Pharm: Chemo, Immuno, Tox

Question 1

6 mechanisms that cause Anticancer drug resistance

Answer 1

1) Increased DNA repair
2) Formation of trapping agents
3) Changes in target enzyme
4) Decreased activity of prodrugs
5) Inactivation of cancer drugs
6) Decreased drug accumulation

Question 2

Drugs for AML

Answer 2

Cytarabine + idrarubicin or daunorubicin

Question 3

Drugs for ALL

Answer 3

Prednisone, vincristine, asparaginase or anthracyclin + intrathecal methotrexate (if with CNS)

Question 4

Drugs for CML

Answer 4

Imatinib mesylate, interferon

Question 5

Drugs for Hodgkin’s lymphoma

Answer 5

ABVD regimen: doxorubicin (A), Bleomycin, Vincristine, Dacarbazine, and prednisone

Question 6

Drugs for NHL

Answer 6

CHOP regimen: cyclophosphamide, doxorubicin, vincristine (O), Prednisone

Question 7

Drugs for Breast carcinoma

Answer 7

cytotoxic agents (?), tamoxifen, aromatase inhibitor (anastrozole), trastuzumab

Question 8

Drugs for Colon carcinoma

Answer 8

5-FU, leucoverin, oxaliplatin

Question 9

Drugs for Ovarian carcinoma

Answer 9

Paclitaxel and carboplatin

Question 10

Drugs for Pancreatic carcinoma

Answer 10

Gemcitabine, erlotinib

Question 11

Drugs for Prostate carcinoma

Answer 11

GnRH agonist (leuprolide) or antagonist (abarelix) and androgen receptor antagonist (flutamide)

Question 12

Drugs for Lung carcinoma

Answer 12

Carboplatin, paclitaxel, bevacizumab

Question 13

Drugs for Prostate Carcinoma

Answer 13

PEB regimen: Cisplatin, etoposide, bleomycin

Question 14

Rescue therapy for methotrexate

Answer 14

Leucovorin (folinic acid)

Question 15

Rescue therapy for cyclophosphamide

Answer 15

Mesna (Mercaptoethanesulfonate)

Question 16

Rescue therapy for doxorubicin

Answer 16

Dexrazoxane

Question 17

Rescue therapy for cisplatin

Answer 17

Amifostine + mannitol

Question 18

Log kill hypothesis

Answer 18

cytotoxic drugs kill a constant proportion of cells not a certain number.

Question 19

Types of alkylating agents

Answer 19

Nitrogen mustards (chlorabucil, cyclophosphamide, mechlorethamine)
Nitrosoureas (carmustine, lomustine)
Alkyl sulfonates (busulfan)

Have alkylating activity (cisplatin, dacarbazine)

Question 20

MoA of Alkylating agents

Answer 20

CCNS

Alkylate nucleophilic groups particularly N7 guanine => abnormal base pairing and DNA strand damage

Question 21

Toxic breakdown product of cyclophosphamide

Answer 21

acrolein

Question 22

MoA of Procarbazine (used in NHL and brain tumors)

Answer 22

forms H2O2 generating free radicals that cause DNA strand scission

Question 23

Antimetabolites typically work against which 3 compounds?

Answer 23

Folic acid (methotrexate)
Purines (mercaptopurine, thioguanine)
Pyrimidines (fluorouracil, cytarabine, gemcitabine)

Question 24

Uses of methotrexate

Answer 24

Choriocarcinoma, leukemia, NHL, Primary CNS lymphoma, Breast cancer, Head and neck cancer, bladder cancer, RA, psoriasis, ectopic pregnancy

Question 25

SE of methotrexate

Answer 25

Bone marrow suppression, mucositis, crstalluria

Question 26

MoA of 5-FU

Answer 26

Inhibits thymidylate synthase = thymineless cell death

Question 27

Cytarabine vs. gemcitabine

Answer 27

C: Inhibits DNA polymerase
G: inhibits RNA reductase

Question 28

What phase are antimetabolites most active

Answer 28

S phase

Question 29

Types of Natural product anticancer drugs

Answer 29

Vinca alkaloids (vinblastine, vincristine)
Podophyllotoxins (etoposide, teniposide)
Taxanes (paclitaxel, docetaxel)

Question 30

Mechanism of action of Vinca alkaloids

Answer 30

Prevents microtubule spindling (therefore, it acts on the M phase)

Question 31

Drug for Kaposi Sarcoma

Answer 31

Vinblastine

Question 32

Drug for Wilm’s tumor and Neuroblastoma

Answer 32

Vincristine

Question 33

Types of Antitumor antibiotics

Answer 33

Anthracyclines (doxorubicin, daunorubicin, idrarubicin, mitoxantrone)
Bleomycin
Mitomycin

Question 34

What anti-cancer drugs cause dose dependent cardiomyopathy

Answer 34

Anthracyclines

Question 35

Tyrosine kinase inhibitor

Answer 35

Imatinib

Question 36

Monoclonal antibody versus her2/neu (+) breast cancer

Answer 36

Trastuzumab

Question 37

MAB versus VEGF

Answer 37

Bevacizumab

Question 38

Treatment of Hairy cell leukemia

Answer 38

Interferon