Heme/Oncology II Flashcards
azathioprine
purine analog
antimetabolite
6-mecaptopurine
purine analog
antimetabolite
6-thioguanine
purine analog
antimetabolite
purine analog antimetabolites
decreased de novo purine synthesis
activated by HGPRT
increased toxicity with allopurinol and febuxostat
azathioprine and 6-MP
because metabolized by xanthine oxidase
cladribine
purine analog antimetabolite
tx of hairy cell leukemia
cladribine
cytarabine
pyrimidine analog - antimetabolite
inhibits DNA polymerase
cytarabine adverse
pancytopenia
5-fluorouracil
pyrimidine analog
complexes folic acid
inhibits thymidylate synthase
-decreased dTMP > decreased DNA
tx basal cell cancer, colon cancer, pancreatic cancer
methotrexate
folic acid analog
inhibit dihydrofolate reductase
rediced dTMP > decreased DNA
medical abortion
misoprostol and methotrexate
rescue of methotrexate
leucovorin
adverse methotrexate
hepatotoxic
pulmonary fibrosis
mucosal ulcers
myelosuppression
antimetabolites
all S phase specific
bleomycin
induce free rad formation
-break DNA strands
adverse bleomycin
pulmonary fibrosis
skin hyperpigmentation
mucositis
myelosuppression
dactinomycin
intercalate in DNA
for childhood tumors
doxorubicin
generate free radicals
-intercalate in DNA - breaks in DNA
adverse doxorubicin
cardiotoxicity - dilated cardiomyopathy
prevent cardiotoxicity with doxorubicin
dexrazoxane - iron chelating agent
busulfan
cross link DNA
adverse busulfan
pulmonary fibrosis
hyperpigmentation
cyclophosphamide
cross link DNA - guanine N7
require liver bioactivation
ifosfamide
cross link DNA - guanine N7
require liver bioactivation
adverse cyclophosphamide
hemorrhagic cystitis
prevent hemorrhagic cystitis with cyclophosphamide
mesna
thiol group binds toxic metabolites
carmustine
nitrosurea
lomustine
nitrosurea
semustine
nitrosurea
streptozocin
nitrosurea
nitrosurea
require bioactivation
-cross BBB
cross link DNA
tx of brain tumors
paclitaxel
hyperstabilize polymer microtubule in M phase
anaphase cannot occur
vincristine
vinka alkaloid
-bind and inhibit beta-tubulin polymerization
prevent mitotic spindle formation
-M phase arrest
vinblastine
vinka alkaloid
-bind and inhibit beta-tubulin polymerization
prevent mitotic spindle formation
-M phase arrest
adverse vincristine
neurotoxic - areflexic, peripheral neuritis
adverse vinblastine
bone marrow suppression
cisplatin
cross link DNA
carboplatin
cross link DNA
adverse cisplatin
nephrotoxicity
ototoxicity
reverse cisplatin nephrotoxicity
amifostine - free rad scavenger
chloride - saline diuresis
etoposide
inhibit topoisomerase II - more DNA degradation
irinotecan
inhibit topoisomerae I - prevent DNA unwinding and replication
topotecan
inhibit topoisomerae I - prevent DNA unwinding and replication
teniposide
inhibit topoisomerase II - more DNA degradation
hydroxyurea
inhibit ribonucleotide reductase
decreased DNA synthesis - S phase specific