Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Heme/Onc > Oncology Drugs > Flashcards

Oncology Drugs Flashcards

1
Q

What is the mechanism of action of Alkylating agents?

A

Cause intra- and inter-strand cross-links between DNA bases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What drugs are in the category of Alkylating agents?

A 
Cyclophosphamide
Dacarbazine (DTIC)
Ifosfamide
Mechlorethamine
Melphalan
Nitrosureas
Procarbazine
Temozolamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The metabolites of which Alkylating agents are toxic to the bladder and how can you protect against this toxicity?

A

Cyclophosphamide
Ifosfamide

Use hydration + MESNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which Alkylating agents penetrate the CNS?

A

Nitrosoureas
Procarbazine
Temozolamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What Alkylating agent is the parent drug of the class?

A

Mechlorethamine - nitrogen mustard gas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the mechanism of action of the Platinum derivative drugs?

A

Cross-link DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What drugs are in the category of Platinum derivative drugs?

A

Carboplatin
Cisplatin
Oxaliplatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

For each of the Platinum derivative drugs (Carboplatin, Cisplatin, Oxaliplatin), rank the following toxicities in order from greatest to least:
Renal
Neuro
Heme

A 
Carboplatin = Heme >>>> Renal/Neuro
Cisplatin = Renal > Neuro > Heme
Oxaliplatin = Neuro >> Heme >>>> Renal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the mechanism of action of Anti-tumor antibiotics?

A

Damage DNA physical structure by intercalating into DNA helix and alter DNA function by inhibiting RNA/protein synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What drugs are in the category of Anti-tumor antibiotics?

A

Actinomycin D

Bleomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What cancer is Acitnomycin D a curative regimen for?

A

Pediatric cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are toxicities of Acinomycin D?

A

Myelosuppression
Nausea/vomiting/diarrhea
Muscositis
Radiation recall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are toxicities of Bleomycin?

A

Pulmonary and cutaneous toxicity, especially with decreased renal function
Can persist in lung and cause fatal recall of lung toxicity during surgery with high O2 inspired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why does Bleomycin cause pulmonary and cutaneous toxicity, especially with decreased renal function?

A

Tissues clear it with bleomycin hydrolase - but lungs and skin lack this hydrolase
Therefore, if renal clearance of the drug is decreased, the drug can build up in lungs and skin, causing toxic effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the mechanism of action of the Topoisomerase directed agents?

A

Forms a complex of the drug, enzyme, and DNA and the drug stabilizes the break, preventing repair and altering function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the Topoisomerase I directed agents?

A

Irinotecan

Topotecan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the Topoisomerase II directed agents?

A

Anthracyclines - Doxorubicin, Daunorubicin, Idarubicin
Mitoxantrone
Etoposide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are toxicities of Irinotecan?

A 
2 types of diarrhea
- Early = atropine sensitive
- Late = reflecting enterohepatic clearance
Myelosuppression
Nausea/Vomiting/Fatigue/Alopecia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are toxicities of Topotecan?

A

Nausea/Vomiting/Fatigue/Alopecia

Myelosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are toxicities of anthracyclines (Doxorubicin, Daunorubicin, Idarubicin)?

A

Myelosuppression
Mucositis
Alopecia
Cardiac toxicity due to free radical generation (but Idarubicin less cardiotoxic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How are the anthracyclines (Doxorubicin, Daunorubicin, Idarubicin) cleared and when must you dose adjust?

A

Cleared by liver

Adjust in hepatic failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What drugs are in the category of antimetabolites?

A 
Methotrexate
5-Fluorouracil
Cytaracine
Gemcitabine
Fludarabine
Mercaptopurine
Pentostatin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the mechanism of action of methotrexate?

A

Folate inhibitor

Inhibits dihydrofolate reductase, blocking DNA/RNA formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the side effects of methotrexate?

A

At standard dose - myelosuppression, mucositis

At high doses - intentionally give lethal dose, but with leucovorin (to rescue normal cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the mechanism of action of 5-Fluorouracil?

A

Pyrimidine analog

Inhibits thymidine synthesis by forming complex with folate and thymidylate synthase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the side effects of 5-Fluorouracil?

A

Myelosuppression
GI
Cerebellar/neurocognitive
Rare coronary spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What can be used to enhance the toxicity of 5-FU to cancer cells?

A

Leucovorin

Enhances complex of thymidilate synthase + folate +5-FU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the mechanism of action of cytarabine (Ara-C) and Gemcitabine?

A

Cytosine analog

Inhibits DNA synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the side effects of Cytarabine and Gemcitabine?

A

Myelosuppression
Cerebellar effects
Eye irritation
Hand/foot syndrome - prominent with gemcitabine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What antimetabolite drugs are the purine analogs?

A

Fludarabine

Mercaptopurine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the mechanism of action of pentostatin?

A

Behaves like a purine analog

Not incorporated into DNA directly, inhibits adenosine deaminase and signals apoptosis in T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the mechanism of action of asparaginase?

A

Clears circulation of asparagine

Decreases protein synthesis in susceptible cells types and indirectly damages DNA

33
Q

What are some side effects of asparaginase?

A

Hypersensitivity
Hyperglycemia
Pancreatitis
Altered clotting functions

34
Q

What is the mechanism of action of Hydroxyurea?

A

Reversible inhibition of ribonucleotide reductase by chelation of non-heme Fe
–> decreased dNTP pools –> stalled replication –> apoptosis

35
Q

What are some side effects of hydroxyurea?

A

Myelosuppression

Mucositis

36
Q

What are the microtubule directed cytotoxic agents?

A

Vincristine
Vinblastine
Paclitaxel
Dacitaxel

37
Q

What is the mechanism of action of vincristine and vinblastine?

A

Mitotic inhibitor - blocks mitosis

38
Q

What are the toxicities of vincristine and vinblastine?

A

Vincristine - neurotoxic > myelosuppression

Vinblastine - myelosuppression > neurotoxic

39
Q

What is the mechanism of action of Paclitaxel and Docitaxel (taxanes)?

A

Microtubule polymerstabilizers

Promote microtubule formation but are abnormal and shortened; do not function normally

40
Q

What are toxicities of Paclitaxel and Docitaxel?

A

Myelosuppression
Neuropathy
Fluid retention - vascular leak
Hypersensitivity reactions

41
Q

What is the mechanism of action of arsenical?

A

Generate free radicals

42
Q

What are side effects of arsenic?

A

Heavy metal toxicity - kidney, cardiac conduction (QT prolongation)

43
Q

What are the hormonal oncologics?

A 
Goserelin
Tamoxifen
Letrozole
Examestane
Prednisone
44
Q

What is the mechanism of action of Goserelin?

A

LHRH analog

Decrease LH release by pituitary and decrease testosterone production

45
Q

What is the mechanism of action of Tamoxifen?

A

Estrogen receptor antagonist

46
Q

What is the mechanism of action of Letrozole?

A

Type II aromatase inhibitor

Non steroidal - target P450 aromatase

47
Q

What is the mechanism of action of Examestane?

A

Type I aromatase inhibitor

Steroidal - target substrate binding site

48
Q

What is the mechanism of action of prednisone?

A

Glucocorticoid receptor action induces apoptosis in lymphoid tissue

49
Q

What is the mechanism of action of tretinoin (all trans retinoic acid)?

A

Induces differentiations of leukemia cells bearing translocation t(15;17) that alters structure & function of retinoic acid

50
Q

What are side effects of all trans retinoic acid?

A

Teratogenic
Cutaneous (dry skin, ocular kaeratitis)
Increased intracranial pressure
Differentiation syndrome

51
Q

What is differentiation syndrome?

A

Cytokine storm in APL after all trans retinoic acid

Presents with fever, peripheral edema, pulmonary opacities, hypoxemia, respiratory distress, hypotension, etc.

52
Q

What drug should be given to control differentiation syndrome?

A

Dexamethasone (steroids)

53
Q

What drugs are in the category of tyrosine kinase inhibitors and what is the target for each?

A

Imatinib - BCR-ABL
Erlotinib - EGF receptor
Sorafenib - multitarget (VEGF, raf, others)
Sunitinib - multitarget (VEGF, raf, others)

54
Q

What are side effects of Imatinib?

A

Cytopenias
Liver abnormalities
Fluid retention
Rare cardiomyopathy

55
Q

What are side effects of Erlotinib?

A

Diarrhea

Cutaneous

56
Q

What are side effects of Sorafenib, Sunitinib?

A

Hypertension
Proteinuria
Clotting/bleeding

57
Q

What are side effects of Interferon?

A

Fatigue
Cytopenia
Fever, chills

58
Q

What is mechanism of action of Interleukin-2?

A

Induces T cell response, cytolytic for tumors

59
Q

What are side effects of Interleukin-2?

A

Hypotension
Vascular leak
Altered mental status
Cardiopulmonary effects

60
Q

What drugs are antibodies and what is their target?

A

Cetuximab - anti-EGFR
Trastuzumab - anti-Her2/neu
Rituximab - anti-CD20

61
Q

What are side effects of antibodies?

A

Infusion reaction = fever, chills, hypotension, bronchospasm

62
Q

What drug is an antiangiogenic agent?

A

Bevacuzimab

Anti-VEGF monoclonal antibody that prevents angiogenesis

63
Q

What are treatments of choice for AML?

A

High dose Cytarabine (Ara-C) and Danorubicin (anthrocycline)

64
Q

What are major side effects of AML treatment with Cytarabine and Danorubicin?

A

Tumor lysis syndrome
Cytarabine-induced cerebellar toxicity
Cardiomyopathy due to anthracycline

65
Q

What are treatments of choice for APL?

A

All trans retinoic acid, arsenic

66
Q

What are major side effects of APL treatment with all trans retinoic acid or arsenic?

A

Differentiation syndrome due to all trans retinoic acid

67
Q

What are treatments of choice for CML?

68
Q

What are major side effects of CML treatment with Imatinib?

A

Resistance to imatinib

69
Q

What are treatments of choice for ALL?

A

Asparaginase
Intrathecal chemo
PCP prophylaxis
Cryoprecipitate

70
Q

What are major side effects of ALL treatment with Asparaginase?

A

Allergic reaction, thrombosis, pancreatitis

71
Q

What are treatments of choice for CLL?

A

Wait and see

72
Q

What are treatments of choice for Hodgkin’s lymphoma?

A 
ABVD combination chemo +/- radiation
A - Adriamycin (Doxorubicin)
B - Bleomycin
V - Vinblastine
D - Dacarbazine
73
Q

What are major side effects of Hodgkin’s treatment with ABVD?

A

Doxorubicin - cardiac toxicity
Bleomycin - pulmonary toxicity
Myelosuppression
Nausea/Fatigue/Vomiting

74
Q

What are treatments of choice for DLBCL (diffuse large B-cell lymphoma)?

A 
R-CHOP +/- radiation
Rituximab (CD20 antibody)
Cyclophosphamide
Doxorubicin
Vincristine
Prednisone
75
Q

What are major side effects of treatment with R-CHOP?

A

Rituximab - infusion reaction
Cyclophosphamide - bladder toxicity, at high doses also cardiac toxicity and lung toxicity
Doxorubicin - cardiac toxicity
Vincristine - neurotoxicity, myelosuppression
Prednisone

76
Q

What are treatments of choice for follicular lymphoma?

A

Close surveillance
Treat if symptomatic
Drugs of choice are controversial

77
Q

What are treatments of choice for MALT lymphoma?

A

Triple therapy for H. pylori

78
Q

What are treatments of choice for T cell non-Hodgkin lymphoma?

A 
CHOP
Cyclophosphamide
Doxorubicin
Vincritine
Prednisone
79
Q

What are treatments of choice for multiple myeloma?

A

Multiagent therapy with Bisphosphate therapy

Heme/Onc (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions