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Step 1 Pharm > Oncology > Flashcards

Oncology Flashcards

1
Q

Interferes with S phase (2)

A

Antimetabolites

Etoposide

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2
Q

Interferes with G2 phase (2)

A

Bleomycin

Etoposide

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3
Q

Interferes with M phase (2)

A

Vinca alkaloids

Taxols

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4
Q

Folic acid analog

Inhibits dihydrofolate reductase

Reduces dTMP, DNA and protein synthesis

Leukemia, lymphoma, choriocarcinoma, sarcomas

Abortion, ectopic pregancy, rheumatoid arthritis, psoriasis

Myelosuppression, macrovesicular fatty change in liver, mucositis, teratogen

A

Methotrexate

Myelosuppression reversible with leucovorin

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5
Q

Pyrimidine analog

Metabolite 5F-dUMP complexes to folic acid

Inhibits thymidylate synthase

Decreases dTMP, DNA, protein synthesis

Colon cancer, basal cell carcinoma (topical)

Myelosuppression, photosensitivity

A

5-Fluorouracil (5-FU)

Myelosuppression reversed by thymidine

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6
Q

Pyrimidine analog

Inhibits DNA Pol

Leukemias, lymphomas

SE: leukopenia, thrombocytopenia, megaloblastic anemia

A

Cytarabine

(arabinofuranosyl cytidine)

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7
Q

Purine analogs (3)

Decreases purine synth

Activated by HGPRT

Leukemias

SE: bone marrow, GI, liver

Metabolized by xanthine oxidase

(What increases toxicity?)

A

Azathioprine

6-mercaptopurine (6-MP)

6-thioguanine (6-TG)

Allopurinol increases toxicity

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8
Q

Intercalates in DNA

Wilm’s tumor, Ewing’s sarcoma, rhabdomyosarcoma, childhood tumors

SE: myelosuppression

A

Dactinomycin

(actinomycin D)

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9
Q

Noncovalent interacalation in DNA

Causes breaks in DNA

Generates free radicals

Solid tumors, leukemias, lymphomas

SE: cardiotoxicity (dilated cardiomyopathy), myelosuppression, alopecia, toxic to tissues after extravasation

(What prevents cardiotoxicity?)

A

Doxorubicin

(Adriamycin)

Daunorubicin

Dexrazoxane prevents cardiotoxicity

(iron chelating agent)

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10
Q

Induces free radical formation

Which causes breaks in DNA

Testicular cancer, Hodgkin’s lymphoma

Pulmonary fibrosis, skin changes

Minimal myelosuppression

A

Bleomycin

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11
Q

Covalent interstrand crosslinks with DNA

at guanine N-7

Alkylating agent- requires bioactivation

Solid tumors, leukemia, lymphoma, some brain cancers

Myelosuppression, hemorrhagic cystitis

(How to treat hemorrhagic cystitis?)

A

Cyclophosphamide, ifosfamide

Mesna

(binds toxic metabolites)

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12
Q

Alkylating agent- requires bioactivation

Cross BBB

Brain tumors (inc. GBM)

CNS toxicity (dizziness, ataxia)

A

Nitrosoureas

Carmustine, lomustine, semustine, streptozocin

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13
Q

Alkylates DNA

CML, bone marrow ablation before transplant

SE: pulmonary fibrosis, hyperpigmentation

A

Busulfan

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14
Q

Bind tubulin in M phase

Block polymerization, mitotic spindles

Solid tumors, leukemias, lymphomas

(1) areflexia, peripheral neuritis, paralytic ileus
(1) bone marrow suppression

A

Vincristine

(areflexia, peripheral neuritis, paralytic ileus)

Vinblastine

(bone marrow suppression)

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15
Q

Stabilizes polymerized tubules in M phase

No mitotic spindle breakdown

Ovarian, breast carcinomas

Myelosuppression, hypersensitivity

A

Paclitaxel

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16
Q

Cross-links DNA

Testicular, bladder, ovary, lung carcinoma

Nephrotoxic, acoustic nerve damage

(How to prevent nephrotoxicity?)

A

Cisplatin, carboplatin

Amifostine, chloride diuresis

(Prevents nephrotoxicity)

17
Q

Inhibits topoisomerase II

DNA degradation ensues

Solid tumors, leukemias, lymphomas

Myelosuppression, GI irritation, alopecia

A

Etoposide, teniposide

18
Q

Inhibits ribonucleotide reductase

Decreases DNA synthesis (S phase)

Melanoma, CML, sickle cell disease (increase HbF)

Bone marrow suppression, GI upset

A

Hydroxyurea

19
Q

Glucocorticoid

May trigger apoptosis

CLL, non-Hodgkin’s lymphoma, immunosuppressant

SE: Cushing’s, immunosuppression, catraracts, acne, osteoporosis, hypertension, peptic ulcers, hyperglycemia, psychosis

A

Prednisone, prednisolone

20
Q

Blocks estrogen binding to receptor-positive cells

Antagonist in breast, agonist in bone

Breast cancer treatment/prevention,

osteoporosis prevention

(2) Which increases risk of endometrial cancer?

A

Tamoxifen, raloxifene

Tamoxifen increases risk of endometrial cancer, can give hot flashes

Raloxifene is endometrial antagonist

21
Q

Monoclonal antibody against HER2

(a tyrosine kinase)

HER-2 positive breast cancer

SE: cardiotoxicity

A

Trastuzumab

(Herceptin)

22
Q

bcr-abl tyrosine kinase inhibitor

(Philadelphia chromosome)

CML, GI stromal tumors

SE: fluid retention

A

Imatinib

(Gleevec)

23
Q

Monoclonal antibody to CD20

Non-Hodgkin’s lymphoma, rheumatoid arthritis

A

Rituximab

(w/ methotrexate for RA)

24
Q

Inhibits B-Raf kinase w/V600E mutation

Metastatic melanoma

A

Vemurafenib

25
Q

Monoclonal antibody to VEGF

(inhibits angiogenesis)

Solid tumors

A

Bevacizumab

26
Q

Acoustic nerve damage

A

Cisplatin, carboplatin

27
Q

Peripheral neuropathy

A

Vincristine

28
Q

Pulmonary fibrosis (2)

A

Bleomycin, busulfan

29
Q

Cardiotoxicity (2)

A

Doxorubicin

Trastuzumab

30
Q

Nephrotoxicity

A

Cisplatin, carboplatin

31
Q

Hemorrhagic cystitis

A

Cyclophosphamide

32
Q

Myelosuppression

(3 antimetabolites)

A

5-FU

6-MP

Methotrexate

33
Q
A

Step 1 Pharm (19 decks)

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