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Antineoplastic Drugs Flashcards

(60 cards)

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1
Q

Methotrexate MOA

A

-inhibition of DHF reductase
(“meat sticks chef trying to replace the folate leafs”)

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2
Q

Methotroxate is useful in treating ...

A

-cancers
(“Cracked crab”)

-MTX with misoprostol used as abortifacient and ectopic pregnancy

(“Empty uterus backpack”)
(“baby keychain on the side”)

-invasive molar pregnancy, trophoblastic tumors and choriocarcinoma
(“Mole keychain”)

-Methotrexate treats psoriasis
(“Silver knee/elbow pads”)

-Methotrexate is first line treatment for rheumatoid arthritis or DMARD
(“Joint lantern with flame”)

-used for immunosuppressive therapy such as IBD, SLE, vasculitis, dematomyositis
(“Torn antibody latern”)

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3
Q

Methotrexate Side Effects

A

-folate deficiency
(“Foliage falling”)

-megaloblastic anemia
(“Blasting firework lantern”)

-pancytopenia, myelosuppression
(“Falling pan of sushi:”)

-immunosuppressed have increased risk for infection
(“Cane”)

-lung fibrosis (restrictive lung dz)
(“Fibrotic lung bonsai”)

  • hepatotoxicity, monitor LFTs
    (“Liver spot on apron”)

-causes baldness
(“Bald guy”)

  • mucositis
    (“Guy eating hot meat stick”)
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4
Q

what is the antidote for Methotroxate toxcity ?

A

folinic acid

(“Lucky feline”)

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5
Q

5’-Fluorouracil MOA

A

inhibits thymidylate synthase to block thymidine production

  • increase dUMP via inhibition of thymidylate synthase
    (“Buildup of dumpling plates”)

(“Full guy”)

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6
Q

5’-Fluorouracil Side Effects

A

-diarrhea
(“Stained pants”)

-photosensitivity and rash
(“Sensitive photos”)

-increases myelosuppression and infection
(“Falling pan of sushi”)

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7
Q

5 -Fluorouracil Antidote

A

NO ANTIDOTE! MUAHAHAHAHA!!!!!!!

(“Knocked over cat”)

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8
Q

Hydroxyurea MOA

(“Hydro rock area”)

A

ribonucleotide reductase inhibitor, blocks thymidine synthesis

  • ribonucleotide reductase converts UDP to deoxy-UDP
    (“Crossed out OXY”)
  • UDP (uridine diphosphate) is precursor to pyrimidine nucleosides
    (“UDP sign”)

(“inhibited wait list waitress”)

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9
Q

Hydroxyurea can treat …

A

sickle cell anemia

  • increase HbF, protection against HbS
    (“Raised baby with Hb coin”)

(“Zen sickle”)

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10
Q

Hydroxyurea Side Effect

A

myelosuppression and increased infection side effect
(“Falling pan of sushi”)

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11
Q

6 Mercaptopurine MOA

(“CAPTured gypsy”)

A

Azathioprine is prodrug
(“AZmeralda”)
——————————————————————————–
-cytotoxic purine analog

  • need HGPRT (enzyme) to activate 6-MP

(“HiGh Priest”)

​-block synthesis of IMP
(“captive toppling imp”)

-inhibits DNA synthesis, blocks S phase
(“broken stair way”)

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12
Q

6-Mercaptopurine can treat …

A

hematogenous malignancies

  • ALL
    (“stained glass window with crabs, antibody archers and T knights”)

​​-used for immunosuppressive therapies

  • SLE
  • ​grafts
  • ​ inflammations

(“torn lanterns with antibodies and bone”)

-rheumatoid arthritis, DMARD
(“bone lantern”)

-Inflammatory Bowel Disease
(“inflamed colonic lanterns”)

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13
Q

6-Mercaptopurine Side Effects

A

-bone marrow suppression
(“nun with bone tray feeding bird”)

-immunosuppression and increased risk for infection monitor pt with CBCs
(“statue with cane”)

-pancreatitis
(“pancreas sponge”)

-hepatotoxicity or hepatitis
(“liver stain on apron”)

-allopurinol inhibits breakdown of 6 mercaptopurine and azathioprine increasing risk of toxicity

  • may cause a mild rash
    (“purine bead necklace”)
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14
Q

Mycophenolate Mofetil MOA

(“quasimoto”)

A

-IMP dehydrogenase inhibitor

  • decrease GMP synthesis, decreased lymphocyte production
    (“knocking over GruMPy statue”)
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15
Q

Mycophenolate Mofetil is used to treat …

(“Quasimoto”)

A

-for immunosuppressive therapy

  • grafts
  • SLE
  • MG
  • rheumatoid arthritis (DMARD)

(“swinging on lanterns”)

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16
Q

Mycophenolate Mofetil Side Effects

(“Quasimoto”)

A

-GI effects
(“nauseated quasi-mofetil”)

-immunosuppressive side effects
(“nuns”)

-increased infection in immunosuppressed
(“cane”)

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17
Q

Cladribine, Cytarabine, Gemcitabine MOA

A

-inhibit DNA polymerase → inhibit the S phase of the cell cycle

(“Cracked replication fork”)
(“Stone Phase”)

  • cytarabine and gemcitabine are pyrimidine analogs
    (“Pyrimidine shapes”)
  • ​cladribine is a purine analog
    (“Purine shaped hammer”)
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18
Q

Cladribine can treat …

A

hairy cell leukemia

(“Hairy caveman”)

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19
Q

Cytarabine can treat …

A

only active against hematologic malignancies

(“Scratched out antibody archers and T-cell swordsman”)

  • AML
  • ​ non-Hodgkin lymphoma
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20
Q

Gemcitabine can treat…

(“gems inside geode”)

A
  • active against both hematologic malignancies and
  • *solid** tumors

(“Cracked crab fossil on solid rocks”)

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21
Q

Cladribine, Cytarabine, Gemcitabine Side Effects

A

-can cause immunosuppression and increased risk of infection
(“Immunosuppressed cane”)

-can cause myelosuppression
(“Broken marrow”)

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22
Q

Name the Alkylating agents

A

Cyclophosphamide
(“Cyclops Polyphemus”)

Busulfan
(“Beautiful sirens”)

Nitrosureas
(“Mustang”)

  • Carmustine
  • ​Lomustine

​Ifosfamide

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23
Q

Cyclophosphamide
Busulfan
Nitroureas
MOA

A

alkylating agents donate an alkyl group → DNA cross-links

  • cell cycle NON-specific

**Cyclophosphamide is activated by CYP450**

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24
Q

Cyclophosphamide can be used to treat …

A

treats many hematologic and solid malignancies

  • leukemias and lymphomas,
  • breast cancer,
  • ​ ovarian cancer
    (“Torn cancer crab”)

potent immunosuppressive therapy
treatment of

  • nephrotic syndrome,
  • nephritic syndrome,
  • vasculitis,
  • ​autoimmune hemolytic anemia
    (“Torn antibody”)
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25
Cyclophosphamide **Side Effects**
can cause **myelosuppression** ("Broken marrow") -can cause **hemorrhagic cystitis** ("Red urine kid fountain") * co-administration of 2-mercaptoethanesulfonate **(MESNA)** prevents _hemorrhagic cystitis_ ("Protective maze surrounding red urine fountain") -increases risk of **bladder cancer** ("Cancer crab belt buckle") * high grade transitional cell carcinoma can cause **hyponatremia** due to **SIADH** ("Inappropriately wet head") -cause **infertility** and **premature menopause** ("Dried up fruit tree") ​ ​
27
Busulfan can be used to treat ... | ("beautiful sirens")
useful as a conditioning agent **prior to bone marrow transplantation** ("Severely depleted marrow")
28
**Nitrosoureas** Carmustine Lomustine ("Mustang Centaurs") Streptozotocin ("Striped zebra centaur") are used to treat ...
**highly lipophilic** →cross BBB → treat **brain tumors** * glioblastoma multiform ("Brain tree")
29
**Nitrosoureas** Carmustine Lomustine ("Mustang Centaurs") Streptozotocin ("Striped zebra centaur") **Side Effects**
can cause **neurotoxicity ("**Dizzy centaur") * convulsions * dizziness * ​ataxia
30
Busulfan **Side Effects** | ("Beautiful Sirens")
-can cause **lung toxicity** * acute lung injury * interstitial fibrosis * ​alveolar hemorrhage -can cause a **hyperpigmentation** reaction ("Beautiful TAN sirens")
31
Name **Cytotoxic Platinum** analogs
* *Cis**platin * *Carbo**platin * *Oxali**platin
32
Cisplatin Carboplatin Oxaliplatin **MOA**
bind DNA and form **intrastrand** and **interstrand** cross-links | ("Cross-linked helix necklace")
33
Cisplatin Carboplatin Oxaliplatin can treat ...
treat various **solid malignancies** * non-small cell lung cancer, * ​ small cell lung cancer, * ​ testicular cancer, * ​ovarian cancer, bladder cancer | ("Crumpled crab")
34
Cisplatin Carboplatin Oxaliplatin **Side Effects**
can cause **ototoxicity →** especially cisplatin * sensorineural hearing loss, tinnitus ("Ototoxic earrings") can cause **neurotoxicity**→especially cisplatin * peripheral neuropathy ("Neuropathic gloves") can cause **nephrotoxicity** → especially cisplatin * acute kidney injury ("Nephrotoxic purse") * ​_amifostine_ (an organic thiophosphate) can **prevent** cisplatin-induced _nephrotoxicity_ ("Amethyst") → scavenges free radicals produced by cisplatin in the kidney (“Free, rare”) * _​IV saline diuresis_ prevents cisplatin-induced nephrotoxicity ("saline fluids") -can cause **acute tubular necrosis** * muddy brown casts ("Muddy drain tube") -can cause **immunosuppression** and increased risk of infection→especially carboplatin ("Immunosuppresed cane") ​ -can cause **myelosuppression**→especially carboplatin ("Depleted bone jewelry box") ​
35
Name the Kinase Inhibitors | ("Broken nib")
**Ima**tinib ("Imitating") **Erlo**tinib ("Earl Geoffrey") **Suni**tinib ("Rising sun") **Sora**fenib ("Soaring eagle") **Vemura**fenib ("Venom")
36
Imatinib ("Imitating") **MOA**
**tyrosine kinase** inhibitor ("Inhibited tire swing") * imatinib blocks the tyrosine kinase domain of the **BCR/ABL** fusion protein →in **CML** ("BREAKABLE") * ​imatinib blocks the **c-kit** tyrosine kinase →in **GIST** ("Congress kit")
37
**Imatinib** can be used to **treat**
-treat a variety of **hematologic** and **solid malignancies** * **chronic myeloid leukemia -CML** (increased levels of mature granulocytes – eosinophils, neutrophils, basophils [[BCR/ABL]] ("Copious pink, white, and blue granules") * ​gastrointestinal stromal tumors **(GIST)** [[c-kit]] ("Crab buttons on belly") | ("Cracked crab")
38
Imatinib **Side Effects**
can cause **fluid retention**→ **ankle** and **periorbital edema** ("Baggy pantaloons")
39
Erlotinib **MOA** | ("British Earl")
Blocks the epidermal growth factor receptor **(EGFR)** tyrosine kinase ("Earl Geoffrey")
40
Erlotinib ("British Earl")
treats solid tumors with EGFR overexpression * e.g. non-small cell lung cancer – **NSCLC** ("Big lapel with crab badge")
41
Erlotinib **Side Effects**
can cause a **papulopustular acneiform rash** ("Spotty rash") can cause **diarrhea** ("Muddy pantaloons")
42
Sunitinib/Sorafenib **MOA** ("Rising sun") ("Soaring eagle")
inhibits the vascular endothelial growth factor receptor →**VEGFR** tyrosine kinase | ("Inhibiting vegetables")
43
Sunitinib and Sorafenib can treat...
cancer with **VEGFR** overexpression * e.g. r**enal cell carcinoma** ("Flank crab buckles")
44
sunitinib and sorafenib **Side effects**
can cause **hyperkeratosis** and **skin rashes** VEGF-targeted therapies are associated with an increased **risk of hemorrhage** ("Bleeding wound") | ("Callused and sunburned")
45
Vemurafenib **MOA** | ("Venom")
-blocks **B-Raf** kinase | ("B. Fra")
46
Vemurafenib can treat...
vemurafenib treats V600E BRAF positive **malignant melanoma** | ("Disseminated ink")
47
Name the Monoclonal Antibodies used in treatment of Cancer
**Rituximab** ("coronation ritual") **Cetuximab** ("tusks") **Bevacizumab** ("Beverage lady") **Alemtuzumab** ("Alms") **Trastuzumab** ("Tapestry weaver")
48
Rituximab **MOA**
Rituximab and Cetuximab are **chimeric monoclonal antibodies** ("Chimera sigil") binds **CD20** on B-cells ("Grabbing “XX” straps") rituximab **depletes B cells** (binds CD20) ("Pulling down antibody archer")
49
**Rituximab** can be used to treat ...
treats **chronic lymphocytic leukemia (CLL)** ("Chronic tapestry with antibody archers and T knights") - rituximab treats **rheumatoid arthritis** * disease modifying anti-rheumatic drug – DMARD ("Rheumatic lantern") -is useful for i**mmunosuppressive therapy** (e.g. microscopic polyangiitis, Wegener’s granulomatosis) ("Torn antibody")
50
Rituximab **Side Effects**
can cause i**mmunosuppression** and increased risk of **infection** ("Immunosuppressed cane") -may be associated with a higher risk of progressive multifocal leukoencephalopathy **(PML)** ("White laurel leaves") -can cause an **infusion reaction** (e.g. headache, fever, skin rash, pruritus, dyspnea, hypotension) ("Swollen cherub with ivy") -chimeric antibodies (e.g. rituximab, rarely cetuximab) can cause **serum sickness** e.g. fever, rash, arthralgia **within 7-10 days** ("Delayed onset poisoning")
51
Cetuximab **MOA** | ("Tusks")
binds the epidermal growth factor receptor **(EGFR)** * EGFR is a receptor **tyrosine kinase** ("Tire swing") | ("Giraffe")
52
Cetuximab **can treat ...**
treats **solid tumors** * e.g. colorectal cancer, squamous cell carcinoma ("Cracked crab")
53
Cetuximab **Side Effects**
can cause a **papulopustular acneiform rash** ("Red spots")
54
Bevacizumab **MOA** | ("Beverage Lady")
binds **VEGF** * inhibits growth of blood vessels in tumors binds VEGF ("Chopping vessels") | ("Chopped vegetables")
55
Bevacizumab can treat ...
treats **metastatic tumors** * e.g. colorectal cancer, squamous cell carcinoma ("Cracked crab") -treats **wet macular degeneration** ("Wet center of retina pillow")
56
Bevacizumab **Side Effects**
-can cause **bleeding** ("Blood spatter") -increases the risk for **thrombotic events** ("Ice clots")
57
Alemtuzumab **MOA** | ("Alms")
-binds **CD52** on B and Tcells **depletes B** and **T** cells (binds CD52) ("Pulling down antibody archer and T knight") | ("52 pattern")
58
Alemtuzumab can treat...
treats **chronic lymphocytic leukemia (CLL)** ("Chronic tapestry with antibody archers and T knights")
59
Trastuzumab **MOA** | ("Tapestry weaver")
binds **epidermal growth factor receptor 2** * HER2, c-erbB2 * ​HER2 is a receptor tyrosine kinase ("Tire swing") | ("Her 2 babies")
60
Trastuzumab can treat ...
treats **HER2 positive breast** cancer ("Crab bra")
61
Trastuzumab can cause ...
trastuzumab can cause **cardiotoxicity** * e.g. decreased LVEF, heart failure ("Unraveling heart")

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