Pharmacology for Hematology Oncology Flashcards

1
Q

Heparin mechanism

A

cofactor for antithrombin: II, Xa decr

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2
Q

Used to monitor heparin

A

PTT

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3
Q

rapid reversal of heparin

A

protamine sulfate

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4
Q

Enoxaparin

A

LMWH

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5
Q

dalteparin

A

LMWH

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6
Q

mechansim, advantage of LMWH

A

acts on Xa, no lab monitoring, not reversible

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7
Q

Mechanism of HIT

A

antibody-heparin-PF4 complex (IgG)

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8
Q

Argatroban

A

hirudin (leech derivative)- HIT alternative

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9
Q

bivalirudin

A

hirudin (leech derivative)- HIT alternative

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10
Q

Used to monitor warfarin

A

PT

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11
Q

Used to reverse warfarin

A

Vit K, fres frozen plasma

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12
Q

Apixaban

A

Factor Xa inhibitor

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13
Q

rivaroxaban

A

Factor Xa inhibitor

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14
Q

Aminocaproic acid

A

used to treat thrombolytic toxicity

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15
Q

Alteplase

A

tPA, thrombolytic

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16
Q

retelplase

A

rPA, thrombolytic

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17
Q

tenecteplase

A

TNK-tPA, thrombolytic

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18
Q

Aspirin overdose

A

respiratory alkalosis superimposed by metabolic acidosis

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19
Q

Clopidogrel

A

irreversible ADP receptor and GPIIb/IIIa inhib

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20
Q

ticopidine

A

irreversible ADP receptor and GPIIb/IIIa inhib

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21
Q

Prasugrel

A

irreversible ADP receptor and GPIIb/IIIa inhib

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22
Q

ticagrelor

A

irreversible ADP receptor and GPIIb/IIIa inhib

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23
Q

Use of ADP receptor inhibitors (3)

A

acute coronary syndrome, coronary stenting, thrombotic stroke prevention

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24
Q

Toxicity of ADP receptor inhibitors

A

neutropenia, TTP/HUS

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25
Q

cilostazol

A

PDEIII inhib

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26
Q

dipryrimadole

A

PDEIII inhib

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27
Q

Mechanism of PDEIII inhib

A

Incr cAMP in platelets, inhib plt aggregation, vasodilation

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28
Q

use of PDEIII Inhib

A

intermittent claudication, coronar vasodilation, prevent stroke, TIA, angina

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29
Q

Toxicity of PDEIII inhib

A

Nausea, headache, facial flushing, hypotension, abd pain

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30
Q

Abciximab

A

GPIIb/IIIa inhib (monoclonal Ab)

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31
Q

Eptifibatide

A

GPIIb/IIIa inhib

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32
Q

Tirofiban

A

GPIIb/IIIa inhib

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33
Q

Leucovorin use

A

reverses myelosuppresion assoc with MTX (folinic acid)

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34
Q

MTX mechanism

A

Folic acid analog; inhib dihydrofolate reductase; decr dTMP

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35
Q

MTX uses

A

leukemia, lymphoma, choriocarcinoma, sarcoma

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36
Q

MTX toxicity

A

myelosuppression, macrovesicular fatty change in liver, mucositis, teratogenic

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37
Q

5-FU mechanism

A

pyrimidine analog; inhibits thymidylate synthase

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38
Q

5-FU uses

A

colon cancer, pancreatic cancer, basal cell

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39
Q

5-FU toxicity

A

myelosuppression, photosensitivity

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40
Q

cytarabine mechanism

A

pyrimidine analog

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41
Q

cytarabine uses

A

leukemia, lymphoma

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42
Q

cytarabine toxicity

A

leukopenia, thrombocytopenia, megalobastic anemia

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43
Q

6-MP, 6-TG mechanism

A

purine (thiol) analog

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44
Q

Aspirin overdose

A

respiratory alkalosis superimposed by metabolic acidosis

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44
Q

Aspirin overdose

A

respiratory alkalosis superimposed by metabolic acidosis

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45
Q

Clopidogrel

A

irreversible ADP receptor and GPIIb/IIIa inhib

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45
Q

Clopidogrel

A

irreversible ADP receptor and GPIIb/IIIa inhib

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46
Q

ticopidine

A

irreversible ADP receptor and GPIIb/IIIa inhib

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46
Q

ticopidine

A

irreversible ADP receptor and GPIIb/IIIa inhib

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47
Q

Prasugrel

A

irreversible ADP receptor and GPIIb/IIIa inhib

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47
Q

Prasugrel

A

irreversible ADP receptor and GPIIb/IIIa inhib

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48
Q

ticagrelor

A

irreversible ADP receptor and GPIIb/IIIa inhib

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48
Q

ticagrelor

A

irreversible ADP receptor and GPIIb/IIIa inhib

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49
Q

Use of ADP receptor inhibitors (3)

A

acute coronary syndrome, coronary stenting, thrombotic stroke prevention

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49
Q

Use of ADP receptor inhibitors (3)

A

acute coronary syndrome, coronary stenting, thrombotic stroke prevention

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50
Q

Toxicity of ADP receptor inhibitors

A

neutropenia, TTP/HUS

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50
Q

Toxicity of ADP receptor inhibitors

A

neutropenia, TTP/HUS

51
Q

cilostazol

A

PDEIII inhib

51
Q

cilostazol

A

PDEIII inhib

52
Q

dipryrimadole

A

PDEIII inhib

52
Q

dipryrimadole

A

PDEIII inhib

53
Q

Mechanism of PDEIII inhib

A

Incr cAMP in platelets, inhib plt aggregation, vasodilation

53
Q

Mechanism of PDEIII inhib

A

Incr cAMP in platelets, inhib plt aggregation, vasodilation

54
Q

use of PDEIII Inhib

A

intermittent claudication, coronar vasodilation, prevent stroke, TIA, angina

54
Q

use of PDEIII Inhib

A

intermittent claudication, coronar vasodilation, prevent stroke, TIA, angina

55
Q

Toxicity of PDEIII inhib

A

Nausea, headache, facial flushing, hypotension, abd pain

55
Q

Toxicity of PDEIII inhib

A

Nausea, headache, facial flushing, hypotension, abd pain

56
Q

Abciximab

A

GPIIb/IIIa inhib (monoclonal Ab)

56
Q

Abciximab

A

GPIIb/IIIa inhib (monoclonal Ab)

57
Q

Eptifibatide

A

GPIIb/IIIa inhib

57
Q

Eptifibatide

A

GPIIb/IIIa inhib

58
Q

Tirofiban

A

GPIIb/IIIa inhib

58
Q

Tirofiban

A

GPIIb/IIIa inhib

59
Q

Leucovorin use

A

reverses myelosuppresion assoc with MTX (folinic acid)

59
Q

Leucovorin use

A

reverses myelosuppresion assoc with MTX (folinic acid)

60
Q

MTX mechanism

A

Folic acid analog; inhib dihydrofolate reductase; decr dTMP

60
Q

MTX mechanism

A

Folic acid analog; inhib dihydrofolate reductase; decr dTMP

61
Q

MTX uses

A

leukemia, lymphoma, choriocarcinoma, sarcoma

61
Q

MTX uses

A

leukemia, lymphoma, choriocarcinoma, sarcoma

62
Q

MTX toxicity

A

myelosuppression, macrovesicular fatty change in liver, mucositis, teratogenic

62
Q

MTX toxicity

A

myelosuppression, macrovesicular fatty change in liver, mucositis, teratogenic

63
Q

5-FU mechanism

A

pyrimidine analog; inhibits thymidylate synthase

63
Q

5-FU mechanism

A

pyrimidine analog; inhibits thymidylate synthase

64
Q

5-FU uses

A

colon cancer, pancreatic cancer, basal cell

64
Q

5-FU uses

A

colon cancer, pancreatic cancer, basal cell

65
Q

5-FU toxicity

A

myelosuppression, photosensitivity

65
Q

5-FU toxicity

A

myelosuppression, photosensitivity

66
Q

cytarabine mechanism

A

pyrimidine analog

66
Q

cytarabine mechanism

A

pyrimidine analog

67
Q

cytarabine uses

A

leukemia, lymphoma

67
Q

cytarabine uses

A

leukemia, lymphoma

68
Q

cytarabine toxicity

A

leukopenia, thrombocytopenia, megalobastic anemia

68
Q

cytarabine toxicity

A

leukopenia, thrombocytopenia, megalobastic anemia

94
Q

6-MP, 6-TG mechanism

A

purine (thiol) analog

95
Q

What activates 6-MP

A

HGRPT

96
Q

What metabolizes 6-MP and what increase toxicity

A

xanthine oxidase; allopurinol

97
Q

Dactinomycin mechanism

A

intercalates DNA

98
Q

Dactinomcyin uses

A

Wilms tumor, Ewing sarcoma, rhabdomyosarcoma (Childhood tumors)

99
Q

Doxorubicin mechanism

A

free radicals– intercalate DNA

100
Q

Doxorubicin toxicity

A

cardiotoxicity, myelosuppression, alopecia

101
Q

Dexrazoxane

A

used to prevent cardiotoxicity of doxorubicin

102
Q

bleomycin mechanism

A

free radical– DNA break

103
Q

bleomycin uses

A

testicular cancer, hodgkin lymphoma

104
Q

bleomycin toxicity

A

pulm fibrosis, mucositis, skin change

105
Q

cyclophosphamide, iphosphamide mechanism

A

covalently x-link DNA at guanine N-7

106
Q

cyclophosphamide toxicity

A

hemorrhagic cystitis, myelosuppression

107
Q

mesna

A

used to prevent hemorrhagic cystitis by cyclophsophamide

108
Q

carmustine, lomustine, semustine

A

nitrosurea

109
Q

streptozocin

A

nitrosurea

110
Q

nitrosurea mechanism

A

cross-link DNA, cross-link DNA

111
Q

nitrosurea uses

A

brain tumors

112
Q

nitrosurea toxicity

A

CNS (convulsions, dizziness, ataxia)

113
Q

busulfan mechanism

A

cross-link DNA

114
Q

busulfan use

A

CML

115
Q

busulfan toxicity

A

sever myelosuppression, pulm fibrosis, hyperpigmentation

116
Q

vincristine, vinblastine mechanisms

A

vinca alkaloid, b-tubulin inhibition

117
Q

vincristine toxicity

A

neurotox (areflexia, peripheral neuritis), paralytic ileus

118
Q

paclitaxel mechanism

A

hyperstabilizes polymerized microtubules

119
Q

paclitaxel use

A

ovarian, breast cancer

120
Q

cisplatin, carbolplatin mechanism

A

cross-link DNA

121
Q

cisplatin use

A

testicular, bladder, ovary, lung carcinoma

122
Q

amofostine

A

used to prevent cisplatin toxicity

123
Q

cisplatin toxicity

A

nephrotoxicity, acoustic nerve damage

124
Q

Etopside, teniposide mechanism

A

inhibit topoisomerase II

125
Q

irinotecan, topotecan mechansim

A

inhibit topoisomerase I

126
Q

irinotecan use

A

colon cancer

127
Q

topotecan use

A

ovarian, small cell lung cancer

128
Q

hydroxuyrea mechansim

A

inhibit ribonucleotide reductase, decr DNA synth

129
Q

hydroxurea uses

A

melanoma, CML, sickle cell

130
Q

predinsone mechanism

A

trigger apoptosis

131
Q

prednisone use

A

CLL, NHL

132
Q

tamoxifen mechanism

A

SERM, partial agonist of endometrium

133
Q

raloxifene mechansim

A

SERM, endometrial antagonist

134
Q

Trastuzumab mechanism

A

HER-2 monoconal Ab

135
Q

Trastuzumab toxicity

A

cardiotoxicity

136
Q

Imantinib toxicity

A

fluid retention

137
Q

rituximab target

A

CD20

138
Q

vemurafenib mechanism

A

small mol inhib of B-Raf kinase, V600E mut

139
Q

vemurafenib toxicity

A

metastatic melanoma

140
Q

bevacizumab mechanism

A

monoconal Ab against VEGF