Cancer

Question 1

Alkylating drugs

Answer 1

Nonspecific
x-link DNA

Cyclophosphamine
Chlorambucil
Melphalan
Lomustine
Procarbazine
Cisplatin
Carboplatin

Question 2

Alkylating drugs

Mustard gas derivatives

Answer 2

Cyclophosphamine
Chlorambucil
Melphan

Question 3

Cyclophosphamine

Answer 3

Require liver activation = acrolein (cause hemmoragic cystitis)
Tx: pred(diuretic) n-acelylcytene(antioxidant)
MESNA = antidote

SIADHS (hyponatremia via innaproprate ADH)
=lymphoma/hemangiosarcoma

Question 4

Chlorambucil

Answer 4

Non specific alkylating agent Mustard gas deriv xlink DNA
Sub for clyclophosphamine (dec toxicity but dec efficacy)
KEEP COLD
= chronic lymphocytic leukemia and feline small cell lymphoma

Question 5

Melphalan

Answer 5

Non specific alkylating agent Mustard gas deriv xlink DNA

=multiple myeloma

Question 6

Lomustine

Answer 6

Non specific alkylating agent nitrosourease xlink DNA

90% PO absorption
Hepatotoxicity (tx:alipoic acid)
CROSS BBB
= lymphoma in brain

Question 7

Procarbazine

Answer 7

Non specific alkylating agent non nitro deriv xlink DNA

“Maryland”
Rescue drug only use when others not working

Question 8

Cisplatin

Answer 8

Non specific alkylating agent Platinum derivative deriv xlink DNA

“Plantol” 
*KILLS CATS*
Inc proton binding = local effect (esp horses)
Renal toxicity and severe nausea 
Not common in vet med 
= osteosarcoma and SCC

Question 9

Carboplatin

Answer 9

Non specific alkylating agent Platinum derivative deriv xlink DNA
“Paraplatin”
Feline safe!
More commonly used for dec toxicity 
W/ cancer vaccine = osteosarcoma

Question 10

Anti cancer Antibiotics

Answer 10

Phase nonspecific
Anthracyclines

Inhibit topoisomerase II
Vesicants

Doxorubicin
Actinomyces D
Mitoxantrone

Question 11

Doxorubicin

Answer 11

Phase nonspecific antibiotic inhibit topoisomerase II vesicant
Dose dec if bilirubin inc
*CARDIOTOXICITY and Anaphylaxis
Secretion on active form esp in cats
Dexrazone (zinecard)= protective against for toxicity
= lymphoma and sub for carboplatin for osteosarcoma sand hemangiosarcoma a

Question 12

Major side effect/ toxicity of doxorubicin

Answer 12

Besicant and cardiotoxicity

Question 13

Protective agent for doxorubicin toxicity

Answer 13

Derazone

Question 14

Actinomycin D

Answer 14

Phase nonspecific antibiotic inhibit topoisomerase II vesicant

Non cardio toxic sub for doxorubicin =lymphoma
Fecal and urine excretion

Question 15

Mitoxantrone

Answer 15

Phase nonspecific antibiotic inhibit topoisomerase II vesicant

No free radical damage (dec effectiveness)
Expensive (blue green urine)
= TCC + thymomas

Question 16

Phase nonspecific enzymes

Answer 16

L asparagine

Question 17

L aspaaragine

Answer 17

Enz degrades asparagine (max@G1)
Effective 1st line drug (= clinical remission)
* ANAPHYLAXIS by foreign bacterial protein
Alone NOT myelosuppressive but may inc vincristine mylosuppresion
SUBQ
=lymphoma

Question 18

Risk of Lasparaginase

Answer 18

ANAPHYLAXIC

Question 19

Hormone cancer therapy

Answer 19

Prednisone
Immunosuppressive steroid inhibits DNA sxn
Don’t use w/NSAIDS
= lymphoma mast cell insulin ima intracranial neoplasia

Question 20

Targeted therapy

Answer 20

Receptor tyrosine (RT) kinase inhibitors 
   Toceranib (KIT PDGF VEGF)
   Masitnib (KIT PDGF) 
DNA polymerase inhibition 
   Tanovea-Ca1

Question 21

Toceranib

Answer 21

RT kinase inhibitor (KIT PDGF VEGF)
Primarily KIT action
Negative effect on BM GI SKIN RENAL
=mast cell

Question 22

Masitnib

Answer 22

RT kinase inhibitor (KIT PDGF VEGF)
More selective for KIT than toceranib 
Primary action on PDGF 
Negative effect on BM GI SKIN RENAL
=mast cell 

NOT FDA approved

Question 23

Tanovea CA1

Answer 23

Targeted therapy DNA polymerase inhibition
“Rabacfosadine” 
Active excretion up to 5 days 
Activated by liver
PULMONARY FIBROSIS esp terriers 
Vomit skin and sec appetite

Question 24

Risk of tanovea

Answer 24

Pulmonary fibrosis (esp terriers)

Question 25

Phase specific anti cancers

Answer 25

``` Antimetabolites Cysteine arabinoside Methotrexate Plant alkaloids Vincristine Vinblastin ```

Question 26

Antimetabolites

Answer 26

Target DNA sxn: S phase Insert nonfunctional nucleotides into DNA Allow radiation to have inc effect Inc BM damage ... should give colony stimulating unity (fulcristine) Cross BBB ``` Cytosine arabinoside (cytosar) Methotrexate ```

Question 27

Cytosine arabinoside (cytosar)

Answer 27

``` Phase specific antimetabolite (S) Insert nonfunctional pyrimidine CRI Crosses BBB = lymphoma + CNS tumors ```

Question 28

Methotrexate

Answer 28

Phase specific antimetabolite (S) Dihydrofolate reductase inhibitor (= no Purine) CROSSES BBB Reversible w/ leucovorin = lymphoma CNS tumor and osteosarcoma

Question 29

Plant alkaloids

Answer 29

M phase specific bind spindles prevent either assembly or disassembly VESICANT

Question 30

Vincristine

Answer 30

Pause M specific plant alkaloids prevents assembly of spindles Hepatic secretion (dose dec with inc bilirubin) PERIPHERAL NEUROPATHY = lymphoma

Question 31

Negative effect or vincristine

Answer 31

Peripheral neuropathy

Question 32

Vinblastin

Answer 32

Pause M specific plant alkaloids prevents assembly of spindles ``` Hepatic secretion( dec dose w/ inc bilirubin) = MAST CELL TUMOR ```

Question 33

Vinblastin tumor type

Answer 33

MAsT CELL TUMOR

Question 34

Antidote to clyclophosphamine hemmoragic cystitis

Answer 34

MESNA

Question 35

What causes hemmoragic cystitis

Answer 35

Active acrolein from liver activation of cyclophosphamine

Question 36

Side effects of CYCLOPHOSPHAMINE

Answer 36

Hemmoragic cystitis TCC SIADHS

Question 37

Which drug has 90% absorption PO

Answer 37

Lomustine | Alkylating drug