Oncology Flashcards
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Methotrexate (MTX)
1) CA: leukemia, lymphoma, choriocarcinoma, sarcoma; non-CA: abortion, ectopic preg, rheumatoid arthritis, psoriasis
2) folate analog: inhibits DHFR –> decr dTMP –> decr DNA + protein syn
3) myelosuppression (reverse w/ leucovorin); macrovesicular fatty liver change; mucositis; teratogenic
4) S-phase specific
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
5-fluorouracil (5-FU)
1) colon CA, basal cell carcinoma (topical)
2) pyrimidine analog bioactivated to 5F-dUMP (covalently complexes folate) –> complex inhibits thymidylate synthase –> decr dTMP –> decr DNA + protein syn
3) myelosuppression (not reversible w/ leucovorin); OD rescue w/ thymidine; photosensitivity
4) S-phase specific
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Cytarabine (arabinofuranosyl cytidine)
1) leukemia, lymphoma
2) pyrimidine analog –> inhibit DNA polymerase
3) leukopenia, thrombocytopenia, megaloblastic anemia
4) S-phase specific
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Azathioprine
1) leukemias
2) purine (thiol) analog –> decr de novo purine syn
3) BM, GI, liver; metabolized by xanthine oxidase so incr toxicity w/ allopurinol
4) S-phase specific; activated by HGPRT
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
6-mercaptopurine (6-MP)
1) leukemias
2) purine (thiol) analog –> decr de novo purine syn
3) BM, GI, liver; metabolized by xanthine oxidase so incr toxicity w/ allopurinol
4) S-phase specific; activated by HGPRT
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
6-thioguanine (6-TG)
1) leukemias
2) purine (thiol) analog –> decr de novo purine syn
3) BM, GI, liver; metabolized by xanthine oxidase so incr toxicity w/ allopurinol
4) S-phase specific; activated by HGPRT
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Dactinomycin (actinomycin D)
1) Wilm’s tumor, Ewin’s sarcoma, rhabdomyosarcoma; peds tumors
2) intercalates in DNA
3) myelosuppression
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Doxorubicin (Adriamycin)
1) solid tumors, leukemias, lymphomas
2) makes ROS; non-covalently intercalate in DNA –> breaks DNA –> decr replication
3) cardiotoxicity* (dilated cardiomyopathy; use dexrazoxane, Fe chelator, to prevent), myelosuppression, alopecia; toxic to tissues following extravasation
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Daunorubicin
1) solid tumors, leukemias, lymphomas
2) makes ROS; non-covalently intercalate in DNA –> breaks DNA –> decr replication
3) cardiotoxicity* (dilated cardiomyopathy; use dexrazoxane, Fe chelator, to prevent), myelosuppression, alopecia; toxic to tissues following extravasation
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Bleomycin
1) testicular CA, Hodgkin’s lymphoma
2) ROS formation –> causes breaks in DNA strands
3) pulm fibrosis*, skin changes; minimal myelosuppression
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Cyclophosphamide
1) solid tumors, leukemia, lymphoma, some brain CAs
2) alkylating agent: covalently X-link DNA at guanine N-7
3) myelosuppression; hemorrhagic cystitis (partly prevent w/ mesna, thiol grp of mesna binds toxic metabolite)
4) need liver bioactivation
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Ifosfamide
1) solid tumors, leukemia, lymphoma, some brain CAs
2) alkylating agent: covalently X-link DNA at guanine N-7
3) myelosuppression; hemorrhagic cystitis (partly prevent w/ mesna, thiol grp of mesna binds toxic metabolite)
4) need liver bioactivation
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Carmustine
1) brain tumors (incl glioblastoma multiforme)
2) alkylating agent: nitrosourea
3) CNS toxicity: dizziness, ataxia
4) needs bioactivation; X’s BBB –> CNS
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Lomustine
1) brain tumors (incl glioblastoma multiforme)
2) alkylating agent: nitrosourea
3) CNS toxicity: dizziness, ataxia
4) needs bioactivation; X’s BBB –> CNS
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Semustine
1) brain tumors (incl glioblastoma multiforme)
2) alkylating agent: nitrosourea
3) CNS toxicity: dizziness, ataxia
4) needs bioactivation; X’s BBB –> CNS
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Streptozocin
1) brain tumors (incl glioblastoma multiforme)
2) alkylating agent: nitrosourea
3) CNS toxicity: dizziness, ataxia
4) needs bioactivation; X’s BBB –> CNS
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Busulfan
1) CML; also to ablate BM before BMT
2) alkylating agent
3) pulm fibrosis*; hyperpigmentation
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Vincristine
1) solid tumors, leukemias, lymphomas
2) microtubule inhibitor: alkaloid that binds to tubulin in M phase + blocks polymerization so mitotic spindle can’t form
3) neurotoxicity: areflexia, periph neuritis; paralytic ileus
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Vinblastine
1) solid tumors, leukemias, lymphomas
2) microtubule inhibitor: alkaloid that binds to tubulin in M phase + blocks polymerization so mitotic spindle can’t form
3) BM suppression (VinBLASTine BLASTS Bone Marrow)
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Paclitaxel
1) ovarian + breast carcinomas
2) microtubule inhibitor: hyperstabilizes polymerized microtubules in M phase so mitotic spindle can’t break down (blocks anaphase)
3) myelosuppression, hypersensitivity
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Cisplatin
1) testicular, bladder, ovary, lung carcinomas
2) X-links DNA
3) nephrotoxicity (prevent w/ amifostine, ROS scavenger), acoustic nerve damage, chloride diuresis
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Carboplatin
1) testicular, bladder, ovary, lung carcinomas
2) X-links DNA
3) nephrotoxicity (prevent w/ amifostine, ROS scavenger), acoustic nerve damage, chloride diuresis
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Etoposide
1) solid tumors, leukemias, lymphomas
2) topo II inhibitor –> incr DNA degradation
3) myelosuppression, GI irritation, alopecia
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Teniposide
1) solid tumors, leukemias, lymphomas
2) topo II inhibitor –> incr DNA degradation
3) myelosuppression, GI irritation, alopecia
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Hydroxyurea
1) melanoma, CML, sickle cell dz (incr HbF)
2) inhibits ribonucleotide reductase –> decr DNA syn (S-phase specific)
3) BM suppression, upset GI
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Prednisone
1) CA chemotx: CLL, non-Hodgkin’s lymphomas; immunosuppressant (autoimmune dz)
2) glucocorticoid; may trigger apoptosis; may work on non-dividing cells
3) Cushing-like sx’s; immunosuppression, cataracts, acne, osteoporosis, HTN, peptic ulcers, hyperglycemia, psychosis
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Prednisolone
1) CA chemotx: CLL, non-Hodgkin’s lymphomas; immunosuppressant (autoimmune dz)
2) glucocorticoid; may trigger apoptosis; may work on non-dividing cells
3) Cushing-like sx’s; immunosuppression, cataracts, acne, osteoporosis, HTN, peptic ulcers, hyperglycemia, psychosis
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Tamoxifen
1) breast CA tx + prophylaxis; prevent osteoporosis
2) SERM: R antagonist in breast + agonist in bone; block estrogen binding to ER+ cells
3) partial agonist in endometrium –> incr endometrial CA risk; “hot falshes”
4) compare toxicity to raloxifene
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Raloxifene
1) breast CA tx + prophylaxis; prevent osteoporosis
2) SERM: R antagonist in breast + agonist in bone; block estrogen binding to ER+ cells
3) no incr in endometrial carcinoma b/c it’s an endometrial antagonist
4) compare toxicity to tamoxifen
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Trastuzumab (Herceptin)
1) HER-2 (+) breast CA
2) monoclonal ab against HER-2 (c-erbB2), a tyrosine kinase –> kill breast CA cells taht overexpress HER-2 (ab-dependent cytotoxicity)
3) cardiotoxicity
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Imatinib (Gleevec)
1) CML, GI stromal tumors
2) Ph chr bcr-abl tyroxine kinase inhibitor
3) fluid retention
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Rituximab
1) non-Hodgkin’s lymphoma, rheumatoid arthritis (w/ MTX)
2) monoclonal ab against CD20 (found on most B-cell neoplasms)
3) N/A
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Vemurafenib
1) metastatic melanoma
2) small molec inhibitor of B-Raf kinases that have V600E mute
3) N/A
4) N/A
1) uses 2) class/ MOA 3) ADE 4)Fun fact/note
Bevacizumab
1) solid tumors
2) monoclonal ab against VEGF –> inhibits angiogenesis
3) N/A
4) N/A
