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Heme/Onc > Onc Pharm > Flashcards

Onc Pharm Flashcards

1
Q

Cisplatin

A 
Alkylating Agent (all stages)
- cross links DNA

Acute: Nausea, Nephrotoxicity, Ototoxicity, EMETOGENIC

Delayed: IRREVERSIBLE NEUROTOXICITY

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2
Q

Carboplatin

A 
Alkylating Agent (all stages)
- cross links DNA

Acute: Nausea, Vomiting, Ototoxicity, Nephrotoxicity

Delayed: Myelosuppression

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3
Q

Oxaliplatin

A

Alkylating Agent (all stages)

Acute: Family, Toxicities

Delayed: Reversible Neurotoxicity

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4
Q

Busulfan

A

Alkylating Agent (all stages)

Acute: Nausea, Vomiting

Delayed: Pulmonary Fibrosis*, Myelosuppression

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5
Q

Cyclophosphamide

A

Alkylating Agent (all stages)

Acute: Nausea, Vomiting

Delayed: Hemorrhagic Cystitis*, Myelosuppression

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6
Q

Carmustine

A 
Alkylating Agent (all stages)
(can cross BBB)

Acute: Nausea, Vomiting

Delayed: Myelosuppression, CNS Toxicity

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7
Q

Procarbazine

A

Alkylating Agent (all stages)

Acute: Nausea, Vomiting

Delayed: Myelosuppression,
RISK OF SECONDARY MALIGNANCY
Adverse drug interactions with anti-depressants (b/c metabolites act as MAOinhibitors)

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8
Q

Antimetabolites

Cell Cycle Specificity
Mechanism

A

S-Phase Specific

Interferes with DNA synthesis

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9
Q

6-Mercaptopurine

A

Anti-Metabolite (S-Phase)

Purine Analog, Inhibits enzymes of purine synthesis

Myelosuppression*. Diarrhea
Thiopurine Methyl Transferase (TPMT) deficiency can result in severe toxicities

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10
Q

Cladribine

A

Anti-Metabolite (S-Phase)

Purine Analog, Inhibits enzymes of purine synthesis

Myelosuppression, Immunosuppression (CD4, CD8)

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11
Q

Cytarabine (Ara-C)

A

Anti-Metabolite (S-Phase)

Pyrimidine Analog (Hematologic Malignancies Only)
Inhibits DNA Polymerase*

Acute: GI
Chronic: Myelosuppression (panCYtopenia)
NOTE: Ara-CTP is a major cytotoxic metabolite

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12
Q

5-Fluorouracil (5-FU)

A

Anti-Metabolite (S-Phase)

Pyrimidine Analog
FdUMP inhibits TS
FdUTP inhibits DNA synthesis
FUTP inhibits RNA processing

Catabolized by Dihydropyridine Dehydrogenase (DPD)
If DPD low in liver, TOXICITY is LIFE THREATENING

Myelosuppression, Neutotoxicity
Derm -> Hand-Foot Syndrome w/ continuous infusion

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13
Q

Capecitabine

A

Anti-Metabolite (S-Phase)

Pro/Pro Drug
Metabolites converted to 5-FU in liver

Consider DPD levels

Myelosuppression, Neutotoxicity
Derm -> Hand-Foot Syndrome w/ continuous infusion

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14
Q

Methotrexate

A

Anti-Metabolite (S-Phase)

Folic Acid Analog, Competitively inhibits DHFR and TS

Myelosuppression*
rescued by Leucovorin*

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15
Q

Pemetrexid

A

Anti-Metabolite (S-Phase)

Folic Acid Analog, Inhibits TS

Myelosuppression, Skin Rashes, Mucositis, Diarrhea, Fatigue

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16
Q

Gemcitabine

A

Anti-Metabolite (S-Phase)

Pyrimidine Analog
Inhibits DNA Poly, Blocks DNA/RNA repair, Chain Termination

Neutropenia, Hemolytic Uremic Syndrome (HUS)*

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17
Q

Vinca Alkaloids

Mechanism, Phase

A

Inhibits microtubule polymerization by binding to beta-tubulin (preventing spindle formation)

Mitotic Phase Arrest (M Phase)

18
Q

Vinblastine

A

Vinca Alkaloid (M-Phase)

Inhibits microtubule polymerization by binding to beta-tubulin (preventing spindle formation)

Potent Vesicant (blistering agent)*
Alopecia
Myelosuppression, Nausea, Vomiting

Solid Tumors, Leukemias
Hodgkin Lymphoma

19
Q

Vincristine

A

Vinca Alkaloid (M-Phase)

Inhibits microtubule polymerization by binding to beta-tubulin (preventing spindle formation)

Peripheral neuropathy*
Autonomic Defects* (ortho. hypotension, urinary retention)
SIADH*
Myelosuppresion

Solid Tumors, Leukemias
Non-Hodgkin Lymphoma

20
Q

Taxanes

Mechanism, Phase

A

Enhances microtubule polymerization (cannot break down)

M Phase

21
Q

Paclitaxel

A

Taxane (M-Phase)

Enhances microtubule polymerization (cannot break down)

Hypersensitivity* (prevented with meds that dilute drug)
Peripheral Sensory Neuropathy*
Nausea, Vomiting

22
Q

Abraxane

A

Taxane (M-Phase)

Enhances microtubule polymerization (cannot break down)

Paclitaxel formulated with albumin carrier - decreases toxicity
NO HYPERSENSITIVITY*

23
Q

Docetaxel

A

Taxane (M-Phase)

Enhances microtubule polymerization (cannot break down)

Hypersensitivity* (prevented with meds that dilute drug)
Peripheral Sensory Neuropathy*
Nausea, Vomiting

24
Q

Ixebepilone

A

Epothilone B Agent (M-Phase)

Binds tubulin and stabilizes microtubules

Myelosuppresion, Hypersensitivity, Neurotoxicity

Approved for Breast Cancer

25
Q

Etoposide

A

Epipodophylotoxin
Topoisomerase II Inhibitor (S-Phase)

Alopecia, Myelosuppresion, GI

26
Q

Topotecan

A

Camptothecan
Topoisomerase I Inhibitor (S-Phase)

APPROVED FOR SCLC*

Alopecia, Myelosuppresion, GI

27
Q

Irinotecan

A

Camptothecan
Topoisomerase I Inhibitor (S-Phase)

Pro-drug converted in the liver

DIARRHEA (late can be severe)

28
Q

Anthracycline
(Anti-Tumor Antibiotic)

Mechanism, Toxicity

A 
Inhibit Topoisomerase II
DNA intercalation (blocks RNA and DNA) -> Breaks DNA
Binds to Cell Membranes
Generates Semi-Quinone Free Radicals**
(CARDIOTOXICITY)
29
Q

Doxorubicin

Adriomycin

A

Anthracycline
(Anti-Tumor Antibiotic)

Used in combination therapy (ABVD for HL)
IV Admin

CARDIOTOXICITY* (generates free radicals that intercalate with DNA, break DNA)
toxicity reduced with dexrazoxone (iron chelating)
Myelosuppression, GI

30
Q

Daunorubicin

A

Anthracycline

Anti-Tumor Antibiotic

31
Q

Idarubicin

A

Anthracycline

Anti-Tumor Antibiotic

32
Q

Mitocantrone

A

Anthracycline
(Anti-Tumor Antibiotic)

BLUE SCLERA and FINGERNAILS**
Myelosuppression, GI, Alopecia

33
Q

Mitomycin C

A

Antibiotic
Activated by reduction

All Phases

Acts on tumor cells in Hypoxic Environment*

Hemolytic Uremic Syndrome**
GI

34
Q

Bleomycin

A

Antibiotic
Binds DNA - DS, SS Breaks
G2 Specific

Pulmonary Fibrosis

35
Q

Retinoic Acid (ATRA)

A

Acute Promyelocytic Leukemia
t(15;17) PML-RARa
(AML, M3)

Treatment leads to cell differentiation and death

Leukocytosis
Capillary Leak Syndrome (pulm edema ,resp failure)
Renal Failure

36
Q

Arsenic

A

Acute Promyelocytic Leukemia
t(15;17) PML-RARa
(AML, M3)

37
Q

Imatinib

A

Tyrosine Kinase Inhibitor
“Gleevec”
BCR-ABL t(9;22) CML

Binds to catalytic cleft in ABL (tyrosine kinas)

Resistance from mutations that abrogate binding of drug

38
Q

Dasatinib

A

Newer Tyrosine Kinase Inhibitor

Specifically to overcome imatinib resistance

39
Q

Trastuzumab

A

“Herceptin”

HER2 (Human Epidermal Growth Factor Receptor 2)

Tras2zumab = Her2
HeartCeptin = cardiotoxicity
40
Q

Trastuzumab DM1

A

Toxin-Conjugated Trastuzumab

Thrombocytopenia, Elevated Transaminases

41
Q

Lapatinib

A

HER1, HER2 Competitive Inhibitor

Rash, Diarrhea

Heme/Onc (1 decks)

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