Phamacology And Treatment

Question 1

What is the treatment for Acute Intermittent Porphyria?

Answer 1

Give: glucose and heme, which inhibit the ALA synthase

Question 2

What is the treatment for lead poisoning in kids or adults??

What if the child has very high levels of lead?

Answer 2

EDTA or succimer

—> Dimercaprol + succimer

Question 3

What drug is used for the treatment of CML? What is it’s MOA?

Answer 3

Imatinib- specifically targets the the Philadelphia chromosome translocation, by inhibiting bcr-abl tyrosine kinase activity

Question 4

What is the treatment for the M3 subtype of AML? What is the associated translocation?

Answer 4

All-trans retinoic acid

t (15;17)

Question 5

What are the 3 drugs that cause pulmonary fibrosis?

Answer 5

• Methotrexate
• Bleomycin
• Busulfan

Question 6

How does methotrexate differ from 5-Fluorouracil?

Answer 6

Methotrexate is a folic acid analog that inhibits dihydrofolate reductase. 5-FU: is a pyrimidine analog that inhibits thymidylate synthase

Question 7

What medication intercalates DNA and produces oxygen free radicals , making it cardiotoxic? And why?

Answer 7

Doxorubicin and Daunorubicin

Cardiac muscle lacks superoxide dismutase which oxidizes free radicals in tissues

Question 8

What DNA alkylating agent is used in brain cancer?

Answer 8

Nitrosoureas- carmustine

Question 9

Treatment for childhood tumors (Ewing Sarcoma, Wilms Tumor, and rhabdomyosarcoma)?

Answer 9

Dactinomycin

Question 10

What combination of medications are used to treat:
Small cell lung cancer
Prostate cancer
Testicular cancer

Answer 10

Eliminate ball cancer:
Etoposide
Bleomycin 
Cisplatin
Or:
Etoposide
Ifosfamide
Cisplatin

Question 11

What medications blocks topoisomerase I? What do they treat?

Answer 11

Tipotecan and Irinotecan

Irinotecan: tx- metastatic Colon CA

Topotecan: Tx- small cell lung ca
Ovarian CA
Cervical CA

Question 12

Prednisone is used to treat what cancers? Why?

Answer 12

Used to treat lymphoid tumors
-CLL

And prednisone triggers apoptosis

Question 13

What is the MOA of Tamoxifen?

Answer 13

Estrogen receptor antagonist in the breast, and ER agonist in the bone. It’s also a partial agonist in the endometrium

Question 14

What is the difference between Tamoxifen and Raloxifene?

Answer 14

Used in osteoporosis (ER agonist in bone and ER antagonist in breast), but in addition, it is an antagonist in the endometrium

Question 15

What is the most important side effect of Trastuzumab?

Answer 15

Cardiotoxic

Question 16

What is the MOA of Imatinib? What malignancies does it treat?

Answer 16

Enzyme inhibitor that targets the mutant Philadelphia chromosome (t 9:22), BCR-ABL tyrosine kinase.

Used to treat:
CML
ALL
AML

Question 17

What is the MOA of Warfarin? What enzymes does it inhibit? What blood test does it affect?

Answer 17

It directly inhibits epoxide reductase which is responsible for recycling vitamin K.
Without Vit K, liver is unable to produce clotting factors: II, VII, IX, and X
In addition to protein C and a S
—> affects PT

Question 18

What are the 3 main thrombolytics? What is their MOA?

Answer 18

Streptokinase, Urokinase, Alteplase (tPA)

MOA: activate plasmin—> plasmin degrades fibrin (clot buster)

Question 19

What are the indications for thrombolytics?

What are some contraindications (5)?

What is the rescue drug?

Answer 19

• Early ST-elevation (our in the boonies)
• Acute stroke

CIs: Pt with active bleeding, Hx of intracranial bleeding, recent surgery, unknown bleeding disorder, or severe hypertension

Rescue: Aminocaproic acid

Question 20

What is the general MOA of Alkylating agents?

Name a few:

Answer 20

Cross-links DNA

Busulfan
Cyclophosphamide/Ifosfamide
Nitrosoureas
Procarbazine

Question 21

What are the 4 anti tumor antibiotics?

Answer 21

Bleomycin
Dactinomycin (actinomycin D)
Doxorubicin/Danorubicin

Question 22

What medications blocks topoisomerase II leading to increased DNA degradation? What do they treat?

Answer 22

Etoposide and Teniposide

Solid tumors (testicular and small cell lung cancer), Leukemia’s and lymphomas

SE: alopecia and myelosuppresion.

Question 23

What is the MOA of Erlotinib? When is it used?

Answer 23

Monoclonal antibody that targets EGFR tyrosine kinase inhibitor.

Seen: non-small cell lung carcinoma

Question 24

What is the MOA of Imatinib? When is it used?

Answer 24

Monoclonal antibody against the tyrosine kinase inhibitor of BCR-ABL (Phili chromo in CML) and c-kit (GI tumors)

Use: GI stromal tumors and CML

SE: fluid retention

Question 25

What is the MOA of Bortezomib and carfulzomib?

Answer 25

Proteasome inhibitors, induce arrest at G2-M phase and apoptosis.

Use: Multiple myeloma, mantle cell lymphoma

SE: peripheral neuropathy, heroes zoster reactivation

Question 26

What medication is being described: small molecule inhibitor of BRAF oncogene (+) melanoma. What’s te the clinical uses?

Answer 26

Vemurafenib

Metastatic melanoma

Question 27

What medication is being described: recombinant uricase that catalyzes metabolism of Uric acid to allantoin?

Answer 27

Rasburicase

Clinical use: prevention of tumor lysis syndrome