Antineoplastic drugs

Question 1

DNA synthesis inhibitors

Answer 1

Methotrexate
Mercaptopurine
Floururacil

Question 2

Methotrexate - Clinical use

Answer 2

Induce remission in children with childhood leukemia, ALL, breast cancer, osteosarcoma, lymphoma, choriocarcinoma, bladder cancer

Question 3

Mercaptopurine - Clinical use

Answer 3

Combo with MTX: Maintain remission of Acute lymphocytic leukemia (ALL)

Question 4

Fluorouracil - Clinical use

Answer 4

Breast, colorectal, and gastric and skin cancer

Question 5

DNA cross-linking and intercalating drugs

Answer 5

Cyclophosphamide
Carmustine
Cisplatin
Busulfan
Bleomycin
Doxorubicin

Question 6

Cyclophosphamide - Clinical use

Answer 6

Chronic lymphocytic leukemia, non-Hodgkin lymphoma.
Breast, lung, and ovarian cancers.

Immunosuppressant: RA and many autoimmune diseases

Question 7

Cyclophosphamide - Adverse effects

Answer 7

Pancytopenia, Hemorrhagic cystitis (can be prevented or treated with mesna), cardiac toxicity, electrolyte disturbances, and GI toxicity

Hemorrhagic cystitis –> Urinary frequency, irritation, blood loss
-Mesna binds to acrolein, the drug metabolite that causes cystitis, and converts it to an inactive substance

Question 8

Nitrogen mustard

Answer 8

Cyclophosphamide

Question 9

Nitrosourea drug

Answer 9

Carmustine

Question 10

Carmustine - Clinical use

Answer 10

Brain tumors (ex. astrocytoma)

Question 11

Platinum compound

Answer 11

Cisplatin

Question 12

Cisplatin - Clinical use

Answer 12

First-line: Testicular, ovarian, cervical, bladder, and lung cancers.

Other solid tumors.

Question 13

DNA alkylating drug

Answer 13

Busulfan

Question 14

Busulfan - Clinical use

Answer 14

Chronic myeloid leukemia (CML)

Question 15

Busulfan - Adverse effects

Answer 15

Dose-limiting myelosuppression.

Pulmonary fibrosis (“busulfan lung”, nonproductive cough and difficult breathing).

Question 16

DNA intercalating drug

Answer 16

Bleomycin

Question 17

Bleomycin - Clinical use

Answer 17

Hodgkin lymphoma, non-Hodgkin lymphomas, testicular cancer, several other solid tumors.

Question 18

Anthracycline drug

Answer 18

Doxorubicin

Question 19

Doxorubicin - Clinical use

Answer 19

Breast cancer, bladder and ovarian cancer, Hodgkin disease, hematologic disorders, solid tumors

Question 20

DNA topoisomerase inhibitors

Answer 20

Etoposide

Irinotecan

Question 21

Etoposide - Clinical use

Answer 21

non-hodgkin lymphoma, lung, gastric, testicular cancer

Question 22

Irinotecan - Clinical use

Answer 22

Colorectal, GI and lung cancer

Question 23

Mitotic inhibitors

Answer 23

Paclitaxel

Vincristine

Question 24

Vincristine - Clinical use

Answer 24

Hodgkin and non-hodgkin lymphomas , neuroblastoma

Question 25

Vincristine - Adverse effects

Answer 25

Peripheral neuropathy, Paresthesia, Cranial nerve damage | Little myelosuppression.

Question 26

Paclitaxel - Clinical use

Answer 26

Breast and ovarian cancer, non-small cell lung cancer

Question 27

Enzyme and Proteasome Inhibitors

Answer 27

Bortezomib Imatinib Vemurafenib

Question 28

Bortezomib – Clinical use

Answer 28

Multiple myeloma | Mantle cell lymphoma

Question 29

Imatinib – Clinical use

Answer 29

Chronic myeloid leukemia. GI stromal tumors associated with c-kit mutations.

Question 30

Vemurafenib – Clinical use

Answer 30

Combined for synergistic effect for treating metastatic melanoma

Question 31

Cancer Immunotherapy Agents

Answer 31

Rituximab Trastuzumab Interferon alfa

Question 32

Rituximab – Clinical use

Answer 32

non-Hodgkin lymphoma

Question 33

Trastuzumab – Clinical use

Answer 33

Metastatic breast cancer

Question 34

Immunosuppressant Drugs

Answer 34

``` Azathioprine Mycophenolate Basiliximab Daclizumab Cyclosporine Sirolimus Tacrolimus ```

Question 35

Basiliximab, Daclizumab – Clinical use

Answer 35

Renal transplantation (they prevent acute transplant rejection)