pharmacology Flashcards
2 syndromes that cause radiation hypersensitivity
ataxia telangiectasia and Nijmegen leakage syndrome
name 3 radiation sensitizer drugs
doxo, dactinomycin, and gemcitabine
what is included in flank XRT for wilms
whole vertebral body
what is included in cranial irradiation for ALL
posterior half of eye and C2
spinal irradiation extends to what
S3 and theca sac
enzyme responsible for most phase 1 reaactions
cytochrome P450- oxidation and demythelation, usually activating or deactivating drugsTMPT
key example for phase 2 drug metabolism
TPMT and gilberts and irinotecan metabolism
formula for clearance
Dose/AUC
list 5 strategies to circumvent the BBB
HIGH DOSE chemo, use drugs that actually cross BBB, disrupt BBB, or regional chemo
CNS volume reaches 80% off adult volume by what age
3 yars
Volume of CSF
135-150 mL
Goldie Coleman hypothesis
Cancer cells mutate and become resistance to therapy at a rate that
depends on the cancer’s inherent genetic instability
* Probability that a cancer contains a resistant clone is dependent on the
mutation rate and size of the tumor
* Even when tumor burden is low there is likely to be at least one drug
resistant clone
Class: ifosphamide and cyclophosphamide
classic alkylating
class: thiotepa
classic alkylating
class: busulfan
classic alkylation
class: platinums
non classic alkylating
class of chemo drugs that cause cardiotoxicity
anthracyclines
2 chemo classes that cause peripheral neuropathie
alkaloids, cisplatin
name the chemo drug that can cause neurological toxicity and mental status and may be he3lped with methylene blue
ifosphamide
Key late effects of alkylators: 5
gonadal atrophy and loss of reproductive function (esp busulfan), pulmonary fibrosis (busulfan, carmustine aka BCNU), renal dysfunction, ototoxicity (really cisplat), and second cancers
category of drug- fludarabine and clofarabine
purine analogs aka anti metabolitesmech
category of drug= cytarabine
pyrimidine analog aka antimetabolite
drug that is known for radiation recall
gemcitabine
high doses of this drug can cause acute cerebellar syndrome - name drug and define syndrome
cytarbine. Nystagmus, ataxis, dysmetria, dysarthria, usually day 3-8, 30% of patients have residual defect
