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Hematology > Basics > Flashcards

Basics Flashcards

1
Q

cell cycle non-specific

A
  • alkylators
  • platinums
  • anthracyclines (antitumor antibiotics)
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2
Q

cell cycle specific

A
  • S: anti-metabolites

- M: vinca alkaloids, taxanes

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3
Q

ondansetron

A
  • antiemetic: serotonin antagonist
  • tox: headaches, hiccups, constipation, QT prolong
  • acute nausea
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4
Q

aprepitant

A
  • antiemetic: NK-1 antagonist
  • tox: drug interactions (ocp, warfarin, increased steroid concentration), hiccups, fatigue
  • acute and delayed nausea
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5
Q

dexamethasone

A
  • antiemetic: glucocorticoid
  • tox: glucose intolerance, insomnia, agitation
  • acute and delayed nausea
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6
Q

prochlorperazine

A
  • antiemetic: dopamine antagonist
  • tox: extrapyramidal effects (akathisia), sedation
  • delayed nausea
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7
Q

metoclopramide

A
  • antiemetic: dopamine antagonist
  • tox: extrapyramidal side effects (akathisia), sedation
  • delayed nausea
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8
Q

lorazepam

A
  • antiemetic: benzo
  • sedation, retrograde amnesia
  • anticipatory
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9
Q

epoetin alfa

A
  • growth factor: ESA
  • short acting
  • tox: htn, rash, arthralgias
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10
Q

darbepoetin alfa

A
  • growth factor: ESA
  • long acting
  • tox: htn, rash, arthralgias
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11
Q

filgrastim

A
  • growth factor: G-CSF

- tox: fever, bone pain, increased uric acid/LDH/alkaline phosphatase, rare splenic infarct

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12
Q

cyclophosphamide

A
  • chemo: alkylating agent, nitrogen mustard
  • tox: urotoxic (hemorrhagic cystitis), delayed nausea/vomiting, cardiotoxic, immunosuppression, neutropenia
  • Mesna
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13
Q

isophosphamide

A
  • chemo: alkylating agent, nitrogen mustard
  • tox: neurotoxic (cross BBB), lethargy, confusion, seizure, encephalopathy, hemorrhagic cystitis, neutropenia, nephrotoxic (ATN)
  • Mesna
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14
Q

chlorambucil

A
  • chemo: alkylating agent, nitrogen mustard
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15
Q

melphalan

A
  • chemo: alkylating agent, nitrogen mustard
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16
Q

cisplatin

A
  • chemo: alkylating agent, platinum analog

- tox: nephrotoxic, anemia, neurotoxic (axonal degeneration, peripheral neuropathy, auditory, visual disturbances)

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17
Q

oxaliplatin

A
  • chemo: alkylating agent, platinum analog

- tox: neurotoxic (peripheral neuropathy, paresthesias), myelosuppression, hepatotoxic, asthenia

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18
Q

carboplatin

A
  • chemo: alkylating agent, platinum analog

- tox: hypersensitivity, neurotoxic (if w/ cisplatin), increased toxicity if given prior to taxane

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19
Q

dacarbazine

A
  • chemo: alkylating agent, triazene
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20
Q

prednisone

A
  • chemo: hormonal agent, glucocorticoid
  • mech: cytolytic and immunosuppressive
  • tox: short term (glucose intolerance, insomnia, agitation, appetite stim, fluid retention); long term (HPA axis suppression, Cushing’s, osteoporosis, cataracts)
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21
Q

dezamethasone

A
  • chemo: hormonal agent, glucocorticoid
  • moa: cytolytic and immunosuppressive
  • tox: short term (glucose intolerance, insomnia, agitation, appetite stim, fluid retention); long term (HPA axis suppression, Cushing’s, osteoporosis, cataracts)
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22
Q

danazol

A
  • chemo: hormonal agent, androgen
  • moa: suppress pituitary output of FSH and LH
  • tox: edema, flushing, htn, hirsutism, voice change, increased leukocytes/erythrocytes/platelets
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23
Q

flutamide

A
  • chemo: hormonal agent, anti-androgen
  • moa: block androgen uptake and binding in nucleus
  • tox: hot flashes, decreased libido, gynecomastia, transient lft abnormalities, impotence
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24
Q

bicalutamide

A
  • chemo: hormonal agent, anti-androgen
  • moa: block androgen uptake and binding in nucleus
  • tox: hot flashes, decreased libido, gynecomastia, transient lft abnormalities, impotence
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25
Q

tamoxifen

A
  • chemo: hormonal agent, anti-estrogen
  • moa: bind/block estrogen receptor, works in G1, stimulated tfg-beta to decreased proliferation
  • tox: menopausal symptoms, fluid retention, peripheral edema, tumor flare, dvt/pe, endometrial hyperplasia
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26
Q

raloxifene

A
  • chemo: hormonal agent, anti-estrogen
  • moa: bind/block estrogen receptor, works in G1, stimulated tfg-beta to decreased proliferation
  • tox: menopausal symptoms, fluid retention, peripheral edema, tumor flare, dvt/pe, endometrial hyperplasia
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27
Q

alkylating agents: moa and general toxicity

A
  • moa: DNA alkylation, inter/intrastrand crosslinks

- tox: bone marrow suppression, nausea, vomiting, diarrhea, anorexia, sterility, amenorrhea, secondary malignancy

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28
Q

aromatase inhibitors: moa and general toxicity

A
  • moa: competitive inhibitors of aromatase, block conversion of androgen to estrogen (inhibit P450)
  • tox: decreased bone density, GI upset, increased serum lipid, vaginal dryness, night sweats
29
Q

anastrozole

A
  • chemo: hormonal agent, aromatase inhibitor

- tox: asthenia, hot flashes, peripheral edema, arthralgias

30
Q

letrozole

A
  • chemo: hormonal agent, aromatase inhibitor

- tox: arthralgias, musculoskeletal pain, hot flashes, milde increased lfts

31
Q

exemestane

A
  • chemo: hormonal agent, aromatase inhibitor

- tox: hot flashes, fatigue, headaches

32
Q

leuprolide

A
  • chemo: hormonal agent, LH-RH agonist
  • moa: gonadotropin suppression via feedback inhibition, decreased LH and FSH release from pituitary
  • tox: hot flashes, gynecomastia, tumor flare, increased serum cholesterol, peripheral edema, asthma
33
Q

goserelin

A
  • chemo: hormonal agent, LH-RH agonist
  • moa: gonadotropin suppression via feedback inhibition, decreased LH and FSH release from pituitary
  • tox: hot flashes, gynecomastia, tumor flare, increased serum cholesterol, peripheral edema, asthma
34
Q

methotrexate

A
  • chemo: antimetabolic
  • moa: S-phase, bind reversibly to dihydrofolate reductase to inhibit tetrafolate production, folate depletion = no purines. renal and biliary elimination
  • tox: low dose (myelosuppression, maybe hepatotoxic), high dose (myelosuppression, nephrotoxic [tubules], GI toxic, pneumonitis, mucositis, leukoencephalopathy)
  • leucovorin
  • *drain effusions prior to treatment
  • **intrathecal
35
Q

cytarabine (ara-c)

A
  • chemo: antimetabolic
  • moa: S-phase, phosphorylated pyrimidine analog, inhibits DNA polymerase
  • tox: conventional (myelosuppression, flu-like syndrome, mucositis, hand-foot syndrome), high (cerebellar toxic, ocular toxic, noncardiogenic pulmonary edema)
  • intrathecal
36
Q

5-fluorouracil

A
  • chemo: antimetabolic
  • moa: S-phase, inhibits thymidylate synthase
  • tox: myelosuppression, mucositis, diarrhea, hand-foot syndrome, neurotoxic, cardiotoxic, photosensitivity, metallic taste, phlebitis
  • leucovorin augments
  • *enzymatic clearance (safe for hepatic/renal dysfunctino)
37
Q

gemcitabine

A
  • chemo: antimetabolic
  • moa: S-phase, pyrimidine analog, inhibits DNA polymerase
  • tox: myelosuppression, flu-like syndrome, infusion rxn, proteinurea, hematuria, maculopapular skin rash
38
Q

hydroxyurea

A
  • chemo: antimetabolic
39
Q

fludarabine

A
  • chemo: antimetabolic
40
Q

doxorubicin

A
  • chemo: anti-tumor antibiotic, anthracyclines
  • moa: promote free radical production, intercalate DNA to block synthesis, topoII inhibitior
  • tox: myelosuppression, alopecia, urine color change, vesicant, chronic cardiomyopathy, acute ekg changes
  • dexrazoxane for cardioprotection
41
Q

daunorubicin

A
  • chemo: anti-tumor antibiotic, anthracyclines
  • moa: promote free radical production, intercalate DNA to block synthesis, topoII inhibitior
  • tox: myelosuppression, alopecia, urine color change, vesicant, chronic cardiomyopathy, acute ekg changes
  • dexrazoxane for cardioprotection
42
Q

bleomycin

A
  • chemo: anti-tumor antibiotic, anthracyclines
  • moa: free radical production causing DNA breaks, binds DNA
  • tox: pulmonary toxic, skin toxic, alopecia, mucositis, stomatitis
43
Q

irinotecan

A
  • chemo: plant alkaloid, camptothecins
  • moa: topo I inhibitor
  • tox: neutropenia, thrombocytopenia, eosinophilia, GI (diarrhea, cholinergic sundromes), alopecia, asthenia, anorexia, fatigue, increased lfts/bilirubin, derm rxn, rare pneumonitis
44
Q

vincristine

A
  • chemo: plant alkaloid, vinca alkaloid
  • moa: M-phase, disturb microtubule formation (bind building blocks), and arrest cell in metaphase
  • tox: biliary clearance, vesicant, peripheral neuropathy
45
Q

vinblastine

A
  • chemo: plant alkaloid, vinca alkaloid
  • moa: M-phase, disturb microtubule formation (bind building blocks), and arrest cell in metaphase
  • tox: biliary clearance, vesicant, myelosuppression
46
Q

vinorelbine

A
  • chemo: plant alkaloid, vinca alkaloid
  • moa: M-phase, disturb microtubule formation (bind building blocks), and arrest cell in metaphase
  • tox: biliary clearance, vesicant, myelosuppression
47
Q

paclitaxel

A
  • chemo: plant alkaloid, taxane
  • moa: M-phase arrest, enhance microtubule polymerization (inhibit disassembly)
  • tox: myelosuppression, neuropathies, infusion related rxn
48
Q

docetaxel

A
  • chemo: plant alkaloid, taxane
  • moa: M-phase arrest, enhance microtubule polymerization (inhibit disassembly)
  • tox: myelosuppression, neuropathies, infusion related rxn, hand-food syndrome
49
Q

monoclonal antibodies: moa

A
  • apoptosis, complement-mediated cytotoxicity, Ab dependent cellular toxicitu
  • radiolabeled Ab, chemo-conjugated Ab
50
Q

rituximab

A
  • chemo: monoclonal Ab
  • anti CD20
  • tox: immunosuppressive, infusion related rxn, tumor lysis, HAMA/HACA, skin rxn
51
Q

cetuximab

A
  • chemo: monoclonal Ab
  • anti EGFR
  • tox: infusion related rxn, acneiform rash, asthenia, hepatotoxic
52
Q

trastuzumab

A
  • chemo: monoclonal Ab
  • anti HER2
  • tox: infusion related rxn, generalized pain, asthenia, headache, myelosuppression, cardiotoxic
53
Q

bevacizumab

A
  • chemo: monoclonal Ab
  • anti VEGF
  • tox: black box (impaired wound healing, GI perforation, hemorrhage), htn, thrombotic events, bleeding episodes
54
Q

eculizumab

A
  • chemo: monoclonal Ab

- anti complement C5

55
Q

brentuximab vendotin

A
  • chemo: monoclonal Ab

- anti CD30 conjugated to microtubule disrupting agent

56
Q

ipilimumab

A
  • chemo: monoclonal Ab

- anti CTLA4

57
Q

nivolumab

A
  • chemo: monoclonal Ab

- anti PD1

58
Q

imatinib

A
  • chemo: tyrosine kinase inhibitor
  • BCR-ABL tk inhibitor (philadelphia)
  • tox: edema, fluid retention, cytopenia, increased lft, cardiotoxic
59
Q

erlotinib

A
  • chemo: tyrosine kinase inhibitor

- EGFR inhibitor

60
Q

ibrutinib

A
  • chemo: tyrosine kinase inhibitor

- Bruton’s tyrosine kinase inhibitor

61
Q

thalidomide

A
  • chemo: imid
  • moa: antiangiogenesis, immunomodulatory, induce apoptosis
  • tox: neurotoxicity (axonal damage, decreased sensory), distal paresthesias, hyperesthesias, sedation, depression (hypothyroidism), cardiotoxic (peripheral edema, bradycardia, thrombosis), teratogenic
62
Q

lenalidomide

A
  • chemo: imid
  • moa: antiangiogenesis, immunomodulatory, induce apoptosis
  • tox: neurotoxicity (axonal damage, decreased sensory), distal paresthesias, hyperesthesias, sedation, depression (hypothyroidism)
63
Q

hypomethylating agents: moa

A
  • S-phase, incorporation into DNA, bind and deplete DNA methyltransferase, re-expression of epigenetically silent genes
  • hypermethylation associated with cancer by altered gene expression
64
Q

azacytidine

A
  • chemo: hypomethylating agent

- tox: myelosuppression, diarrhea

65
Q

decitabine

A
  • chemo: hypomethylating agent

- tox: myelosuppression, diarrhea

66
Q

bortezomib

A
  • chemo: proteasome inhibitor
  • moa: prevent proteolysis of ubiquitinated proteins and disruption of normal intracellular protein metabolism, downregulate transcription
  • tox: fatigue, malaise, myelosuppression, peripheral sensory neuropathy
67
Q

ATRA

A
  • chemo: vitamin A analog
  • moa: binds PML-RAR fusion protein to interfere with function
  • tox: capillary leak syndrome, APL differentiation syndrome
68
Q

ATO

A
  • chemo: arsenical
  • moa: targets PML-RAR fusion protein leading to cellular differentiation
  • tox: QT prolongation, AV block, toursade, APL differentiation syndrome

Hematology (6 decks)

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