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Pharm Fall > What Chemo Drugs DO > Flashcards

What Chemo Drugs DO Flashcards

1
Q

Bevacizumab: what it targets

A
  • Active against isoforms of VEGF

- Prevents activation and promotion of angiogenesis

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2
Q

Bevacizumab: adverse effects

A
  • GI bleeding
  • CNS hemorrhage
  • Vaginal bleeding
  • HTN
  • Bleeding episodes
  • Thrombotic events
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3
Q

Sunitinib/ Sorafenib: what it targets

A
  • inhibits VEGFR-2 and platelet derived growth factor receptor
  • Suni used for kidney CA, GI stromal tumor and pancreatic neuroendocrine tumors
  • Sora used for advanced kidney, liver, thyroid CA
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4
Q

Sunitinib/Sorafenib: adverse effects

A
  • CHF with sunitinib

- Hand-foot syndrome with sorafenib

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5
Q

Lapatinib: what it targets

A
  • inhibits BOTH intracellular kinase domains of EGFR (HER-1) and HER-2
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6
Q

Lapatinib: adverse effects

A
  • QT prolongation
  • increased diarrhea
  • hepatotoxicity
  • rash
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7
Q

Erlotinib: what it targets

A
  • EGFR-tyrosine kinase inhibitor that blocks signal transduction pathways
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8
Q

Erlotinib: adverse effects

A
  • Rash

- Diarrhea

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9
Q

Trastuzumab: what it targets

A
  • Binds to HER-2

- Used for metastatic breast CA

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10
Q

Trastuzumab: adverse effects

A
  • *Black box warning
  • Cardiac failure
  • Do not give with anthracene derivatives
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11
Q

Panitumumab: what it targets

A
  • EGFR ligand (binds to HER-1 receptor)

- Used for metastatic colon CA

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12
Q

Panitumab: adverse effects

A

Same as cetuximab

  • fatigue
  • GI complaints
  • Abd. pain
  • sudden death/ cardiopulmonary arrest
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13
Q

Cetuximab: what it targets

A
  • Binds specifically to EGFR (HER-1)

- Used for metastatic colorectal CA, neck and head CA

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14
Q

Cetuximab: adverse effects

A
  • fatigue
  • GI complaints
  • Abd. pain
  • Rarely sudden cardiac death
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15
Q

Alemtuzumab: what it targets

A
  • Directed against CD52

- Used for Bcell chronic lymphocytic leukemia

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16
Q

Alemtuzumab: adverse side effects

A
  • *Black Box Warning
  • opportunistic infections
  • severe infusion related reactions
  • hematologic toxicity
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17
Q

Ibritumomab/ Tositumomub: what it targets

A
  • Binds to CD20

- Used for relapsed/refractory low grade follicular or transformed Bcell non-hodgkin lymphoma

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18
Q

Ibritumomab/Tositumomub: adverse effects

A
  • severe infusion related rxns (anaphylaxis)
  • Thrombocytopenia
  • Neutropenia
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19
Q

Rituximab: what it targets

A
  • Binds to CD20

- Used for Non-hodgkins lymphoma and CLL

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20
Q

Rituximab: adverse effects

A

From the infusion related complex:

  • fever
  • chills
  • nausea
  • asthenia
  • headache
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21
Q

Vorinostat: what it does

A
  • Histone deacetylase inhibitor
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22
Q

Vorinostat: adverse effects

A
  • PE/DVT

- Dose related thrombocytopenia and anemia

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23
Q

Arsenic Trioxide: what it does

A

Helps with:

  • inducing the growth progression of cancerous cells into mature normal cells
  • induces apoptosis
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24
Q

Asparaginase: what it does

A

Enzyme which degrades L-asparagine and decreases its supply and also inhibits protein synthesis (leukemia)

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25
Q

Hydroxyurea: what it does

A

Inhibits ribonucleotide reductase. (inhibits DNA synthesis)

Used for sickle cell anemia and to lower patients WBC count before chemo

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26
Q

Hydroxyurea: adverse effects

A

At higher doses:

  • clastogenicity
  • mutagenicity
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27
Q

Bleomycin: what it does

A

Anti-tumor, antibiotic

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28
Q

Bleomycin: adverse effects

A
  • Pulmonary fibrosis

- Skin and Lung toxicities

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29
Q

Cisplatin/carboplatin/oxaliplatin: what they do

A

Kill cells by intercalating with the DNA

30
Q

Cisplatin: adverse effects

A
  • nephrotoxicity
  • ototoxicity
  • peripheral neuropathy
  • emesis
  • anemia
31
Q

Carboplatin: adverse effects

A
  • hematologic toxicity
  • renal damage
  • peripheral neuropathy
  • ototoxicity
  • N/V
    (not as bad as cisplatin)
32
Q

Oxaliplatin: adverse effects

A
  • moderate emesis
  • peripheral neuropathy
  • cold induced neuropathies
  • NOT nephrotoxic or ototoxic
33
Q

Carmustine (or BCNU)/ Lomustine (CCNU): what it does

A

Direct application to residual tumor tissue following surgical resection of brain tumors (IV or wafer)

34
Q

Bendamustine: what it does

A

Active against “quiet” AND dividing cells (lymphoid cancers like CLL and non-hodgkins)

35
Q

Cyclophosphamide/ifosfamide: what they do

A

Used for solid tumors and hematologic cancers

36
Q

Cyclophosphamide: adverse affects

A

In high doses it can cause hemorrhagic cystitis

37
Q

Ifosfamine: adverse affects

A
  • hemorrhagic cystitis
  • encephalopathy
  • CNS toxicity
38
Q

Mitoxantrone: what it does

A

Intercalating topoisomerase II inhibitor. Used in MS patients

39
Q

Mitoxantrone: adverse effects

A
  • Cardiotoxicity

- AML

40
Q

Doxorubicin/Daunorubicin/Idarubicin/Epirubicin: what it does

A

Intercalating topoisomerase inhibitors (insert or stack between base pairs in the DNA)

41
Q

Doxorubicin/Daunorubicin/Idarubicin/Epirubicin: adverse effects

A
  • AML
  • Ftal CHF in doses>400 (doxo)
  • *Administer Totect within a 6 hour window if the pt is at risk for these symptoms
42
Q

Etoposide/Teniposide: what they do

A

Damage tumor cells by causing strand breakage through inhibition of topoisomerase II

43
Q

Etoposide/Teniposide: adverse effects

A
  • Severe myelosupression with
  • infection or
  • bleeding
44
Q

Topotecan/Irinotecan: what they do

A

Through SN-38 (active metabolite) they inhibit topoisomerase I enzyme activity

45
Q

Topotecan/Irinotecan: adverse effects

A

Higher risk of diarrhea and neutropenia (can treat diarrhea with loperamide)

46
Q

Estramustine: what it does

A

Binds to microtubule associated proteins that are part of the structural support for microtubules. Binding causes the separation of the microtubules causing disassembly.(inhibit assembly)

47
Q

Epothilone/Ixabepilone: what it does

A

Binds to microtubules so they can not disassemble. Cannot pull the microtubules apart

48
Q

Epothilone/Ixabepilone: adverse effects

A

Similar to taxanes

49
Q

Paclitaxel/Docetaxel: what it does

A

Promotes microtubule assembly and therefore interfere with microtubule disassembly (prevent disassembly from happening)

50
Q

Paclitaxel: adverse effects

A
  • Myelosupression
  • increased neurotoxicity
  • hypersensitive reactions
  • premedicate with corticosteroids and antihistamines to decrease allergic reactions
  • DO NOT give to pt with neutrophils<1500
  • Do not give for solid tumors
51
Q

Docetaxel: adverse effects

A
  • myelosuppression
  • increased fluid retention
  • premedicate with corticosteroids
  • DO NOT give to pt with bilirubin>ULN or SGOT/SGPT>1.5ULN
52
Q

Vinca Alkaloids: what they do

A

Mitotic inhibitors. Inhibits assembly of microtubules

53
Q

Vinca Alkaloids: adverse effects

A

Increased risk of extravasation (apply heat if this occurs)

54
Q

Antifolates: what they do

A

Inhibit dihydrofolate reductase which reduce dietary folates. (floats are needed for DNA synthesis)

55
Q

Antifolates: adverse effects

A
  • neutropenia
  • thrombocytopenia
  • mucositis
  • hepatotoxicity
  • N/V
  • renal tubular necrosis with methotrexate (vigorous hydration!!!!)
56
Q

Cladribine: what it does

A

Antitumor activity affects both actively dividing and resting cancer cells. Resists deactivation by adenosine deaminase

57
Q

Cladribine: adverse effects

A
  • myelosupression

- increased risk of opportunistic infection

58
Q

Pentostatin: what it does

A

Inhibits adenosine deaminase

59
Q

Pentostatin: adverse effects

A
  • Pulmonary toxicity if given with fludarabine

- Dose limiting severe renal, liver, pulmonary and CNS toxicities

60
Q

Fludarabine: what it does

A

Interferes with DNA polymerase, causing chain termination

61
Q

Fludarabine: adverse effects

A

Dose limiting toxicity:

  • myelosupression
  • increased risk of opportunistic infection
62
Q

Mercaptopurine/Thioguanine: what they do

A

Converted to ribonucleotides that inhibit purine biosynthesis. (TPMT)

63
Q

Mercaptopurine/ Thioguanine: adverse effects

A
  • hepatic toxicity
  • myelosuppression
  • Mercaptopurine metabolism is decreased by xanthine oxidase inhibitor (allopurinol). Make sure you reduce it by 75% when administered together and monitor
64
Q

Azacytidine/Decitabine: what they do

A
  • Slows progression of myelodisplastic syndrome to AML

- Reduce tranfusion requirements an allows for normal hematopoiesis

65
Q

Azacytidine/Decitabine: adverse effects

A

Myelosuppresion

66
Q

Gemcitabine: what it does

A

Inhibits DNA polymerase activity and ribonucleotide reductase

67
Q

Cytarabine: what it does

A

Phosphorylated to its active form within tumor cells which inhibit DNA polymerase (responsible for strand elongation)

68
Q

Cytarabine: adverse effects

A

Dose dependent

  • cerebellar syndrome of dysarthria, nystagmus and ataxia
  • bone suppression w/ leukopenia, thrombocytopenia and anemia
  • N/V
  • and. pain
  • oral ulceration
  • hepatic dysfunction
69
Q

Capecitabine: what it does

A

Orally active pyrimidine analog of uracil and is a prodrug of 5-FU

70
Q

Capecitabine: adverse effects

A
  • *Black box warning: monitor INR if pt is on coumadin. Increased risk of bleeding!
  • neutropenia
  • thrombocytopenia
  • anemia
  • Hand-foot syndrome
  • diarrhea
71
Q

5-Fluorouracil: what it does

A

Phosphorylated to fluorodeoxyuridine monophosphate which binds tightly and interferes with the function of THYMIDYLATE SYNTHESIS which is required for synthesis of thymidine

Pharm Fall (12 decks)

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