Pharm/Malignancies Flashcards
Describe the most effect drug cocktail for treating AML
ARA-C (pyrimidine analog)
Thioguanine (purine analog)
Daunorubicin (free rad generator)
What are the major side effects of common AML drugs
All 3 are myelosuppressive; opportunistic infections; daunorubicin has cumulative dose cardiotoxicity
Gemtuzumab is an example of mAbs with this mechanism
Carriers of radioactive substances and other toxins to target cells
Drug used for post-remission AML therapy
ARA-C
These two drugs specifically target the translocation product in APL
ATRA & arsenic trioxide
Describe differences in ATRA and arsenic trioxide
Arsenic compound has CV toxicities; ATRA doesn’t
Describe common therapy for ALL (non-Philadelphia)
Corticosteroid
Vincrystine
Anthracycline
Describe common therapy for ALL cases with the Philadelphia chromosome translocation
Imatinib
Imatinib MOA
BCR-ABL fusion protein tyrosine kinase inhibitor
What is the Philadelphia chromosome translocation?
t(9;22)
Imatinib side effects
GI issues inc nausea; elevated hepatic enzyme levels; cytopenias (watch CBCs)
Can imatinib be used in both CML and AML?
No, only in AML
First-line therapy for CML
Imatinib
Name two tyrosine kinase inhibitors similar to Imatinib and give benefits
Nilotinib and dasatinib are 2nd generation to imatinib and offer different binding orientation that circumvents common resistance mutations in tumor cells
Describe common CLL treatment regimen
Fludarabine
Cyclophosphamide
Rituximab
Alemtuzumab MOA and indication
Binds CD52 and induces cytotoxic mechanisms (CLL)
Bendamustine MOA and indication
Antimetabolite and also alkylating agent that causes DNA-crosslinking and p53 activation (CLL)
Hairy cell leukemia drugs
Cladiribine, IFN-A2b, Pentostatin
Describe the action of synthetic interferons
Induce host immune response and also an anti-proliferative effect on tumor
Hodgkin’s lymphoma typical combination therapy
doxorubicin
Vincristine
Cyclophosphamide/bleomycine
Corticosteroid
Hodgkin’s treatment approach
Combination therapy with several MOAs; cycle treatment with drug-free time to allow blood count normalization between treatments
What is the dose-limiting toxicity of alkylating agents?
Myelosuppression
What do you do when Hodgkin’s patients don’t respond to induction therapy or they have refractory disease?
High-dose chemo followed by autologous SCT with PB stem cells
What is the usual treatment for non-Hodgkin’s lymphoma?
COMP (Cyclophosphamide, vincristine, MTX, and prednisone for 6 months)
Name the two mAbs with radioactivity and describe MOA
Tositumab is anti-CD20 as well as Ibritumab
Burkitt’s lymphoma treatment and considerations
Cyclophosphamide + methotrexate
Vincristine + doxorubicin
Possibly cytarabine
Use intrathecal route to maximize exposure to CNS
ALL consolidation therapy regimen
MTX + mercaptopurine
Describe the MOA for ATRA
Causes differentiation of APL cells and post-maturation apoptosis
This type of leukemia/lymphoma seems to have the most treatment options of the ones we studied (AKA if I don’t know a drug it probably is for this)
ALL
