Cancer Chemotherapy Flashcards Preview

Pharmacology 1 > Cancer Chemotherapy > Flashcards

Flashcards in Cancer Chemotherapy Deck (52):
1

Alkylating agents

Cyclophosphamide, cisplatin, Procarbazine, Dacarbazine, Busulfan, Carmustine

2

Antimetabolites

5-fluorouracil, methotrexate
gemcitabine, 6-mercaptopurine, cytarabine

3

Natural products

Etoposide, paclitaxel, vincristine, Vinblastine

4

Antitumor antibiotics

Bleomycine, doxorubicin, mitomycin, actinomycin D,

5

Miscellaneous

Imatinib, cetuximab

6

Hormonal

Prednisone, tamoxifen

7

Log-kill hypothesis

anticancer drugs kill a fixed proportion of a tumor cell population, not a fixed number of tumor cells

8

Cell Cycle Nonspecific Drugs (CCNS)

G0 phase (CCNS)
Cisplatin
Antitumor antibiotics,
Nitrosureas (Lomustine, carmustine)

9

Cell cycle Specific Drugs (CCS) S phase

S phase (66 MECH)
6-mercaptopurine, 6 thioguanine, Methotrexate
Etoposide, Cytarabine, Hydroxyurea,

10

Cell cycle Specific Drugs (CCS) G2 phase

Bleomycine

11

Cell cycle Specific Drugs (CCS) M phase

Vinblastine
Vincrisine
Paclitaxel

12

Use of chemotherapy in patients with localized cancer before performing local therapy (surgery)

Neoadjuvant Chemotherapy

13

Chemotherapy done after local treatment procedures such as surgery or radiation

Adjuvant chemotherapy

14

Rescue drug for methotrexate toxicity

Leucoverin

15

Rescue drug for cyclophosphamide toxicity

MESNA (mercaptoethane sulfate)

16

Rescue drug for doxorubicin toxicity

Dexrazoxane

17

Rescue drug for Cisplatin toxicity

Amifostine

18

Class Alkylating agent
MOA: Forms DNA cross-links resulting in inhibition of DNA synthesis and function.
Uses: Non-hodgkin's lymphoma, CLL
AE: bone marrow suppression, HEMORRHAGIC CYSTITIS

Cyclophosphamide

19

Class Alkylating agent
MOA: Forms DNA cross-links resulting in inhibition of DNA synthesis and function.
Uses: Testicular CA, Ovarian CA, Advanced colon CA
AE: Nephrotoxicity

Cisplatin
Advanced colon CA (Oxaliplatin)

20

Class Alkylating agent
MOA: Forms hydrogen peroxide w/c generates free radicals that cause DNA strand scission
Uses: Hodgkin's lymphoma, Non-hodgkin's lymphoma
AE: Leukemogenic, Disulfiram rxn, BMS

Procarbazine

21

Class Alkylating agent
MOA: Forms hydrogen peroxide w/c generates free radicals that cause DNA strand scission
Uses: Hodgkin's lymphoma, Non-hodgkin's lymphoma
AE: BMS, Phototoxicity, Flu-like syndrome

Dacarbazine

22

Class Alkylating agent
MOA: Forms DNA cross-links resulting in inhibition of DNA synthesis and function.
Uses: CML
SE: Pulmonary fibrosis, Adrenal insufficiency , Skin pigmentation
Notes: SPAREs the bone marrow

Busulfan

23

Class Alkylating agent
MOA: Forms DNA cross-links resulting in inhibition of DNA synthesis and function.
Uses: BRAIN TUMORS, melanoma, skin CA
SE: CNS toxicity

Carmustine
- highly lipophilic, able to pass the BBB

24

Class: Antimetabolite, DMARD
MOA: Inhibits dihydrofolate reductase. Decrease synthesis of thymidylate, AA, purine nucleotides.
Uses: ChorioCA, Primary CNS lymphoma, RA, Psoriasis, Ectopic pregnancy
SE: BMS

Methotrexate

25

Class: Antimetabolite
MOA: Inhibits de novo purine nucleotide synthesis. Activated by HGPRT.
Uses Acute Leukemias (ALL, AML), CML
SE: BMS, Hepatotoxicity

6 Mercaptopurine (purine)

26

6 MP metabolism is inhibited by?

Allopurinol and febuxostat

27

Class Antimetabolite
MOA Inhibits thymidylate synthase
Uses: Colorectal CA, Bladder CA, Skin CA (basal cell ca, actinic keratoses)
SE: BMS

5 Fluorouracil (pyrimidine)

28

Class Antimetabolite
MOA: Inhibits DNA synthesis and repair. Inhibits ribonucleotide reductase with reduced formation of dNTPs.
Uses: Acute leukemias (ALL,AML), CML in blast crisis
Notes: Most specific for S phase cell cycle

Cytarabine (pyrimidine)

29

Class Antimetabolie
MOA: Inhibits DNA synthesis and repair. Inhibits ribonucleotide reductase with reduced formation of dNTPs.
Uses: Pancreatic CA

Gemcitabine

30

Class: Vinca Alkaloid
MOA: Prevents microtubule assembly. Causes cell arrest at metaphase
Use: Acute Leukemias, Lymphomas
SE: Peripheral neuritis, paralytic ileus
Note: Spares Bone marrow

Vinblastine

31

Class: Vinca Alkaloid
MOA: Prevents microtubule assembly. Causes cell arrest at metaphase
Uses: Testicular CA, Kaposi's sarcoma
SE: BMS

Vincristine

32

Class: Podophyllotoxin
MOA: Inhibits DNA topoisomerase II. Inhibits mitochondrial electron transport.
Uses: Lung CA, Prostate CA, Hodgkin's lymphoma
SE: BMS, GI irritation, Alopecia

Etoposide

33

Class Camptothecin
MOA Inhibits topoisomerase I
Uses: Advance ovarian ca (2nd line), small cell lung ca
Metastatic Colorectal CA

Topotecan: Advance ovarian ca (2nd line), small cell lung ca

Irinotecan: Metastatic Colorectal CA

34

Class: Taxane
MOA: interferes with mitotic spindle. Prevents microtubule disassembly into tubulin monomers.
Uses: Advance breast and ovarian CA

Paclitaxel

35

SE of Paclitaxel

Neutropenia, thrombocytopenia, peripheral neuropathy

36

SE of Docetaxel

Neurotoxicity, BMS

37

Class: Antitumor antibiotic
MOA: generates free radicals, w/c cause DNA strand breaks, Intercalates with DNA
Use: Testicular CA
SE: Pulmonary fibrosis
Notes: Specific for G2 phase of cell cycle

Bleomycin

38

Class: Antitumor antibiotic
MOA Binds to dsDNA. Inhibits DNA-dependent RNA synthesis. CCNS
Use: Melanoma, Wilm's Tumor, Rhabdomyosarcoma
SE: BMS

Actinomycin D

39

Class Tyrosine Kinase Inhibitors
MOA: Inhibits tyrosine kinase activity of the protein product of bcr-abl oncogene in CML; Inhibits c-kit tyrosine kinase in GIST
Use: CML, GIST
SE: Fluid retention, Drug interactions

Imatinib

40

Class Monoclonal antibody
MOA: acts against breast ca cells that overexpress the HER2/neu receptor for epidermal growth factor
Uses: Metastatic breast CA
SE: Cardiotoxicity (CHF)

Trastuzumab

41

Class: Monoclonal antibody
MOA: inhibits binding of VEGF to VEGFR leading to inhibition of VEGF signaling. Inhibits tumor vascular permeability but enhances tumor blood flow and drug delivery
Use: Metastatic Colorectal CA, Non-small cell Lung CA, Diabetes retinopathy
SE: Gastrointestinal perforation

Bevacizumab

42

Class: Monoclonal antibody
MOA: Binds to surface protein in NHL cells. Induces complement mediated lysis. Direct cytotoxicity and induction of apoptosis
Uses: Nonhodgkins lymphoma (low grade)

Rituximab

43

Class Interferon
MOA: Endogenous glycoproteins with antineoplastic, immunosuppressive and antiviral actions
Uses: Hair cell leukemia, T-cell lymphoma
SE: Neurologic dysfunction, alopecia, myalgia, depression
Notes: CI include autoimmune disease, history of cardiac arrhythmias and pregnancy

Interferon Alpha

44

Class: substrate-depleting enzyme
MOA: depletes serum asparagine
Uses: ALL
SE Acute pancreatitis

Asparaginase

45

Class Vitamin A derivative
MOA: Allows DNA transcription and differentiation of immature leukemic promyelocytes into mature granulocytes (differentiation therapy)
Uses: Acute promyelocytic leukemia
SE: Retinoic acid syndrome
Notes: Only vitamin that can cure cancer
Does not directly kill cancer cells

All trans retinoic acid

46

Retinoic Acid Syndrome

Dyspnea, fever, wt gain, peripheral edema

47

DOC Retinoic Acid Syndrome

Dexamethasone

48

MOA: suppresses inflammation and immune response. May trigger apoptosis and work on nondividing cancer cells
Use: CLL, Hodgkin's lymphomas
SE: adrenal suppression, growth inhibition, muscle wasting

Prednisone

49

Class: Selective Estrogen Receptor modulator
MOA: Estrogen antagonist actions in breast tissue and CNS. Estrogen agonists effects in uterus, liver & bone
Uses: Hormone responsive breast ca
SE: Endometrial hyperplasia, endometrial ca
Notes: prevents osteoporosis and decrease risk for atherosclerosis

Tamoxifen

50

Class: Androgen antagonist
MOA Competitive antagonist at androgen receptor
Uses: Prostate CA, surgical castration
SE: gynecomastia, hot flushes

Flutamide
Surgical castration (nilutamide)
Notes: less hepatotoxicity with bicalutamide and nilutamide
GnRH analogs (leuprolide) must be co-administered with flutamide to prevent acute flare-up of prostate CA

51

Class: GnRH analog
MOA: Increased LH and FSH secretion with intermittent administration. Reduced LH and FSH secretion with prolonged continuous administration
Uses: Prostate CA, Precocious puberty
SE: Hot flushes, sweats, headache,

Leuprolide

52

Class: Estrogen synthesis inhibitor
MOA: Reduces estrogen synthesis by inhibiting aromatase
Uses: Breast CA, Precocious puberty
Notes: effective against Breast CA that have become resistant to tamoxifen

Anastrozole