Heme/Oncology II

Question 1

azathioprine

Answer 1

purine analog

antimetabolite

Question 2

6-mecaptopurine

Answer 2

purine analog

antimetabolite

Question 3

6-thioguanine

Answer 3

purine analog

antimetabolite

Question 4

purine analog antimetabolites

Answer 4

decreased de novo purine synthesis

activated by HGPRT

Question 5

increased toxicity with allopurinol and febuxostat

Answer 5

azathioprine and 6-MP

because metabolized by xanthine oxidase

Question 6

cladribine

Answer 6

purine analog antimetabolite

Question 7

tx of hairy cell leukemia

Answer 7

cladribine

Question 8

cytarabine

Answer 8

pyrimidine analog - antimetabolite

inhibits DNA polymerase

Question 9

cytarabine adverse

Answer 9

pancytopenia

Question 10

5-fluorouracil

Answer 10

pyrimidine analog

complexes folic acid

inhibits thymidylate synthase
-decreased dTMP > decreased DNA

tx basal cell cancer, colon cancer, pancreatic cancer

Question 11

methotrexate

Answer 11

folic acid analog

inhibit dihydrofolate reductase

rediced dTMP > decreased DNA

Question 12

medical abortion

Answer 12

misoprostol and methotrexate

Question 13

rescue of methotrexate

Answer 13

leucovorin

Question 14

adverse methotrexate

Answer 14

hepatotoxic
pulmonary fibrosis
mucosal ulcers
myelosuppression

Question 15

antimetabolites

Answer 15

all S phase specific

Question 16

bleomycin

Answer 16

induce free rad formation

-break DNA strands

Question 17

adverse bleomycin

Answer 17

pulmonary fibrosis
skin hyperpigmentation
mucositis
myelosuppression

Question 18

dactinomycin

Answer 18

intercalate in DNA

for childhood tumors

Question 19

doxorubicin

Answer 19

generate free radicals

-intercalate in DNA - breaks in DNA

Question 20

adverse doxorubicin

Answer 20

cardiotoxicity - dilated cardiomyopathy

Question 21

prevent cardiotoxicity with doxorubicin

Answer 21

dexrazoxane - iron chelating agent

Question 22

busulfan

Answer 22

cross link DNA

Question 23

adverse busulfan

Answer 23

pulmonary fibrosis

hyperpigmentation

Question 24

cyclophosphamide

Answer 24

cross link DNA - guanine N7

require liver bioactivation

Question 25

ifosfamide

Answer 25

cross link DNA - guanine N7 require liver bioactivation

Question 26

adverse cyclophosphamide

Answer 26

hemorrhagic cystitis

Question 27

prevent hemorrhagic cystitis with cyclophosphamide

Answer 27

mesna thiol group binds toxic metabolites

Question 28

carmustine

Answer 28

nitrosurea

Question 29

lomustine

Answer 29

nitrosurea

Question 30

semustine

Answer 30

nitrosurea

Question 31

streptozocin

Answer 31

nitrosurea

Question 32

nitrosurea

Answer 32

require bioactivation -cross BBB cross link DNA tx of brain tumors

Question 33

paclitaxel

Answer 33

hyperstabilize polymer microtubule in M phase anaphase cannot occur

Question 34

vincristine

Answer 34

vinka alkaloid -bind and inhibit beta-tubulin polymerization prevent mitotic spindle formation -M phase arrest

Question 35

vinblastine

Answer 35

vinka alkaloid -bind and inhibit beta-tubulin polymerization prevent mitotic spindle formation -M phase arrest

Question 36

adverse vincristine

Answer 36

neurotoxic - areflexic, peripheral neuritis

Question 37

adverse vinblastine

Answer 37

bone marrow suppression

Question 38

cisplatin

Answer 38

cross link DNA

Question 39

carboplatin

Answer 39

cross link DNA

Question 40

adverse cisplatin

Answer 40

nephrotoxicity | ototoxicity

Question 41

reverse cisplatin nephrotoxicity

Answer 41

amifostine - free rad scavenger | chloride - saline diuresis

Question 42

etoposide

Answer 42

inhibit topoisomerase II - more DNA degradation

Question 43

irinotecan

Answer 43

inhibit topoisomerae I - prevent DNA unwinding and replication

Question 44

topotecan

Answer 44

inhibit topoisomerae I - prevent DNA unwinding and replication

Question 45

teniposide

Answer 45

inhibit topoisomerase II - more DNA degradation

Question 46

hydroxyurea

Answer 46

inhibit ribonucleotide reductase decreased DNA synthesis - S phase specific