Sketchy Pharm: Cladribine, Cytarabine, Gemcitabine

Question 1

What is the mechanism of cladribine?

Answer 1

It is a purine analog that inhibits DNA polymerase.

(Think of the cave man CLAD in beaR skIN with the hammer that looks like a purine molecule.)

Unlike AMP and GMP, it cannot be broken down by adenosine deaminase and so reaches high intracellular levels.

Question 2

All three of these drugs inhibit which phase of the cell cycle?

Answer 2

S phase (like the Stone phase plaque with the forked DNA molecule over Africa)

Question 3

What are the side effects of cytarabine, cladribine, and gemcitabine?

Answer 3

Immunosuppression (like the broken bone –representing myelosuppression –and the older woman behind the man with the cane)

Question 4

Cytarabine works by what mechanism?

Answer 4

It is a pyrimidine analog that also inhibits S phase.

Think of the pyrimidine-shaped hexagons on the fur of the saber-tooth TYger.

Question 5

Cytarabine is only used to treat ________________.

Answer 5

hematologic malignancies (like the archers and knights on the cave wall behind the tiger)

Question 6

How does gemcitabine work?

Answer 6

It is a pyrimidine analog just like cytarabine (which is why the GEMs are near the TYger).

Question 7

In which cancers is gemcitabine used?

Answer 7

Solid and hematologic cancers (because the gems are solid and tumor-like, but they’re also next to the heme cave)