Pharmacology

Question 1

Temozolomide

Temodar

Answer 1

Class: nonclassic alkylating agent
MOA: methylates guanine residues in DNA and inhabits DNA,RNA, and protein synthesis. Does not cross-linked DNA strands
Side effects: Myelosuppression, N/V, Headache/fatigue, photosensitivity, mild elevation in hepatic transaminases, teratogenic, mutagenic, carcinogenic
Indications: refractory anaplastic astrocytoma, GBM, metastatic melanoma.
Route: oral

Question 2

Procarbazine

Matulane

Answer 2

Class: nonclassic alkylating agent
MOA: inhibits DNA, RNA, and protein synthesis
Side effects: Myelosuppression, N/V, flu like symptoms, CNS toxicity, hypersensitivity, amenorrhea, immunosuppressive, secondary malignancies
Indications: Hodgkins, non-hodgkins lymphoma, brain tumors, cutaneuos T-cell lymphoma.
Route: oral

Question 3

Lomustine

CCNU

Answer 3

Class: Alkylating agent
MOA: metabolites interfere w/synthesis and function of DNA, RNA, and proteins
Side effects: Myelosuppression, N/V, anorexia, impotence, pulmonary toxicity, pulmonary issues, renal toxicity, neurotoxicity, secondary malignancies, alopecia
Indications: Brain tumors, Hodgkins, non-hodgkins lymphoma
Route: oral

Question 4

Etoposide

VePesid

Answer 4

Class: Epipodophyllotoxin, topoisomerase II inhibitor
MOA: Inhibits topoisomerase II by stabilizing the topoisomerase II-DNA
Side effects: Myelosuppression, N/V, Anorexia, alopecia, mucositis, diarrhea, hypersensitivity, metallic taste, inflammation, skin changes, secondary malignancies
Indications: Germ cell, small cell, non small cell, non-hodgkins, hodgkins, gatric cancer
Route: IV- testicular, small cell
Oral: small cell lung

Question 5

Pegfilgrastim

Neulasta

Answer 5

Class: Colony- stimulating growth factor, cytokine
MOA: enhances neutrophil chemotaxis and phagocytosis
Side effects: bone pain, hypersensitivity, leukocytosis, elevations in LDH, Alkaline phosphatase, uric acid
Indications: Adjunct to myelosuppression chemo
Route: Subcutaneous

Question 6

Bevacizumab

Avastin

Answer 6

Class: Monoclonal antibody, anti-VEGF- antibody
MOA: monoclonal antibody that binds to vascular endothelial growth factor
Side effects: Hemorrhage, hypertension, protienurea, delayed wound healing, thromboembolism, GI perforation, local phlebitis
Route: IV

Question 7

Carmustine polymer wafer

Answer 7

implanted into the surgical cavity after the tumor is removed; provides direct drug to the site of the tumor site with the benefit of minimal system toxicity

Question 8

Cisplatin (Platinol)

Answer 8

Class: Platinum compound
MOA: Alkylating agent that interferes with DNA replication by producing DNA crosslinks
Side effects: Nausea, vomiting, neuropathy, hearing loss, tinnitus, peripheral neuropathy, fatigue, electrolyte imbalance, renal failure, neutropenia, thrombocytopenia and hair loss
Route: IV

Question 9

Carboplatin (Paraplatin)

Answer 9

Class: Platinum compound
MOA: Alkylating agent that interferes with DNA replication by producing DNA crosslinks
Side effects: Nausea, vomiting, fatigue, hair loss, tinnitus, loss of appetite, peripheral neuropathy, neutropenia, and thrombocytopenia
Route: IV

Question 10

Vincristine

Answer 10

Class:
MOA: A plant alkaloid that inhibits mitosis
Side effects: decreased peristalsis, abdominal pain, and paralytic ileus,
Route: IV

Question 11

Irinotecan (CPT-11)

Answer 11

Class: Topoisomerase Inhibitor
MOA: prevents the uncoiling of DNA
Side effects: nausea, vomiting, fatigue, neutropenia, thrombocytopenia, and hair loss
Route: IV

Question 12

Methotrexate

Answer 12

Class:
MOA: folic acid inhibitor
Side effect: Nausea, vomiting, loss of appetite, mucositis, oral and GI ulceration, fatigue, pulmonary fibrosis
Route: IV, Oral, IT

Question 13

Phenytoin (Dilantin)

Answer 13

Class: Antiepileptic
MOA: Selective inhibition of sodium channels.
Therapeutic levels: 10-20 mpg/mL
Side effects:gingival hyperplasia, CNS effects ( sedation, ataxia, diplopia, staggering gait, nystagmus, cognitive impairment). Dermatologic effects (measles-like rash). Cardiovascular effects ( dysrhythmias, hypotension)

Question 14

Valproic Acid (Depakote)

Answer 14

Class: Antiepilectic
MOA: suppression of high-frequency neuronal firing through blockade of sodium channels.
Therapeutic levels: 50-100 mpg/mL
Side effects: GI (N/V, indigestion). Hepatotoxicity, Pancreatitis, Hyperammonemia, rash, weight gain, hair loss, tremor, blood dyscrasias

Question 15

Levetiracetam (Keppra)

Answer 15

Class: Antiepilectic
MOA: unknown. we know it does not bind to receptors for GABA.
Therapeutic levels: ?
Side effects: drowsiness, asthenia, agitation, anxiety, psychosis.

Question 16

Lacosamide (Vimpat)

Answer 16

Class: Antiepilectic
MOA: slow inactivation of sodium channels
Therapeutic levels: ?
Side effects: dizziness, headache, diplopia, nasopharyngitis, vomiting, fatigue, incoordination, blurred vision, confusion.

Question 17

Ondansetron (Zofran)

Answer 17

Class: Antiemetic
MOA: Serotonin receptor antagonists
Therapeutic levels: ?
Side effects: headache, dizziness, diarrhea,

Question 18

Granisetron (Kytril)

Answer 18

Class: Antiemetic
MOA: Serotonin receptor antagonists
Therapeutic levels:
Side effects: headache, dizziness, diarrhea, constipation

Question 19

Aprepitant (Emend)

Answer 19

Class: Antiemetic
MOA: blockade of neurokinin 1-type receptors
Therapeutic levels:
Side effects: headache, dizziness, diarrhea, hiccups

Question 20

Osimertinib Tagrisso

Answer 20

Class: kinase inhibitors
MOA: to treat non-small cell lung cancer (NSCLC). TAGRISSO may be used when your non-small cell lung cancer has spread to other parts of the body; certain type of abnormal epidermal growth factor receptor (EGFR) gene, called T790M
Therapeutic levels:
Side effects: lung problems, heart problems, eye problems, diarrhea, rash, dry skin, changes in your nails, including: redness, tenderness, pain, inflammation, brittleness, separation from nailbed, and shedding of nails, tiredness