Pharm/Malignancies

Question 1

Describe the most effect drug cocktail for treating AML

Answer 1

ARA-C (pyrimidine analog)
Thioguanine (purine analog)
Daunorubicin (free rad generator)

Question 2

What are the major side effects of common AML drugs

Answer 2

All 3 are myelosuppressive; opportunistic infections; daunorubicin has cumulative dose cardiotoxicity

Question 3

Gemtuzumab is an example of mAbs with this mechanism

Answer 3

Carriers of radioactive substances and other toxins to target cells

Question 4

Drug used for post-remission AML therapy

Answer 4

ARA-C

Question 5

These two drugs specifically target the translocation product in APL

Answer 5

ATRA & arsenic trioxide

Question 6

Describe differences in ATRA and arsenic trioxide

Answer 6

Arsenic compound has CV toxicities; ATRA doesn’t

Question 7

Describe common therapy for ALL (non-Philadelphia)

Answer 7

Corticosteroid
Vincrystine
Anthracycline

Question 8

Describe common therapy for ALL cases with the Philadelphia chromosome translocation

Answer 8

Imatinib

Question 9

Imatinib MOA

Answer 9

BCR-ABL fusion protein tyrosine kinase inhibitor

Question 10

What is the Philadelphia chromosome translocation?

Answer 10

t(9;22)

Question 11

Imatinib side effects

Answer 11

GI issues inc nausea; elevated hepatic enzyme levels; cytopenias (watch CBCs)

Question 12

Can imatinib be used in both CML and AML?

Answer 12

No, only in AML

Question 13

First-line therapy for CML

Answer 13

Imatinib

Question 14

Name two tyrosine kinase inhibitors similar to Imatinib and give benefits

Answer 14

Nilotinib and dasatinib are 2nd generation to imatinib and offer different binding orientation that circumvents common resistance mutations in tumor cells

Question 15

Describe common CLL treatment regimen

Answer 15

Fludarabine
Cyclophosphamide
Rituximab

Question 16

Alemtuzumab MOA and indication

Answer 16

Binds CD52 and induces cytotoxic mechanisms (CLL)

Question 17

Bendamustine MOA and indication

Answer 17

Antimetabolite and also alkylating agent that causes DNA-crosslinking and p53 activation (CLL)

Question 18

Hairy cell leukemia drugs

Answer 18

Cladiribine, IFN-A2b, Pentostatin

Question 19

Describe the action of synthetic interferons

Answer 19

Induce host immune response and also an anti-proliferative effect on tumor

Question 20

Hodgkin’s lymphoma typical combination therapy

Answer 20

doxorubicin
Vincristine
Cyclophosphamide/bleomycine
Corticosteroid

Question 21

Hodgkin’s treatment approach

Answer 21

Combination therapy with several MOAs; cycle treatment with drug-free time to allow blood count normalization between treatments

Question 22

What is the dose-limiting toxicity of alkylating agents?

Answer 22

Myelosuppression

Question 23

What do you do when Hodgkin’s patients don’t respond to induction therapy or they have refractory disease?

Answer 23

High-dose chemo followed by autologous SCT with PB stem cells

Question 24

What is the usual treatment for non-Hodgkin’s lymphoma?

Answer 24

COMP (Cyclophosphamide, vincristine, MTX, and prednisone for 6 months)

Question 25

Name the two mAbs with radioactivity and describe MOA

Answer 25

Tositumab is anti-CD20 as well as Ibritumab

Question 26

Burkitt’s lymphoma treatment and considerations

Answer 26

Cyclophosphamide + methotrexate
Vincristine + doxorubicin
Possibly cytarabine

Use intrathecal route to maximize exposure to CNS

Question 27

ALL consolidation therapy regimen

Answer 27

MTX + mercaptopurine

Question 28

Describe the MOA for ATRA

Answer 28

Causes differentiation of APL cells and post-maturation apoptosis

Question 29

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)

Answer 29

ALL