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IPT: Hem/Onc/Transplant > More More Block 1 > Flashcards

More More Block 1 Flashcards

1
Q

Process of formation and development of new blood cells that begins with hematopoietic stem cells and requires an adequate supply of minerals (e.g., iron) and vitamins

Erythropoiesis
Hematopoiesis

A

Hematopoiesis

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2
Q

Process which produces new red blood cells that is controlled by a feedback system involving the kidneys and bone marrow

Erythropoiesis
Hematopoiesis

A

Erythropoiesis

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3
Q

What is a hemoglobin?

A

Protein in RBC that carry oxygen and made up of 4 globulin hains and an associated heme group

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4
Q

Which is absorbed better, heme or non heme iron?

A

Heme iron by 3x

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5
Q

Which one is affected by food via absorption, heme or non heme iron?

A

Non heme iron

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6
Q

How is excess iron excreted in the body

A

No physiologic mechanism other than blood loss

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7
Q

AE of iron?

A

Heartburn, nausea, UPPER ab pain, diarrhea + constipation

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8
Q

How much ferrous salt is considered toxic?

A

1-2g is capable of death, esp in young children

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9
Q

Bioavailability of iron in fasting patients?

A

With food, it is about 1/3-1/2

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10
Q

Newest non-salt iron replacement drug name? Benefits?

A

Ferric maltol (Accrufer)

Option for pt intolerant of iron salts + prevents IV iron therapy

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11
Q

Which parenteral iron therapy has BBW of anaphylaxis?

A

Iron dextran

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12
Q

Erythropoietin receptors are a member of which family of proteins? How do they exist?

A

Cytokine receptor family as dimers at the cell membrane

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13
Q

In EPO therapy, what can develop? (AE)

A

Iron deficiency, may stimulate some types of tumor cells

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14
Q

Epoetin alfa vs darbepoetin alfa, plasma half life?

A

Epoetin alfa = 4-8hrs

Aranesp = 21 hrs

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15
Q

Epoetin alfa vs darbepoetin alfa, which one is nearly identical to endogenous hormone?

A

Epoetin alfa, it is a recombinant human EPO

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16
Q

How is darbepoetin alfa modified?

A

4 AA mutations for additional carb side chains, it prolongs the circulatory survival of drug

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17
Q

What is chelate?

A

Chemical complex of metal ion and a multidentate ligand

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18
Q

Iron overload can cause damage to what? What is an example of an chelator?

A

Many organs such as liver and heart

DFO (Deferoxamine) a hexadentate iron chelator

DFP (Deferiprone) BIDENTATE chelator

DFX (Deferasirox) TRIDENTATE chelator

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19
Q

Deferoxamine half life and dosing?

A

Half life = 20-30min

IV or SQ over 8-12 hrs, 5-7 days/week

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20
Q

Deferoxamine AE?

A

Growth retardation, bone abnormalities, ophthalmological and auditory disorders

Negative impact on life, compliance is an issue

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21
Q

Deferiprone half life and dosing?

A

Half life = 3-4hrs

Oral dosing (TID)

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22
Q

Deferiprone AE?

A

Agranulocytosis

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23
Q

Deferasirox half life and dosing?

A

Half life = 8-16hrs

Oral dosing (QD)

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24
Q

Deferasirox admin issues?

A

Poorly soluble in water, so mixed as suspension in fruit juice

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25
Vincristine Vinblastine Vinorelbine Which one causes myelosuppression?
Vinblastine | Vinorelbine
26
Vincristine Vinblastine Vinorelbine Which one causes peripheral neuropathy?
Vincristine
27
Paclitaxel Docetaxel Cabazitaxel Which one causes hypersensitivity?
All of them, Pacilitaxel and Cabazitaxel are pretreated w/ H1 and 2 antagonist and glucocorticoid Docetaxel should be pretreated with dexamethasone only
28
Paclitaxel Docetaxel Cabazitaxel Which one causes progressive fluid retention ?
Docetaxel
29
Mercaptopurine MOA and AE
ATase inhibitor, blocks synthesis of AMP and GMP Poor TPMT metabolizers are at risk for myelosuppression
30
5-FU Capecitabine Cytarabine Gemcitabine Which ones belong to a class of pyrimidine antimetabolites?
5-FU | Capecitabine
31
5-FU Capecitabine Cytarabine Gemcitabine Which ones are DNA polymerase inhibitors?
Cytarabine | Gemcitabine
32
5-FU Capecitabine Cytarabine Gemcitabine Which ones are thymidylate synthase inhibitors?
5-FU | Capecitabine
33
5-FU Capecitabine Cytarabine Gemcitabine Which ones belong to a class of cytidine antimetabolites?
Cytarabine | Gemcitabine
34
5-FU Capecitabine Cytarabine Gemcitabine Which ones have AE of toxicity due to DPD deficiency?
5-FU | Capecitabine
35
5-FU Capecitabine Cytarabine Gemcitabine Which ones have AE of hand-foot syndrome?
Capecitabine
36
5-FU Capecitabine Cytarabine Gemcitabine Which ones should not be used with radiotherapy unless in closely monitored clinical trials?
Gemcitabine
37
Irinotecan Etoposide Doxorubicin Mitoxantrone Which one binds to topoisomerase II?
Etoposide Doxorubicin Mitoxantrone
38
Irinotecan Etoposide Doxorubicin Mitoxantrone Which ones are considered the anthracycline topoisomerase inhibitors?
Doxorubicin | Mitoxantrone
39
Irinotecan Etoposide Doxorubicin Mitoxantrone Which ones are camptothecin topoisomerase inhibitors?
Irinotecan
40
Irinotecan Etoposide Doxorubicin Mitoxantrone Which ones causes blue-green feces and urine?
Mitoxantrone
41
Irinotecan Etoposide Doxorubicin Mitoxantrone Which ones will cause AML after 2 years of therapy (in 2-12% of children)
Etoposide
42
Irinotecan Etoposide Doxorubicin Mitoxantrone Which ones uses dexrazoxane as a protective agent?
Doxorubicin
43
Irinotecan Etoposide Doxorubicin Mitoxantrone Which ones are epipodophyllotoxin topoisomerase inhibitors?
Etoposide
44
Which target in anticancer immunotherapy was the first target?
IL-2
45
MOA of IL-2?
Stimulates T cells and NK cells to attack cancer cells
46
- ximab - momab - mumab - zumab Chimeric Human Humanized Mouse
Mouse - momab Humanized - zumab Chimeric - ximab Human - mumab
47
How does targeting PD-1 achieve anticancer effects?
Elevates production of autocrine paracrine cytokines Enhances production of CD8 cells and cytotoxicity
48
Therapeutic cancer vaccine pearl?
Does not prevent cancer occurence
49
T-VEC pearls?
Injected directly into melanoma tumors and attacks cells regardless of cancer genotype Tumor needs to be large enough to be accurately located
50
Cisplatin Carboplatin Oxaliplatin Which one is treated with amifostine?
Cisplatin; for kidney toxicity
51
``` Cyclophosphamide Ifosfamide Carmustine Lomustine Dacarbazine Temozolomide ``` Which one causes women to clear less and has a higher chance of neutropenia and thrombocytopenia?
Temozolomide
52
``` Cyclophosphamide Ifosfamide Carmustine Lomustine Dacarbazine Temozolomide ``` Which one alkylates O6 of guanine?
Carmustine | Lomustine
53
``` Cyclophosphamide Ifosfamide Carmustine Lomustine Dacarbazine Temozolomide ``` Which one alkylates N7 of guanine?
Cyclophosphamide | Ifosfamide
54
``` Cyclophosphamide Ifosfamide Carmustine Lomustine Dacarbazine Temozolomide ``` Which one causes CNS toxicity cause it can easily cross BBB?
Carmustine | Lomustine
55
``` Cyclophosphamide Ifosfamide Carmustine Lomustine Dacarbazine Temozolomide ``` Which one is considered the most neurotoxic DNA alkylating agent?
Ifosfamide
56
``` Cyclophosphamide Ifosfamide Carmustine Lomustine Dacarbazine Temozolomide ``` Which one methylates O6 of guanine?
Dacarbazine | Temozolomide
57
``` Cyclophosphamide Ifosfamide Carmustine Lomustine Dacarbazine Temozolomide ``` Which one causes kidney and bladder toxicity?
Cyclophosphamide Ifosfamide Mesna is used to prevent the bladder toxicity
58
Which kinase inhibitors inhibit MEK?
traMEtinib (Mekinist) cobiMEtinib (Cotellic)
59
What disease do the MEK inhibitors target?
V600E melanoma BRAF drugs do this too
60
What drugs are used in combo with the MEK inhibitors?
traMEtinib (Mekinist) + dabrafenib (BRAF drug) cobiMEtinib (Cotellic) + vemurafenib (BRAF drug)
61
What are the mTOR inhibitors?
Temsirolimus + Everolimus
62
mTOR inhibitor AE?
Increased infection % and delayed wound healing
63
Thalidomide, pomalidomide, and lenalidomide AE?
Birth defects and thromboembolism Only lenalidomide has myelosuppression
64
Cobimetinib vs Trametinib, which one is taken on an empty stomach?
Trametinib
65
Cobimetinib vs Trametinib Hepatotoxicity
Cobimetinib
66
Cobimetinib vs Trametinib Vascular disorders
Trametinib
67
Cobimetinib vs Trametinib Rhabdomyolysis
Cobimetinib
68
What is the only HER2 drug?
Lapatinib (tykERb) Liver issues Diarrhea, acneiform rash Take on an empty stomach
69
What are the EML4-ALK drugs?
crizotinib (xALKori) + ALectinib (ALecensa)
70
What disease do the EML4-ALK target?
NSCLC
71
EML4-ALK AE?
Lung disease + QT prolongation Only crizotinib (xALKori) has an addition of liver toxicity
72
Which Rx target EGFR?
ERlotinib + osimERtinib
73
What disease do EGFR drugs target?
NSCLC w/ EGFR mutation
74
ERlotinib vs osimERtinib, which one must be taken on an empty stomach?
ERlotinib
75
ERlotinib vs osimERtinib, which one is effective against T790M gatekeeper mutant?
osimERtinib
76
EGFR AE?
Both have interstitial lung disease ERlotinib = diarrhea, acneiform rash osimERtinib = QT-prolongation
77
What are the CDK4/CDK6 drugs?
palboCICLib, riboCICLib, abemaCICLib
78
What disease do the CDK4/CDK6 drugs cover?
HR+, HER2- breast cancer
79
CDK4/CDK6 drugs AE?
All = neutropenia riboCICLib = QT prolongation, liver toxicity abemaCICLib = diarrhea
80
Which drug targets BTK (Brutons tyrosine kinase)?
iBRUtinib
81
BTK AE?
Myelosuppression, anemia
82
BTK disease target?
B cell lymphoma and leukemia
83
What do the BRAF drugs target?
V600E melanoma MEK drugs target this too
84
What are the drugs that target 26S proteasome?
"...zomib" bortezomib and ixazomib
85
bortezomib and ixazomib, which one is the prodrug?
Ixazomib, dosed as PO Bortezomib is dosed as IV
86
bortezomib and ixazomib, which one has boronic acid functional group?
Bof
87
Which rx is effective against T315l mutant?
Ponatinib
88
What are the PARP drugs used for?
BRCA-mutated breast or ovarian cancer
89
PARP drug AE?
MDS or AML
90
What are the drugs that target Pl3K-delta?
iDELalisib
91
What disease does Pl3K-delta cover?
CLL and NHL
92
Pl3K-delta drug AE?
Liver toxicity, pneumonitis, GI issues
93
What drug targets FLT3?
Midostaurin
94
What drug targets HDAC?
Panobinostat

IPT: Hem/Onc/Transplant (7 decks)

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