q

Cisplatin, carboplatin, toxicity

A

Nephrotoxicity and acoustic nerve damage.

Prevent nephrotoxicity with amifostine (free radical scavenger

59
Q

Hydroxyurea, MOA

A

Inhibits ribonucleotide reductase thus inhibits S phase

Also increases HbF

60
Q

Prednisone MOA

A

May trigger apoptosis

61
Q

Prednisone clinical use

A

CLL, Hodgkins, immunosuppressant in AI diseases

62
Q

Prednisone toxicity

A

Cushing like sxs

63
Q

Tamoxifen, MOA

A

SERM-receptor antagonist in breast, agonist in bone.

64
Q

Tamoxifen toxicity

A

Increases risk endometrial carcinoma. Hot flashes.

65
Q

Trastuzumab (herceptin), MOA

A

Monoclonal Ab against HER-2, a tyrosine kinase.

66
Q

Trastuzumab, toxicity

A

Cardio toxicity

67
Q

Imantinib, MOA

A

Bcr-abl tyrosine kinase inhibitor

68
Q

Imantinib, clinical use

A

CML, GI stromal tumors

69
Q

Imantinib, toxicity

A

Fluid retention

70
Q

Rituximab, MOA

A

Monoclonal Ab against CD20, which is found on most B cell neoplasms

71
Q

Rituximab, clinical use

72
Q

Aminocaproic acid

A

Reverses tPA

73
Q

Protamine sulfate

A

Reverses heparin

74
Q

Filgramstim

A

Granulocyte stimulating factor

USMLE Step 1 (15 decks)

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