Oncology begining Flashcards

1
Q

Semi-synthetic Estrogen preparations

A
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2
Q

5- Fluorouracil Inhibits?

What is its mechanism

What type do drug is it?

Sensitive to?

Toxicities? 5

A
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3
Q

Blocking the Metabolism of 17a-Hydroxyprogesterone

A
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4
Q

Estrogen preparations: Natural estrogens and their esters

A
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5
Q

Structure activity relationship of Estrogens

What nucleus with what type od A ring?

3-Hydroxy group

  • Metabolism of this?
  • What is used to block this

Then 17bhydroxyl group

A
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6
Q

Mitomycin: DNA Alkylating Agent

MOA:

  • Inert until? Generates what?
  • What else is generated that can damage the DNA?

Unstable to?

What colored excretion?

Forms?

A
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7
Q

Natural Estrogens: Estradiol

Amongst the natural?

Metabolic vulnerability?

Forms?

A
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8
Q

Chlorotrianisene

What type of drug? Agonist or antagonists and for what hormone?

No free ___ which blocks what? This also means it can be what form?

Distance of what?

A
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9
Q

What are the biosynthetic steps for Estradiol from Androstenendione

A

—> Aromatase gives Estrone

17b-HSD —> Estradiol

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10
Q

Trastuzumab/HER2

Prototypical Example of Drug targeting what factor?

Humanized what?

Strategy for this drug?

Heterodimer of this Receptor triggers?

This is all talking about cancer not really the drug but the reason for the drug

A
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11
Q

Megesterol Acetate

(Megace)

What on the B ring increases activtiy?

How much of oral dose is metabolized?

How does it differ from Medroxyprogesterone?

How does it block metabolism

A
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12
Q

DNA methyltransferase inhibitors

3

DAN

MOA

A
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13
Q

19-Norandrostane Derivative products

A
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14
Q

SAR

19-nortestosterone

What does the NOR mean?

What type of effect does this favor then?

A
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15
Q

Phytoestrogens

Soy isoflavone B-glycosides are?

A
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16
Q

Methyltestosterone

What are its featureS?

What block oxidation at 17 keto

Activity compared to testosterone? An improvement is?

androgenic or anabolic?

what metabolism?

A
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17
Q

Imatinib

Prototypical Small Molecule Kinase Inhibitor

MOA

Inhibits what growth factor and what kinase?

A
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18
Q

Anabolic Agents

flow chart

A
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19
Q

Androgenic + anabolic agents

flow chart

A
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20
Q

Nibs are inhibitors of?

Distinct chemical structure facts

6 Drug interactions, Mutations, distinct __ interaction, Dustinct ___ profiles, Distinct ___ - ___ interactions

A
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21
Q

Norethindrone Acetate Combipatch

Ester __? Metabolized where to form?

Prolonged action in what form?

A
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22
Q

Oxandrolone

WHat blocks 17 keto? what else does this do form wise?

What is going on wiht the A ring?

what form?

A
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23
Q

Ither Kinase Inhibitors

A
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24
Q

Androstane Nuc

what are the parts?

What 4 carbons are important for the 19-norandro derivatives

A
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25
Q

5a-Reductase where does it act?

what is its product formation with testosterone?

A
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26
Q

Ethisterone and Analogues

_ derivative of what?

A
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27
Q

SAR summary of Progesterone and Derivatives

Progestational effects depend on wha 4 things

What mays it fit better to the receptor?

A

Alkene

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28
Q

Progesterone

Prometrium

Duration? Due to?

Where from?

What places are susceptible for metabolism?

A
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29
Q

MonoclonalAntibodies vs. Kinase Inhibitors

Kinase

  • Cytosolic vs. ?
  • REversible vs?
  • ____ target

Monoclonal

  • Extracellular what region of ?
    *
A
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30
Q

Synthetic Estrogenic Agonist

DES

A very ____ ____ estrogen

What Isomer is 10 x more potent than?

Formerly used to?

Now?

A
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31
Q

Raloxifene

What type of activity? And what two things does this help?

What effect on breast tissue?

No ___ effect on the uterus?

form?

A
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32
Q

MAB with a warhead

A
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33
Q

Desogestrel

A
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34
Q

Progesterone

Progestasert

Despite?

A
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35
Q

What does the 17 ethynyl 19-Norandrostane do ofr activity across the board?

A
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36
Q

SAR Summary of Progesterone and Derivatives Synthetic Mods

2 main mods and talk about their effects

A
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37
Q

Estrogens: 17 a group hydroxl

What happens at the 17b group and what enzyme causes it?

A

Hepatic oxidation by 17b-hydroxysteroid dehydrogenase

Makes a less active ketone and limits oral activity

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38
Q

Where is the focus of progesterone drug in the pathway?

A
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39
Q

Chemotherapy targets

  • Combine the selectivity of ___ ___ inhitors with the potent action of another class
  • Are generally broad in spectrum and can be moderately toxic
  • Are useful for the metastic cancers but are nonselective and have many side effects
  • Are more selective and generally less toxic
  • Are more selective and have varying levels of toxicity
  • Draw the picture of where they act
A
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40
Q

There are now proposed cancer hallmarks

Emerging hallmarks and Enabling characteristics

4

A
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41
Q

Progestin Products: Progesterone and Derivatives

Starting at Nat Progestins then from there

A
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42
Q

Anastrozole

Specific?

Tx of?

A
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43
Q

Where is 17a-Hydroxyprogesterone in the Steroid Hormone Syn pathway

A
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44
Q

Medroxyprogesterone Acetate

at teh C6 position ___ is added and this decreases?

This blocks?

A
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45
Q

Intelligent therapy

A
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46
Q

Selective estrogen Receptor Modulators

SERM

What are these trying to circumvent

A
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47
Q

Stanozolol

What does it contain?

blocks oxidatio?

forms? What type of activity?

A
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48
Q

Topo I and II slide

A
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49
Q

Role of the cell cycle in chemotherapy

What controls cell cylce phase transitions? Failre causes?

Control growth and differentiation of targeted distant cells

What controls only nearby cells?

Coming from the cell itself?

Cells in what phase are least senstive to drugs?

Many drugs have what type of selectivty?

A
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50
Q

Tamoxifen and Raloxifene

Which one requires activation?

A
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51
Q

Progestin Products: Progesterone Derivatives

3

A
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52
Q

Epothilones

Complement what other drug?

MOA?
Improved?

What do you not need?

Chemical Stability

A
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53
Q

19-Norandrostane

SAR at c17 what is added and what does it block?

Analogues with what are inactive?

A
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54
Q

AntiAndrogen Chart

A
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55
Q

Anthracyclines DNA intercalation

5 of them all end with

2 MOA

Red quinones

Rings strucvute gives it away

A
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56
Q

Cholane?

A

Small sidechaine than cholestane 4 carbons

two methyls 18 19

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57
Q
A
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58
Q

Estrane nucleus has no?

A

C19 carbons

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59
Q

Testosterone esters

longer the chain longer the?

What type of drugs are they?

what is inhibited?

A
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60
Q

Miscellaneous: Bleomycin-Oxidative Cleavage of DNA

MOA

SE

A
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61
Q

Pregnane nucleus what are the important features? For derivates

A
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62
Q

Etheyleneimines

ThioTEPA

MOA:

Selectivtiy

Activated in?

Deactivation?

Active in the?

A
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63
Q

Medroxyprogesterone Acetate

What SC is introduced? What does this cause?

A

Slow reduction of the keto and double bond 4-5

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64
Q

Saw palmetto

A
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65
Q

BLM-Fe Complex

Damages DNA via?

A
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66
Q

Rescue therapy for methotrexate

Toxicity of Methotrexate

A
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67
Q
A
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68
Q

Hallmarks of Cancer

6 well defined hallmarks

A
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69
Q

Tretoin: Differentiation Therapy

MOA?
SE? Important notes

A
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70
Q

testosterone esters are subject to?

What is there physiological concentration like?

admin?

A
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71
Q

Activations of Capeitabine

Prodrug

Selectivity

SE profile

A
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72
Q

Additional considerations on therapeutic txs

What is necessary so a patient has the best chance of survival?

What is particularly dangerous?

  • This puts stress on?
  • How the these treated?

How long does it have to be to be a new cancer?

Cure means?

A
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73
Q

Practice

A
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74
Q

Letrozole

What does it do?

Tx of? Second line to?

A
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75
Q

Progestin Products

19-Norandrostane Derivatives

The rapid metabolism of progesterone triggered?

A
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76
Q

Esterified estrogens

Estra-cyp

A
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77
Q

Mutations and Biochemical Basis of Cancer

Many paragraphs

Most commonly cancer is caused by what type of mutations?

What is used to rationalized the difference between initiation and transformation?

So whats the deal with increasing age and cancer?

A
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78
Q

Biclutamide

Administered as a?

what enantiomer is inactive?

What does it bind to?

A
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79
Q
A
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80
Q

Role of aromatase?

A
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81
Q

Dienestrol (Synestrol)

What has been maintained?

Active in what wat? But how is it used primarily?

A
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82
Q

esterogen group at 3 position?

Subject to?

What does this limit?

A
  • Phenolic hydroxyl
  • Subject to biotransformation, which limits the duration of action, sulfation and glucuronidation
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83
Q
A
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84
Q

Estrogens 17 alpha ethinylation

Blocks?

Permits?

A
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85
Q

Number the cholesterol

A
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86
Q

Androstane

A
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87
Q

Fluoxymesterone

Bloicks what?

what makes it 5-10x more potent than testosterone?

A
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88
Q

Other Platinum Metal Complexes

Carboplatin and Oxaplatin

MOA?
STructural changes 2

Why does this make them better?

A

Carboxylic acid improves the safety profile and the

Cyclohexan 1,2 diamine overcomes resistance and once it gets to the right site it is more toxic

These drugs have different toxicities so onces put into a cocktail can get complement toxicities

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89
Q

Saw palmetto

A
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90
Q

Taxanes

MOA

Distinct

Lipophilicity and Implications

A

Moderately lipophilic need Emulsfying agent

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91
Q

Conversion of dUMP to dTMP

A
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92
Q

Phytoestrogens

What activity do they have?

The two hydroxyl groups?

A
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93
Q

Antiandrogenic peptides

Leuprolide

Goserelin

These drugs contain what?

GnRH

A

Incorporation of D AMino actids helps this

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94
Q

Classic Chemotherapy and the Cell Cycle

Hallmarks

  1. What must the drugs do?

Kinetics of Cell Division

  1. How can processes occur in cancer cells?
  2. Drugs can?

Classical Agents

  1. How do they interfere with these processes

Newer Agents

  1. Interfere with what pathways?
  2. Inhibit signals associated with? What type of cells?

Selectivty

For each class consider what?

Notes: How do tumor cells grow? How do cocktail target them?

Picture

Terminal Differentiation—>?

Phases of the cell

A
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95
Q
A
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96
Q

Tamoxifen

What isomer is used? What type of compound is it?

Used to treat?

form?

A
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97
Q

Retinoid Therapies to Stimulate Differentiation

A
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98
Q

Triphenylethylene Analogs

What structure is retained? But features what type of moeity that is critical for antiestrogenic activity?

A
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99
Q

Epipodophyllotoxins: Inhibition of?

A

Teniposide is more lipophilic more distribution more potent you can have less drug to get same effect

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100
Q

Dutasteride

What does it do?

and how

forms?

A
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101
Q

17a-Methyltestosterone

What are the key features?

What is blocked?

What does this mean for the drug?

A
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102
Q

General Notes about N-Mustards

MOA

  1. What generates an active electrophile and what does this react with? What is the fast and slow process
  2. What leads to mutation of DNA? And what is the mutation?
  3. What are the two steps prior to chain fragementation and destruction of DNA
  4. What is more difficult to repair mono or bi alkylation?
  5. How does deactivation occur?
  6. Selectivity Occurs from?
  7. Selectivity and Activity are Influences by?
  8. What are group is more reactive?
  9. How is potency influenced?
  10. Two ways that aziridinium formation is depressed?
  11. Prototype Mechlorethamine
A
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103
Q
A
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104
Q
A
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105
Q
A
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106
Q

Leuprolide and Goserelin DisruptEndogenous Hormonal Feedback systems

Action of Androgenic Peptides

  1. Stimulates
  2. Increase
  3. Initially
  4. Loop?
  5. Deprive tumor of?
A
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107
Q

SAR

19-Nortestosterone derivatives

What effect predominate and why?

A combination of what two things provides and overall ____ effect?

A
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108
Q

Fluoxymesterone

Androgen or anabolic acitivy?

more resistant to?

A
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109
Q

Nitrosoureas: Prodrugs

Carmustine

MOA?
Instability

Log P?

It is fragmented into twon parts what are they? They are the active DNA parts

How is this drug prepared for use?

A

Vinyl Cation and the 2-Chloroethylamine so you are mutating DNA at two sites

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110
Q

Nandrolone Decanoate

Absence of? gives it what activity?

what form?

A
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111
Q

Substitution with EWGs attenuate reactvitiy in what way?

P=?

This provide a similar activity to?

What are the drugs/

A

Th

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112
Q

Abx and higher derived natural products

3 classes

A

Topoisomerase Inhibitors

Mitosis Inhibitors

Msc

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113
Q

Dactinomycin: DNA Intercalation

MOA?

DMPK thing cyclic amides

A
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114
Q

Estrane nucleus

A

Absence of 19 carbon

115
Q
A
116
Q

Topoisomoerase Chane the State of?

Why is this a good target?

A
117
Q

17a-Hydroxyprogesterone what is it?

Where is it produced?

A
118
Q

Bitransformation of testosterone?

What is the primary route for inactivation?

A
119
Q

THG article

A
120
Q

C13 Ethyl Derivatives

All have what at C13?

All haev what at C17

A
121
Q

Pregnane

A

Much smaller side chaine

122
Q

Ketoconazole: Antiandrogen and?

MOA

A
123
Q

Cytarabine

What is its major structural change?

How does it work?

MOA?

A
  • Ribose to Arabinose
  • Intracellular kinases phosphorylate to ARA-CTP very polar and cannot leave the cell
  • ARA-CTP inhibits DNA and RNA polymerases and nucleotide reductases
124
Q

Nilutamide

Absorbed where?

Hydantoin analof that blocks?

A
125
Q

Oncogene and Cytokine Antagonists

1 Mature

2 tumor

A
126
Q

Triazole ___ inhibitors

2 of them

Prevent what?

What type of inhibitors?

A
127
Q

Diethylstilbestrol (DES)

Form of ____ with the __ and ___ ___

Two phenolic ___ are set the same ___ as in ____

Why is this important?

A
128
Q

Medroxyprogesterone Acetate

In Prempro

Used in combination with?

A
129
Q

What is armomatase involved in?

A
130
Q

Estrogens indications 4

A
131
Q

SAR and the Androstane Nucleus

What is the minimal requirement for activity?

What are the important positions?

A
132
Q

Exemestane?

What is it?

Reversible or irreversible?

Tx of?

A
133
Q

Nandrolone Decanoate

What is it?

A

Steroid

134
Q

Aromatic Subsitution Attenuates Reactivity

Fast Action of N-Alkyl Mustards

And

Slow activation

Which one is better? and Why?

A
135
Q

Targeting the Pyrimidine Biosynthetic Pathways

What is required for the production of dTTP

What are the two types of drugs?

A
136
Q

Estrogen preparations

A
137
Q

What are the key portions for androgenic activity?

What would make it not have androgenic activit?

What portion also exhibits progestin effects?

A
138
Q

Mutations that affect normal cell growth can lead to?

Normal cell growth is dependent on 3 things

  1. Dependent upon ___ and ___
  2. What leads to new cells?
  3. What leads to differentiated cells?

Control of Cellular Growth by Various Pathways

  1. Inhibitors?
  2. Cell signalling? 2 types

Cancer can Result from Loss of? In 3 kind of way

  1. Malfunction in what?
  2. What can lead to transformed cells?
  3. Damages to? What are tehy called?

Cell–> ____—-> ___

A
139
Q

Estrogens natural sources

A
  • Ovaries
  • Plcenta
  • Adrenal cortex (males and females)
  • Plants (flavoniods)
  • Mare urine
140
Q

Clomphene

Employed to promote?

Form?

What SEs?

A
141
Q

Blocking 3-keto-4-ene metabolism and 6ahydroxyation

What aspects are improved?

A
142
Q

Androgen preparations 3 classes

A
143
Q

Finasteride

what does it do?

what does it treat?

A
144
Q

Dacarbazine and Temozolomide

MOA?

How are they activated?

Which one would be more selectiv then?

What is a giveaway of what they do?

How is resistance forms?

What is the active toxic componenet?

A

Methyl diazonium ion

Activation of Dacarbazine via CYP 1A which makes it more selective because id that is overexpressed in the cancer cell it is more/

Temo is acitvated via water

145
Q

Synthetic Derivatives of Testosterone

What has led to the development of synthetic testosterones?

What are the 2 strats:?

A
146
Q

17 ethylyl 19-Norandrostane products

7

A
147
Q

Imatinib

A
148
Q

Anastrazole and Letrozole Block Oxidative Conversion of Androgens to Estrogens

MOA

Interactions

A
149
Q

Other Antimetabolites

Fludarabine, Cladribine, Clofarabine

Gemcitabine

What type of inhibitors are these?

They are all prodrugs

All are what form?

What do halogens do in these drugs?

What does the phosphate prodrug provide?

All of these drugs have one ending?

A
  • All are injectable
  • Phosphate provides solubility
  • Halogenation slows catabolic processes usually deaminases and phosphorylase can degrade the drug relativeley quickly but with the addition of the halofens on either the base (deaminase) or on the sugar (Phosphorlyase) They can slow this process
150
Q
A
151
Q

What does an ether at the C3 position of an Estrogen cause?

2 things

A
  • Ethers prolong the DOA by preventing sulfation and glucuronidation in vivo
  • The ether derivatives are inactive prodrugs that require hepatic dealkylation for activity
152
Q

Testosterone 4-ene metabolism

what enzyme does it?

What is the product of this? where is this enzyme located?

A
153
Q

Flutamide

Where is it absobed ?

What type of metabolism and what does it produce?

what is more potent than this?

A
154
Q

Resistance to Cancer Chemo

The R word

  • When does it develop?
  • What type of cells are more prone to developing resistance?
  • They commonly arises from what things? 2
  • Current research with agents that disable?
  • Why is this complicated and Challenging?
A
155
Q

Alkylsulfonates: Busulfan

What forms?

MOA?

  • Bifunctional alkylating agent that crosslinks DNA without?
  • Has what good leaving group? Similar to CL for what type of rxn
  • Insterstrand cross-linking of?
  • No activation mean?
  • deactivation by?
  • Replaced by?
A
156
Q

The classical model of APL PAthogenesis

3 points

A
157
Q

Pathway from testosterone to androsterone

Intermediates and enzymes needed

A
158
Q

Norgestimate

A
159
Q
A
160
Q

Phenpropionate

what activity? why?

DOA compared to Decanoate?

Promotes?

A
161
Q

Antiprogestin: Progesterone Receptor Antagonists

Mifepristine also known as?

What does it do?

How does it do it?

A
162
Q

Methotrexate Anion and Cellular Tansport

Glutamate tail

Resistance

Highly crystalline so?

CO2H formulations

A

Cant cross membrane without active transport

Deprotonated into salts - Formulated for injecttions to improve water solubility

163
Q

Generalizations about Antihormones

PD

DMPK

Toxicities

What are there SEs related to?

A
164
Q

DNA Damage by monofunctional Alkylating Agents

Cause cuts or?

A
165
Q
A
166
Q

Androgen Antagonists

Toluidides

What are they ?

what doe they do?

what are they used with?

A
167
Q

testosterone biotransformation another route

What is the most potent androgen?

how is it formed?

A
168
Q

What two modifications at the 17a position do not provide anabolic/androgenic activity?

But one does provide what type of activity?

A
169
Q

SAR summary

Feature essential for estrogenic activity 4 points

Modification where can enhance activity?

WHat provides the greatest activity?

A
170
Q

Mustards that Attenuated Reactivity

2 of them

Why do these have an imporved therapeutic window? 3 reasons

  • Stability how?
  • Increased aqeous stability so what? SEs?
  • Active in what ways but decrease absorption with?
  • Matching
    • Multiple myeloma
    • chronic lympocytic leukemia, maligant lymphoma and hodgkins
    • B-Oxidation to provide phenylacetic acid metabolite
    • Proposed that L-Phe actively transported into cells but may enter cells by facilitated diffusion
A
171
Q

Camptothecins: Inhibition of DNA Topo?

MOA?

Stability?

Prodrug?

Metabolism?

2 other drugs in this class

A
172
Q

Tx of Phytoestrogens?

A
173
Q

SERMs

All approved drugs in this category exhibit?

Why have they been given the name SERM?

A
174
Q

Other progestins to look at

A
175
Q

Estrogens 17b OH esterifications

Provides?

Protects?

What happens in tissue?

A
176
Q

Vincristine and Vinblastine

A
177
Q

Synthetic Conjugated Estrogens

A and B

A
178
Q

Esterified estrogens? Name it

What protects it?

Hydro or lipophilic?

Form?

Duration?

A
179
Q

Nandrolone esters

Decanoate and Phenprionate

in general if some thing doesnt have ___ it is more anabolic

What are some features about these esters?

A
180
Q

Cholestane skeleton?

Example?

A

Long side chain and 2 methyl on 13 and 10

18, 19 methyl

Cholesterol

6 carbons

181
Q

17 α-Ethinyl Estradiol 3-Methyl Ether (Mestranol)

Prodrug or active?

A
182
Q

Synthetic lack ___ structure - ?

3 have estrgenic Agonist activity

Estrogenic antagonist activity

3 type then drugs

A
183
Q

What is another strategy to prevent the oxidation of the 17b-OH group?

Androgen

A
184
Q

SAR for 19-Norandrostane Derivatives

4

A
185
Q

Progesterone metabolism due to reduction

what is the product and where are the changes

A
186
Q

Medroxyprogesterone Acetate

How is it active?

What types are ective how is this different?

What form provide contraception for 3 months?

A
187
Q

Cyclophosphamide and Ifosphamide

Soluble in?

Active in what form?

What is the MOA?

How are these selective?

What is the difference between these two drugs?

What is a product of these drugs that causes toxicity in the bladder?

A

Certain tumors overexpress P450s so these drugs can be activated within those cells

188
Q

Bifunction Alkyating Agents: Damage by?

What is the normal way and what is the alkylating agent causing to cause the damage

What are the mechanisms are which these occur?

End results of both?

A
189
Q

Labeling alpha or Beta

A
190
Q

Oxymetholone

Of the anabolic steroids?

What blocks 17 keto?

Stimulates production of what?

form?

A
191
Q

Abiraterone Inhibits the Biosythesis of Testosterone

MOA

What type of molecule?

A

Blocks CYP17A1 which is responsbile for the coversion of hormones to androgen

192
Q

Antiandrogens

Metabolic Activation Activation?

MOA

Inhibits the binding of?

Selectivity for receptor

Metabolism and excretion

SEs

Flutamide—> Hydroxyflutamide

A
  • Metabolic activation via CYP1A2 Liver function
  • Competitive inhibitor- Inhibits the binding of testosterone and dihydrotestosterone to Androgen receptor–>Causes no translocation of the complex to the nucleus
  • More selective to the AR than ER or PR
  • Hydrocylated-deacylattion aromatic
  • Reversible after stopping the drug:gynecomastia, liver
193
Q

Nilutamide, Biclutamide

Which one doesnt need activation?

MOA

Stereochemistry

Activation?

AS a class what serious SE do they have?

A

Biclutamide is sold as a racemate it as a chiral center doesnt need CYP metabolism so safety for patient is better

194
Q

Norethindrone

What blocks what?

Typically given?

A
195
Q

Indications for progestins?

A
196
Q

General MOA for N-Mustards which are?

How are they acivated?

How are they deactivated?

Alkylation of DNA by Mechlorethamine

A
197
Q
A
198
Q

Hydrolysis of 3-sulfates via intestinal _____?

Forms?

Talking about premarin

What is premarin considered?

A
199
Q

SAR 17bhydroxyl esterification

Example: testosterone heptanoate

What type of molecule does this end up being?

What is the forM?

A
200
Q

Estramustine Phosphate

Actual MOA?
Suitable for?

What type of genic effect?

A
201
Q

Purine Antagonists

Amidophosphoribosyl Transferase Inhibitors

How does TPMT Expression vary?

A

Metabolism Activation via methylation

TPMT leads to an inactive metabolite and thus dose adjustments need to be made it they is high or low expression

202
Q

Bexarotene Forces?

What does it remove?

What does it promote?

A
203
Q

Pentostatin

Its effect is in the what type of pathway? Catabolic or Metabolic

MOA?

4 points

It causes an elevated level of?

Inhibits teh action of what enzyme?

What enzyme does it inhibit?

A

Catabolic

204
Q

What binds heme in Anastrozole and Letrozole

A
205
Q

Estradiol valerate or estradiol cypionate

Which one is more lipophilic and why?

A

Cypionate because 17 B SC

206
Q

Testosterone esters

In general?

Testosterone undecanoate

oral?

A
207
Q

Key structural features of RU-486

Antagonism is mediated by?

A
208
Q

Semi and Bio synthetic sources of progestins?

A
209
Q

Summary of pathway

Where is aromatase involved?

A
210
Q

Cell cycle review

G1

G0

S

G2

M

A
211
Q

Molecular Mechanisms Of Cancer pathways

A
212
Q
A
213
Q
A
214
Q

Danazol

Contains what type of ring?

Inhibitor of waht?

Suppresses?

form?

what blocks 17 keto

A
215
Q

Medroxyprogesterone Acetate (Provera)

What does the liver do? Similar to ___ except for?

What is active?

What decreases reduction of 20-keto

A
216
Q

Flutamide

All compounds in this group have what?

A
217
Q

3-hydroxyl group on estradiol is subject to ______ metabolism especially with ____ and to a lesser extent with?

What do these things cause?

A
  • Phase II metabolism mostly with sulfation but also with glucuronidation
  • Sulfation and Glucuronidation increase polarity and cause more renal elimination
218
Q

Saw palmetto

A
219
Q

17a-Hydroxyprogesterone

Metabolism

what is teh same and what is different in comparison to progesterone metabolism

What does this limit?

A
220
Q

A 3-keto like system can mimic the anabolic activity of an androgen drug what modification increases anabolic acitivty over andorgenic activity? What does it look like?

A
221
Q

Anthracycline-mediated formation of Free radicals

A
222
Q

Role of Aromatase in Cancer?

Block conversion of?

Control?

Aid in?

A
223
Q

How are alkylating agents trying to cell the cancer cells?

What can happen with these that should be noted and can cause more issues?

A
  • Continue to expose the cancer cell to promoters that will increase mutations and promote enough that the cell will hopefully die
  • These can kill you and be cancerous themselves
224
Q

Toremifene

Related to?

What reduces its anti-estrogenic potency?

Other SERMs in trials?

A
225
Q

Natural Estrogens

Estrone

Activity compared to estradiol?

A
226
Q

Vinca Alkaloids: Microtubule?

MOA?

1 and 2

Solubility and Amines?

A
227
Q
A
228
Q

Methotrexate

MOA

3 things

A
229
Q

Alkylating Agents

  • Highly reactive molecules that attack? By what mechanism?
  • Goal of these?
  • Problem?
  • Monofunctional?
  • Bifunctional?
  • Common sites of Mutations? 2
  • What phases do these agents act on?
A

Site of mutation- O6 and N7 positions g bases are generally more prone to alkylate

G1 and S phase where the DNA is the most active

230
Q

What does estrogen activate? And what does this initiate?

A

The ER and initiates Transcription

231
Q

Nat sources of Progestin

4

What is an important note about synthesized progestterone?

A
232
Q

Purine Antagonists

MOA 2

They are drug specific

Mercaptopurine and Thioguanine

Incorpotation into DNA inhibiting Chain elongation and promoting apoptosis

Targeting the rate liminitng step of purine biosynthesis, inhibiting formation of what to what?

A
233
Q

SAR

What causes anabolic activity in androgens?

How can a drug be resistant to aromatase?

A
234
Q

Megesterol Acetate

Active in what form?

Acitivty similar to?

What decreases reduction of 20-keto?

A
235
Q

Estradiol

rxn via sulfation and glucuronidation products

A

Estradiol sulfate and estradiol glucuronidate

236
Q

All the cholesterol compounds we go over are cis or trans? meaning what?

A

All trans and its talking about the fusion of the rings

237
Q

19-Norandrostane

SAR at C17 Improving Progestational over Androgenic acitivty

What group here changes to more progestational?

A

Ethynyl

238
Q

3-keto 4 ene testosterone metabolism via?

What is the product?

A
239
Q

Antiestrogens

Important

2 classes

A

Aromatase Inhibitors Block production and

ER Inhibitors - Block the action

240
Q

Clomiphene

What isomer is the ant antagonist and what one is the agonist?

A
241
Q

SAR for 19-Norandrostane Derivatives

Modifications

4 and what do they do

A
242
Q

What are the four classes of Antimetabolites?

2 types of Inhibitors in this Area

Where do they interact?

What are they targeting?

Can be?

What phase are they active in

A
243
Q

Key progesterone functional groups

What do they do?

A
244
Q
A
245
Q

Does Testosterone have more anabolic or androgenic acitivty?

Short or fast acting?

Metabolism?

A
246
Q

Phytoestrogens?

A
247
Q

Picture of what Nucleosides are Doing in the body.

Draw that picture a bunch

A
248
Q

Bendamustine:

MOA?

What type of Alkylation?

Antimetabolite: An inhibitor of what?

Metabolism?

This drug compared to Melphanan and Chloramubcil and Mechlorethamine?

A

Just know that it contains the aromatic portion that give it selectivity and make it better reactive

Similar to Chloram and Melphanan

249
Q

Fulvestrant and Acolbifene

A
250
Q

Norgestrel and Levonorgestrel

A
251
Q

Mitotane

Structurally related to?

MOA?

Tox

A
252
Q

Antiestrogens

Important in the modification of?

What are the two major groups?

A
253
Q

Note on combination of AR blockage and LHRH

CAB

A
254
Q

Antihormones

General Featurs

5

  • For certain tumors of sex glands and related tissue
  • Deprivation of what? Inhibits tumor growth?
  • WHy are they used in cocktails?
  • Narrow Spectrum compared to?
  • Interaction of drug with cytoplasmic receptors require?
A
255
Q

Two DES analogs?

A
256
Q

How is acrolein detoxified?

What is the rxn that causes this toxicity in the first place?

A

Mesna is a sacroficial replacement so acrelein doesnt reactive with cysteine from the bladders enzymes

257
Q

Saw palmetto

A
258
Q

Pemetrexed

MOA?

Inhibits the formation of?

So that means no new?

Targets? 3

Transport into cells like how?

Cross resistance?

A
259
Q

Gestodene

A
260
Q

Cisplatin: Prototypical Platinum Metal Complex

Pt:?

MOA?

  • Activation by?
  • Forms what? And what does this prevent?
  • Some tumors are resistant to?
  • Some suggested that what what is not required?
A
261
Q

Understanding and Targeting Molecular mechanisms of Cancer

3 Goals of Chemotherapy

  1. Regulate what processes?
  2. Requires understanding of?
  3. Understand the difference between?

Challenges and Problems 3

  1. Poor understanding of?
  2. Cancer often involves?
  3. What type of signalling pathways? What type of cells?
A
262
Q

What are the two main progestin products?

A
263
Q
A
264
Q

New Drugs interfere with Kinase Signaling Pathways

New Addtions

General Properties

A
265
Q

Androgens actions and indications

Has two types of activity

and then

A
266
Q

19-Norandrostane

SAR

What contribute to the androgenic/anabolic effects?

Readily metabolized to?

what is in the A ring?

A
267
Q

Key 19-Andro SAR

Androstane Nucleus without?

A
268
Q

Ethinyl estradiol

What is it?

Prodrug or active?

Important to note about the 17a?

What is it used as?

A
269
Q

Other inhibitors of thymidine biosynthesis

2

Which on requires less activation?

How do they overcome resistance?

A
270
Q

Retinoids

Structurally related to?

What factors?

Bexarotene ?

A
271
Q

Estrogens aromatic where?

A

A rings

272
Q

Megestrol Acetate

MOA

SEs

A
273
Q
A
274
Q

Signaling Cascade Inhibitors: Kinase Inhibitors

A
275
Q

Conjugated Estrogens

Premarin

Saturation in the B ring?

What is important to note about the mixture?

Isolated from?

What form?

A

Sodium Estrone Sulfate

Conjugated estrogens have grreater water solubility- this is the form found in urine

PO, IM, IV

276
Q

5-F-dUMP Irreversibly and Covalently Modifies TS

Cell dies due to?

A
277
Q

Exemestane

Structurally related to?

MOA?

Double bond?

A

Michael Acceptor

DOuble bond add extra binding covalent binding with aromatase

278
Q

Cholesterol —>? Preg?

What is involved?

A
279
Q

Nandrolone Decanoate

What is it?

A

Steroid

280
Q

Aromatase Inhibitors

Letrozoel and Anastrazole

ADME

SEs due to?

A
281
Q

Abiraterone

MOA

Resistance

A
282
Q

Interaction of Cisplatin With DNA

Resistance?

Common sites of Binding?

A

Mutations to the Polymerases that can pass the blockage

Adjacent G-G and G-A

283
Q

Progesterone: Metabolism to?

What is added and different?

What does it get metabolized by?

Addition at 6 you should know whay its metabolized to

A