Miscellaneous Agents Flashcards
What is the MOA of Bleomycin?
Inhibits DNA synthesis by creating single- & double-strand breaks
-free radical production after binding to metal (Fe, Cu)
What is the unique toxicity of Bleomycin?
Pulmonary fibrosis, pneumonitis
Idiosyncratic reactions (test dose sometimes required)
-NO myelosuppression
What should be checked before starting Bleomycin?
-PFT monitoring
-Cumulative lifetime exposure tracking (highest risk after 400 units)
What is the MOA for Procarbazine?
Monoamine Oxidase Inhibitor (MAO-I)
(Alkylating agent (secondary leukemia more often than in other alkylating agents))
What should patients on Procarbazine be counseled on?
reduce high tyramine-containing food and drink (old meat, old cheese, old red wine)
CAUTION: Serotonin syndrome
Dacarbazine (DTIC) and Temozolomide (Temodar) are what type of drugs?
Alkylators
-both Pro-drugs
-both activated into MTIC
Dacarbazine via p450, Temozolomide via serum hydrolysis
What is the side effect of Dacarbazine (DTIC)?
Highly emetogenic (vomiting)
What is the side effect of Temozolomide?
Lymphopenia with long-term use (6 weeks)
need PCP prophylaxis (Bactrim)
What is the MOA of Hydroxyurea?
Antimetabolite
inhibits ribonucleotide diphosphate reductase
-blocks conversion of ribonucleotides → deoxyribonucleotides
What is the indication of Hydroxyurea?
to reduce WBC in leukemia patients
also used in: sickle cell disease
Which alkylating agent binds to the minor groove of the DNA?
Trabectedin
What are the side effects of Trabectedin?
Hepatoxicity !!
Rhabdomyolysis
What is the MOA of Mitomycin C?
Creates guanine-cytosine crosslinks
What are the side effects of Mitomycin C?
-Vesicant (can cause tissue damage when leaked)
-HUS: hemolytic uremic syndrome
-TTP: thrombotic thrombocytopenia purpura
Hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are also seen with which drug?
Gemcitabine
