Jose Chemo Drugs Flashcards
1
Q
What are the categories of Alkylating Agents?
A
MEAT - NP…P
Nitrogen Mustards Ethyleneimines Alkyl Sulfonates Triazenes Nitrosureas (-mustine's) Methylhydrazine
Platinums are similiar
2
Q
What is the MOA of Alkylating Agents?
A
Covalent DNA binding
Crosslinking Guanine Bases
DNA unable to uncoil, separate and replicate
3
Q
What is the cell cycle specificity of Alkylating Agents?
A
CCNS
4
Q
What are the Nitrogen Mustard drugs?
A
C-MIC likes Mustard
Cyclophosphamide
Ifosfamide
Melphalan
Chlorambucil
5
Q
What disease processes is Cyclophosphamide/Ifosfamide used to treat?
A
ALL ALL CANCERS CLL HAVE Hodgkins NO Non-Hodgkins MERCY Multi-My NO NBT WINNING Wilms STORIES STS
6
Q
What are the major toxicities related to Cyclophosphamide?
A
Cardiotoxicity,
Most common toxicity: hemorrhagic cystitis (can be prevented with hydration)
” the dirty C’s”
7
Q
What are the major toxicities related to Ifosfamide?
A
Severe urinary tract and neuro toxicity (sz, coma AMS, cerebral ataxia)
8
Q
What is the cell cycle specificity of Cyclophosphamide?
A
CCNS
9
Q
What is the cell cycle specificity of Ifosfamide?
A
CCNS
10
Q
What is the cell cycle specificity of Melphalan?
A
CCNS
11
Q
What disease is Melphalan used to treat?
A
Multi-My
Mel-Mul-My
12
Q
What is the cell cycle specificity of Chlorambucil?
A
CCNS
13
Q
What diseases is Chlorambucil used to treat?
A
CLL, macroglobulinemia (a form of Non-Hodgkins)
“CLL is in the name…ChLorambuciL”
chloRAMBUcil…Rambo is Macro
14
Q
What are the Ethyleneimine drugs?
A
Thiotepa
EThyleneimine = thioTEpa
15
Q
What is the cell cycle specificity of Thiotepa?
A
CCNS
16
Q
What are the major toxicities of Thiotepa?
A
CNS
“C Thio makes me NervouS”
17
Q
What are the Alkyl Sulfonate Drugs?
A
Busulfan
Anti-lock Breaking System
18
Q
What is the cell cycle specificity of Busulfan?
A
CCNS
19
Q
What diseases is Busulfan used to treat?
A
CML (chronic myelogenous leukemia), Transplantation (bone marrow)
“use the BUS for TRANSporTATION if you Cant Move Legs”
20
Q
What are the major toxicities related to Busulfan?
A
Skin pigmentation, pulmonary fibrosis, and adrenal insuffficiency
“sing SAPpy songs on the BUS”
21
Q
What are the Nitrosurea drugs?
A
Streptozocin
Carmustine
Lomustine
“mustines”
“CARSMUST LOve nitroS”
22
Q
What is the cell cycle specificity of Carmustine?
A
CCNS
23
Q
What is the cell cycle specificity of Lomustine?
A
CCNS
24
Q
What disease is Carmustine used to treat?
A
Hodgkins, Non-Hodgkins, Glioblastoma
the CAR-MUST BLAST-hOMe
25
What are the major toxicities related to Carmustine?
Pulmonary fibrosis, renal failure and secondary leukemia
"People Require Speed"
26
What diseases is Streptozocin used to treat?
ONLY for malignant pancreatic insulinoma, malignant carcinoid
I got STREPT throat from CARCIN's PANCakes
27
What are the Triazene drugs?
Dacarbazine
Temozolomide
"Tri Taking Drugs"
28
What is the cell cycle specificity of Dacarbazine?
CCNS
29
What diseases is Dacarbazine used to treat?
Mal-Mel, Hodgkins, STS,
"DA CARBz Make My Hip Swell"
30
What is the MOA of Dacarbazine?
Methylates DNA, inhibits synthesis...requires activation by the liver.
"DA METH INHIBITS the LIVER"
31
What are the major toxicities related to Dacarbazine?
CNS toxicity with neuropathy and lethargy
Flu-like symptoms
"DA CARBz (think of diabetes-hypo/hyper glycemia) make my nerves toxic, arms numb, tired, feels like the flu
32
What are the Platinum drugs?
-PLATIN's
Cisplatin, Carboplatin, Oxaliplatin
33
What diseases is Cisplatin used to treat?
CHOLANGIOCARCINOMA
NSCLC, SCLC, testicular, bladder, ovarian, esophageal, lung, head and neck, colon, breast Ca.
"Latins love the genitals, breast and colon"
34
What is the MOA of Cisplatin?
Forms intra- and inter-strand DNA cross-links; binding to nuclear and cytoplasmic proteins
35
What are the major toxicities of Cisplatin?
PN, Nephrotoxicity (hydration and diuresis is important), ototoxicity
" PLATINs Never Pay OTO"
36
Which drugs can cross the BBB?
Nitrosureas (Carmustine, Lomustine and Streptozocin)
Triazene: Temozolodmide
Can be used to treat brain tumors
37
Major Toxicities of Alkylating Agents?
Leukemogeneneic (causes leukemia; less common with Cyclophosphamide)
Mucosal Toxicity
Infertility
Neurotoxicity
Myelosuppression: Nadir of granulocytes 6-10 days and recovery taking 14-21 days.
38
What is the toxic effect of Streptozocin?
Renal Failure
STReptozocin = "Stops The Renals"
39
What diseases are treated with Temozolomide?
Malignant glioma and astrocytoma
"Try and grab my GAT"
40
What cell cycle specificity is Temozolomide?
CCNS
41
What is unique about Temozolomide?
Crosses BBB
| Oral administration allows 100% bioavailability
42
What are the major toxicities related to Temozolomide?
Same as Dacarbazine...CNS toxicity with neuropathy and lethargy
Flu-like symptoms
43
What is the MOA of Procarbazine
It is an orally active methylhydrazine (differs from Dacarbazine b/c does not require activation by the liver)...Methylates DNA and inhibits DNA synthesis and function.
Cell cycle is unknown!
44
What diseases are treated with Procarbazine?
Hodgkins and Non-Hodgkins, and brain tumors
"proCARbazINE same as CARmustINE...CAR-MUST BLAST-OMA"
45
What are the toxicities related to Procarbazine?
CNS depression
May provoke HTN b/c blocks metabolism of catecholamines and sympathomimetics
Avoid alcohol due to disulfiram like reactions
Risk of Leukemia
Infertility
DO NOT GIVE WITH OTHER CNS DEPRESSANTS
46
What secondary effects of Platinum drugs are important to monitor for?
Platinum drugs are mutagenic, teratogenic and carcinogenic...Ovarian cancer patients treated with platinum drugs have 4x greater risk of developing leukemia.
47
What is the cell cycle specificity of Antimetabolites?
CCS - S phase
Antimetabolites end in S
48
What are the categories of Antimetabolites?
Folic Acid Analogues
Pyrimidine Analogues
Purine Analogues
Cytidine Analogues
ANTI-ANAL
49
What drugs are Folic Acid Analogues
Methotrexate (MTX)
Pemetrexed
ACID METH & Pot
50
What drugs are Pyrimidine Analogues?
Fluorouracil (5-FU)
51
What is the cell cycle specificity of 5-FU?
CCS - S phase
52
What is the cell cycle specificity of Gemcitabine?
CCS - S phase
Cytidine Analog
53
What diseases are treated with 5-FU?
Metastatic Colon Ca, gastroesophageal (UGI), breast, HEPATOCELLULAR cancer.
54
What is the MOA of 5-FU?
Inhibits TS; incorporation of FUTP into RNA resulting in alteration in RNA processing; incorporation of FdUTP into DNA resulting in inhibition of DNA synthesis and function.
55
What diseases are treated with MTX?
ALL; CHORIOCARCINOMA, OSTEOGENIC SARCOMA
| breast, head, neck and lung cancers, primary CNS lymphoma, non-Hodgkin’s, bladder cancer.
56
What is the MOA of MTX?
Inhibits DHFR; inhibits TS; inhibits de novo purine nucleotide synthesis
57
What toxicities are associated with MTX?
SPONTANEOUS HEMORRHAGE: platelet dysfunction. SEVERE INFECTION
TERATOGENESIS: congenital malformation. MTX is a folate inhibitor and lack of folic acid causes neural tube defects in fetus.
NEUROTOXICITY: encephalopathy
58
What toxicities are associated with 5-FU?
Neurotoxicity: remember the picture
SEVERE GI TOXICITIES: INCLUDING SHOCK AND DEATH
Anorexia, Stomatitis and GI ulcers: makes sense b/c 5FU treats gastroesophageal Ca...some people stop taking because GI effects are too harsh.
59
What diseases are treated with Gemcitabine?
Pancreatic, bladder cancer, breast cancer, non-small cell lung cancer (NSCLC), ovarian cancer, non-Hodgkin’s, STS.
60
What is the MOA of Gemcitabine?
Inhibits DNA synthesis and repair; inhibits ribonucleotide reductase with reduced formation of dNTPs; incorporation of gemcitabine triphosphate into DNA resulting in inhibition of DNA synthesis and function/repair.
dNTP: deoxyribonucleoside triphosphate, which is required for DNA synthesis.
61
What drugs are Purine Analogs?
6-Mercaptopurine
PAM is PURe
62
What is the cell cycle specificity of 6-Mercaptopurine?
CCS - S phase
pop 6 capS in em!
63
What diseases are treated with 6-Mercaptopurine?
Acute lymphocytic and myelogenous leukemia (AML); small cell non-Hodgkin’s lymphoma
"6 A.M."
64
What is the MOA of 6-Mercaptopurine?
Inhibits de novo purine nucleotide synthesis; incorporation of triphospthate into RNA/DNA.
"TRI DE PURe DNA/RNA
65
What toxicities are associated with 6-Mercaptopurine?
Myelosuppression, immunosuppression, and hepatotoxicity.
"6 PURe HIMs"
66
What diseases are treated with Pemetrexed?
Mesothelioma, non-small cell lung cancer
"MET MESO-THE SMALL LUNG"
67
What is the MOA of Pemetrexed?
Inhibits TS, DHFR, and purine nucleotide synthesis
"PemeTrexeD" = PUR, THI, DI
68
What toxicities are associated with Pemetrexed?
skin rash, mucositis, hand-foot syndrome.
69
What drugs are Epipodophyllotoxins?
Etoposide
Teniposide
TEE-P Please
71
What is the cell cycle specificity of Etoposide?
CCS: G1 - S phase
"E fucks G1 in the S PHASE"
72
What is the MOA of Etoposide/Teniposide?
Inhibits topoisomerase II. They form a tertiary complex with topoisomerase II and DNA. Preventing resealing of bound DNA breaks.
TOPO + TOPO = II
73
What diseases are treated with Etoposide?
Testis; breast cancer; Hodgkin’s disease; non-Hodgkin’s; acute myelogenous leukemia (AML); Kaposi’s sarcoma…NSCLC and SCLC; gastric cancer.
Etoposide has 2 O's...think of balls and breasts
74
What diseases are treated with Etoposide?
Testis; breast cancer; Hodgkin’s disease; non-Hodgkin’s; acute myelogenous leukemia (AML); Kaposi’s sarcoma…Non-small cell and small cell lung cancer (NSCLC and SCLC); gastric cancer.
Etoposide has 2 O's...think of balls and breasts
75
What is the cell cycle specificity of Taxanes?
CCS: M-phase
TAX Man
75
What drugs are Taxanes?
Paclitaxel
76
What diseases are treated with Paclitaxel?
Ovarian, breast, lung, prostate, bladder, head and neck cancer…non-small cell and small cell lung cancer (NSCLC SCLC), gastroesophageal cancer.
Think of backPAC... organs that are holow or solid
77
What is the cell cycle specificity of Paclitaxel?
CCS: M-phase
Paclitaxel is the TAX MAN
78
What is the MOA of Paclitaxel?
Inhibits Mitosis; Interferes with microtubule assembly or disassembly.
80
What toxicities are associated with Paclitaxel?
Hypotension, arrhythmias, hypersensitivity, myelosuppression, peripheral sensory neuropathy.
"PAM, Hates, Hates, taxes"
80
What drugs are Vinca Alkaloids?
Vincristine
Vinblastine
Vinorelbine
Vindesine
81
What is the cell cycle specificity of Vinca Alkaloids?
CCS: M-phase
VMA awards
82
What is the MOA of Vinca Alkaloids?
Inhibits Mitosis. Act on mitotic process by interfering with microtubule assembly or disassembly. In the absence of the mitotic spindle, chromosomes that have duplicated cannot align along the division plate.
Microtubules are also found in the brain and function in axonal transfer; therefore these agents have side effects like neurotoxicity.
83
What is the MOA of Vinca Alkaloids?
Inhibits Mitosis. Act on mitotic process by interfering with microtubule assembly or disassembly. In the absence of the mitotic spindle, chromosomes that have duplicated cannot align along the division plate.
Microtubules are also found in the brain and function in axonal transfer; therefore these agents have side effects like neurotoxicity... specifically vincristine
84
What is the MOA of Vincristine?
Inhibits Mitosis
VMA awards
85
What drugs are Anthracycline Antibiotics?
Doxocrubicin
Daunorubicin
Idarubicin
DID you go to AA with aunt rubicin?
86
What is the cell cycle specificity of Anthracycline Antibiotics?
CCNS
Anthrax is not specific...kills all!
87
What is the cell cycle specificity of Doxorubicin?
CCNS
DOX ruins everything!
88
What is the cell cycle specificity of Mitomycin?
CCSN
MIGHTY MYCIN kills all
89
What toxicities are associated with Doxorubicin?
Red urine (not hematuria), CARDIOTOXICITY, myelosuppression, stomatitis
Doxorubicin = rubi red urine
"RU on SMAC?"
90
What diseases are treated with Bleomycin?
Testes and cervical cancer; Hodgkin’s disease; non-Hodgkin’s lymphoma
the B in bleomycin looks like two testicles on its side.. the C is for Cervical
91
What toxicities are associated with Bleomycin?
PULMONARY FIBROSIS: Avoid High FiO2
Allergic reactions, fever, hypotension, skin toxicity, musocitis, alopecia
92
What diseases are treated with Mitomycin?
Stomach, anal, and lung cancer…Superficial bladder cancer, gastric cancer, breast cancer, non-small cell lung cancer, head and neck cancer (in combination with radiotherapy)
Mighty MYCIN is SMAL but will punch you in the gut (GI) and the BREAST (rest) won't BLADDER (matter)
93
What are the categories of Miscellaneous Agents?
Protein Tyrosine
Monoclonal Antibiotics for Hematopoietic/Solid Tumors
Miscellaneous Agents = AM to PM
94
What toxicities are associated with Imatinib?
Fluid retention with ankle and periorbital edema, myalgias, CHF
95
What diseases are treated with Mitomycin?
Stomach, anal, and lung cancer…Superficial bladder cancer, gastric cancer, breast cancer, non-small cell lung cancer, head and neck cancer (in combination with radiotherapy)
Main use is squamous cell anal CA in combo with5-FU
Mighty MYCIN is SMAL but will punch you in the gut (GI) and the BREAST (rest) won't BLADDER (matter)
96
What drugs are Monoclonal Antibodies?
Cetuximab
Gefitibib
Erlotinib
Trastuzumab
MONO GETs you siCk
Monoclonal antibodies inhibit EGFR
97
What are the categories of Hormonal Agents?
Adrenocortico-steroids (Glucocorticoids)
| Anti-estrogens
98
What toxicities are associated with Cetuximab?
Infusion related skin rash, hypomagnesemia, fatigue, interstitial lung disease.
SKINny HYPOs Feel sob
99
What toxicities are associated with Imatinib?
Fluid retention with ankle and periorbital edema, myalgias, CHF
100
What diseases are treated with Prednisone?
ALL, CLL, Hodgkin, Non-Hodgkin, Breast, Multi-My
101
What drugs are Anti-estrogens?
Tamoxifen
102
Which anti-cancer drugs cause hypotension?
Paclitaxil, Bleomycin, Etoposide, L-ASparagine
PACman's Blood pressure is low when he BLEEds on the TOP-SIDE of his ASs.
a PEBbLe broke my skin and i bled to death
103
What is the MOA of Carboplatin/Oxaliplatin ?
Same as Cisplatin.
Forms intra- and inter-strand DNA cross-links; binding to nuclear and cytoplasmic proteins
104
What diseases are treated with Tamoxifen?
Breast Cancer
Tamoxifen for Tits
105
What diseases are treated with Carboplatin?
NSCLC, SCLC, Breast, Bladder, Head and Neck, and Ovarian Cancer
C's in the lungs
106
What diseases are treated with Oxaliplatin?
Colorectal, GI, and Pancreatic Ca
O stands for butt hOle
107
What is special about Streptozocin and toxicity?
It has minimal bone marrow toxicity
STREPTO is good for the BONEs, ya know!
108
What are toxicities of Carboplatin?
Renal toxicity, hepatic dysfunction, PN
109
What are toxicities of Oxalplatin?
Laryngopharyngeal dysesthesias, PN
Oxalplatin has two L's for Laryngo
rotate the p to become a D for dysesthesias
p for PN
110
What is the cell cycle specificity of Daunorubicin/Idarubicin?
anti-tumor antibiotic, specifically an Anthracycline which is a natural product. Natural products are CCNS.
111
What is the MOA of Daunorubicin/Idarubicin?
Oxygen free radicals bind to DNA causing single- and double-strand DNA breaks; Inhibits topoisomerase II; intercalates into DNA
112
What diseases are treated with Daunorubicin?
AML, ALL
113
What diseases are treated with Idarubicin?
AML, ALL, CML in blast crisis
114
What are toxicities of Daunorubicin?
Fever, Red Urine (not hematuria), cardiotoxicity
115
What are toxicities of Idarubicin?
Cardiotoxicity; less cardiotoxic than the other anthracyclines
116
What is the cell cycle specificity of Vinblastine/Vinorelbine?
Vinblastine is a Vinca Alkaloid which are CCS - M phase
117
What diseases are treated with Vinblastine?
Hodgkins, Non-Hodgkins, Germ Cell Cancer, Breast and Kaposi's Sarcoma
118
What diseases are treated with Vinorelbine?
NSCLC, breast and ovarian
119
What are toxicities of Vinblastine?
SIADH, vascular events
120
What are toxicities of Vinorelbine?
SIADH, Constipation (ileus)
121
What is the MOA of Vinblastine/Vinorelbine?
Inhibits Mitosis. Act on mitotic process by interfering with microtubule assembly or disassembly. In the absence of the mitotic spindle, chromosomes that have duplicated cannot align along the division plate.
Microtubules are also found in the brain and function in axonal transfer; therefore these agents have side effects like neurotoxicity...specifically Vincristine
122
What is the cell cycle specificity of Teniposide?
S and G2 phase
2G's on the South SIDE
123
What is the MOA of L-Asparaginase?
An enzyme that when given resulted in decreased access to asparagine (necessary for cell growth, produced by normal cells but not cancer cells) resulting in death of the cancer cell. It does so by hydrolyzing circulating L-asparagine to aspartic acid and ammonia.Tumor cells depend on circulating L-asparagine.
124
What diseases are treated with L-Asparaginase?
ALL
125
What are toxicities of L-Asparaginase?
Hypersensitivity, fever, chills, urticaria...Severe: Bronchospasm, Resp Failure and Hypotension
126
What is the MOA of Dasatinib?
Oral inhibitor of several tyrosine kinases: Bcr-Abl, Src, c-kit, and PDGFR-alpha.
Differs from Imatinib by binding to active and inactive conformations of All kinase domains and overcomes imatinib resistance resulting in mutations in the Bcr-Abl kinase.
127
What diseases are treated with Dasatinib?
CML and Philadelphia chromosome-positive ALL with resistance to Imatinib
SAT IN Cakes and Pies
128
What is the MOA of Nilotinib?
Second-Generation phenyl amino-pyrimidine molecule that inhibits Bcr-Abl, c-kit, and PDGFR-beta tyrosine kinase. Has higher binding affinity for All kinase when compared to Imatinib. Overcomes imatinib resistance resulting from Bcr-Abl mutations.
Nilotinib is number one and number two
129
What diseases is Nilotinib used for?
CML with resistance to imatinib. Recently approved for first line treatment of CML.
Number 1 to Crush Myeloid Leukemia
130
What is the MOA of Erlotinib?
Inhibits EGFR tyrosine kinase leading to inhibition of EGFR signaling.
E EGFR
131
What cautions should be taken with Erlotinib?
Metabolized in liver by CYP3A4; caution taking other agents using same enzyme (phenytoin and warfarin and grapefruit juice).
livER
132
What are toxicities of Erlotinib?
Acne, anorexia and Interstitial Lung Disease.
EaRL went to AA
133
What is Trastuzumab?
HER2/neu Inhibitor
Monoclonal antibody that binds to external domain of HER2/neu
HER2-positive Breast Ca...high rate of recurrence and poor survival rate.
TUZ = 2
134
What are Angiogenesis Inhibitors?
Bevacizumab
Sunitinib
Sorafenib
BASS genesis
135
What diseases are treated with Erlotinib?
NSCLC, pancreatic Ca
PEN
136
What is the MOA of Bevacizumab?
Inhibits binding of VEGF-A to VEGFR leading to inhibition of VEGF signaling; inhibits tumor vascular permeability; enhances tumor blood flow and drug delivery.
BE"V" = "V"EGF
137
What diseases are treated with Bevacizumab?
Colorectal, Breast, NSCLC, RENAL CELL, Glioblastoma multiformae
138
What are toxicities of Bevacizumab?
Hypertension, arterial thromboembolic events, GI perforations, wound healing complications, bleeding proteinuria...VASCULAR TOXICITY
V for VASCULAR
139
What is the MOA of Sorefenib?
Inhibits multiple RTK's, including raf kinase, VEGF-R2, VEGF-R3 and PDGFR-beta leading to inhibition of angiogenesis, invasion, and metastasis
2 SORE V's
140
What diseases are treated with Sorefenib?
Renal cell and HEPATOCELLULAR CARCINOMA
141
What are toxicities of Sorefenib?
Hypertension, fatigue and asthenia, bleeding, hypophosphatemia...VASCULAR TOXICITY
142
What is the MOA of Sunitinib?
Inhibits multiple RTKs, including VEGF-R1, VEGF-R2, VEGF-R3, PDGFR-alpha and PDGFR-beta leading to inhibition of angiogenesis, invasion, and metastasis
need the SUN for three VEGgies
143
What diseases are treated with Sunitinib?
METASTATIC RENAL CANCER, GIST
tini bit of MSG
144
What are toxicities of Sunitinib?
Hypertension, bleeding, CARDIOTOXICITY leading to CHF...VASCULAR TOXICITY
SUN works on the VEGgies (veins)
146
What drugs are Cytidine Analogues?
Gemcitabine
analoGues
147
What is the cell cycle specificity of L-asparaginase?
CCS - G1 phase.
G1 phase is the phase of enzyme synthesis. L-asparaginase is an enzyme, so makes sense it would work on G1.
L-asparaGinase = only 1 "G"phase
151
What is the most frequent adverse effect associated with chemotherapy?
Myelosuppression
