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Cancer chemotherapy(sparsh gupta) Flashcards

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1
Q

Gompertzian model

A

Growth fraction peaks when tumor is approx 37% of its maximum size

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2
Q

Most susceptible atom to Alkylating agents

A

N7 of guanine

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3
Q

Mesna

A

Mercaptoethane sulfonic acid

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4
Q

Mechlorethamine is used in

A

Hodgkin lymphoma

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5
Q

Adverse effects of cyclophosphamide

A

Cardiac dysfunctionPulmonary toxicitySIADH

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6
Q

Anticancer drugs that cause delayed neutropenia

A

Nitrsoureas

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7
Q

Adverse effects of busulfan

A

Adrenal insufficiencyPulmonary fibrosisSkin hyperpigmentationHyperuricemia

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8
Q

CNS side effects of procarbazine

A

HypnosisVivid dreams

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9
Q

Drug used for CLL

A

ChlorambucilAs it spares myelocytes

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10
Q

Cisplatin nephrotoxicity can be prevented by

A

Chloride diuresis Doesnot help against ototoxicity

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11
Q

Cisplatin is inactivated by

A

Aluminium

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12
Q

Drug that can be given to prevent cisplatin induced nephrotoxicity

A

Amifostine

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13
Q

Electrolyte abnormalities associated with cisplatin

A

Reduces all ions Hypomagnesimia HypokalemiaHypophosphatemiaHypocalcemia

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14
Q

Anticancer drugs with strong vesicant properties

A

NitrosoureasMechlorethamine

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15
Q

Alkylating agent with less chance of secondary leukemia

A

Cyclophosphamide

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16
Q

Anticancer drugs causing veno occlusive disease

A

All Alkylating agents in high doses

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17
Q

Alkylating agents causing pulmonary fibrosis

A

All Alkylating agents

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18
Q

Mechanisms of MTX resistance

A

Decreased MTX transporterDecreased formation of MTX polyglutamateIncreased levels of DHFR due to GENE AMPLIFICATION altered DHFRIncreased drug efflux transporter

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19
Q

Enzyme required for activation of MTX and pemetrexed

A

Folylpolyglutamate synthase

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20
Q

MTX is DOC for

A

Choriocarcinoma

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21
Q

Pemetrexed is approved for treatment of

A

Mesothelioma

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22
Q

Citrovorum factor

A

N10 formyl THF

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23
Q

Rx of MTX toxicity

A

Citrovorum factor Alkalinisation of urineDialysis Glucarpidase

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24
Q

Glucarpidase

A

MTX cleaving enzyme

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25
Pralatrexate is used for Rx of
Peripheral T cell lymphoma
26
Adverse effects of MTX
HepatotoxicityPulmonary infiltrates and fibrosisBone marrow supression Mucositis
27
DOC for CLL
Fludarabine
28
Purine analogs
6MP6TGCladribine Fludarabine
29
DOC for Hairy cell leukemia
Cladribine(resistant to degradation by ADA)
30
Drug that must be given to longterm purine analog users
Cotrimoxazole for PCP prophylaxis as long term purine analog use leads to Immunosuppression
31
Dose of which anti metabolites should be reduced when given along with allopurinol
6-MPazathioprine
32
Pyramidine analogs
5FUcytarabineCapecitabineGemcitabine5-azacytidineDecitabine
33
Single most effective agent for induction of remission in AML
Cytarabine
34
Anticancer drug eliminated by lungs
5FUconverted to CO2
35
Adverse effect of capecitabine
Hyperbilirubinemia
36
Metabolism of thiopurines
TPMTthiopurine methyl transferase
37
5FU is catabolised by
Dihydropyramidine dehydrogenase
38
5FU action is augmented by
Leukovorin
39
DOC for pancreatic cancer
Gemcitabine
40
Adverse effect of thiopurines
Hepatotoxicity
41
Adverse effects of 5FU
NeurotoxicityHand foot syndrome
42
Side effect of fludarabine
Arthralgia
43
Side effect of gemcitabine
Diarrhoea
44
Marrow sparing cytotoxic drugs
VincristineBleomycinL-asparaginase
45
Diff btw vincristine and vinblastine
Vinblastine causes bone marrow supressionVincristine has bone marrow sparing effect but dose limiting neurotoxicity
46
Use of vinblastine
Metastatic testicular tumors
47
Use of vincristine
Induction of remission in childhood leukemiasPediatric solid tumors-Wilms,neuroblastoma,rhabdomyosarcoma
48
Taxanes that causes hypersensitivity reactions
Paclitaxel
49
Taxanes that don't cause hypersensitivity reactions
DocetaxelNabpaclitaxel(protein bound paclitaxel)
50
Adverse effect of Taxanes
Bone marrow suppressionNeurotoxicity
51
Taxanes drug interactions
Cisplatin decreases paclitaxel clearance Paclitaxel decreases doxorubicin clearance
52
Use of Cabazitaxel
Rx of refractory metastatic prostate cancer in combination with prednisone
53
MOA of action of Ixabepilone
Microtubule stabilisation
54
Estramustine is combination of
Estrogen and Mechlorethamine
55
Use of estramustine
Prostatic Ca
56
Side effects of estramustine
Gynacomastia Impotence
57
MOA of camptothecins
Inhibits topoisomerase 1
58
Elimination of camptothecins
Irinotecan eliminated in bileTopotecan eliminated by renal route
59
Rx of choice for advanced colorectal carcinoma
Irinotecan+5FU
60
Dose limiting toxicities of camptothecins
Irinotecan-diarrhoea Topotecan- neutropenia
61
Adverse effects of irinotecan
DiarrhoeaMyelosuppressionCholinergic syndrome(inhibits acetyl choline esterase)
62
MOA of etoposide and teniposide
Inhibit topoisomerase 2
63
Use of etoposide
Testicular Ca Prostate CaSmall cell Ca of lung
64
Etoposide induced secondary leukemia
Develops at short intervalNot preceded by myelodysplasiaIt's acute non lymphocytic type
65
Toxicity of etoposide
Hepatotoxicity
66
All anti tumor antibiotics are obtained from
Streptomyces
67
Cardiotoxicity of anthracyclins can be reduced by
Alpha tocopherolDexrazoxane
68
MOA of anthracyclins
Inhibits topoisomerase 2
69
Less cardiotoxic anthracyclin
Mitoxantrone
70
Radiation recall reaction is seen with
Anthracyclins
71
Use of Mitoxantrone
Hormone resistant prostate cancerAMLSPMS(secondary progressive MS)
72
Leukemia caused by Mitoxantrone
Acute promyelocytic leukemia
73
Use of valrubicin
BCG refractory urinary bladder Ca insitu
74
Radiosensitizers
Hydroxy ureaGemcitabineMetronidazole5FUdactinomycin
75
Use of dactinomycin
Solid tumors in children
76
Nature of Bleomycin
Glycopeptide
77
Earliest indicator of adverse effect of Bleomycin
Decreased DLco
78
Adverse effects of Bleomycin
Cutaneous Hyperpigmentation Hyperkeratosis Erythema UlcersPneumonitisPulmonary fibrosisHypersensitivity
79
Bleomycin is metabolised by
Bleomycin hydrolaseIt's concentration is less in skin and lungs
80
Bleomycin toxicity is ________ dependant
Oxygen
81
Hypoxic tumor cells can be killed by
Mitomycin
82
Adverse effect of mitomycin
HUSdelayed bronchospasm
83
Use of mitomycin
Superficial Bladder CaAnal CaTracheal and laryngeal stenosis
84
Adverse effects of docetaxel
Peripheral neuropathyFluid retention
85
Imatinib is the drug of choice for
CMLGIST
86
MOA of Imatinib
Competitive inhibitor of ATP binding of the abl kinase
87
Erlotinib pharmacokinetics
Food increases absorption by 100%Metabolised by CYP3A4
88
Adverse effects of erlotinib
Skin rashDiarrhoeaAnorexia Fatigue
89
Erlotinib is effective in
WomenNon smokersAsiansNon small cell lung CaAdenocarcinoma Bronchioalveolar Ca
90
Use of erlotinib
Non small cell lung cancer with EGFR receptor mutationKRAS mutation cancers don't respond to itPancreatic Ca
91
Use of sorafenib and sunitinib
Sunitinib- RCC,GISTsorafenib-RCC,HCC
92
Adverse effects of sorafenib and sunitinib
Hypertension
93
Route of administration of tyrosine kinase inhibitors
Oral
94
Use of lapatinib
Ca breastInhibits TK associated with her2/neu
95
Use of pazopanib
Advanced RCCMulti targeted TK inhibitor against VEGF,PDGF,c kit
96
Drug that inhibits TK activated by JAK
Tofacitinib
97
Tofacitinib is used against
rheumatoid arthritis
98
Tyrosine kinase inhibitors used in medullary Ca of thyroid
Vandetanib(VEGFR,EGFR)Cabozantinib(c-MET,VEGFR-2)
99
TK inhibitor used in Rx of malignant melanoma
Vemurafenib(BRAF)
100
TK inhibitor used in myelofibrosis
Ruxolitinib(JAK1,2)
101
TK inhibitors used in CML
BosutinibDasatinibImatinibNilotinibPonatinib
102
TK inhibitor used in colorectal cancer
Regorafenib(VEGFR2,TIE2)
103
TK inhibitors used in non small cell carcinoma of lung
Crizotinib(cMET,ALK)Erlotinib(EGFR)Gefitinib(EGFR)
104
TK inhibitors used in advanced RCC
Axitinib(VEGFR1,2,3)Pazopanib(VEGFR1,2,3;PDGFR A,B;cKIT)SorafenibSunitinib
105
TK inhibitors used in pancreatic Ca
SunitinibErlotinib
106
Dose limiting toxicity of transtuzumab
Cardiotoxicity
107
CD52 antagonist
Alemtuzumab(low grade lymphomas and CLL)
108
Monoclonal Ab against EGFR
CetuximabPanitumumabEGFR positive metastatic colorectal Ca
109
CD33 Antagonist
Gemtuzumab ozogamycinCD33 positive AML
110
CD 20 antagonists conjugated with radioisotopes
I131-tositumomabY90-ibritumomab tiuxetanUsed for relapsed lymphomas
111
Recombinant IL-2 with diphtheria toxin
Denileukin diftitoxUsed for recurrent cutaneous T cell lymphoma
112
Adverse effects of cetuximab
Rash Hypomagnesimia ILD
113
Rituximab is used against
CLLAIHAITPNHLRACHINA
114
Use of cetuximab
Colorectal CaHead and neck cancer
115
Advantage of panitumumab
Fully human Mab No rash
116
Adverse effects of bevacizumab
HypertensionThromboembolismImpaired wound healingGIT perforation
117
Use of bevacizumab
ColorectalBreastGlioblastoma Metastatic RCCnon small cell lung Ca
118
Adverse effects of flutamide
Hot flushes Gynacomastia Hepatic dysfunction
119
Complete androgen blockade
AR blockersGnRH agonists
120
MOA of abiraterone
17 A hydroxylase inhibitorProstate Ca
121
Drugs that inhibit 17 A hydroxylase
EtomidateAbiraterone
122
Drugs that inhibit 11 B hydroxylase
MetyraponeEtomidate
123
SERD
Selective estrogen receptor downregulatorFulvestrant
124
Aromatase inhibitors
1G-Aminoglutethimide2GFormestaneFadrozoleRogletimide3GExemestaneAnastrazoleLetrozoleVorozole
125
Adverse effects of aminoglutethemide
Adrenal insufficiencyMyelosupression Rash
126
Adverse effects of L asparaginase
Severe hypersensitivity reactions Acute pancreatitisCVT
127
Asparaginase is used in treatment of
LeukemiasLymphomas
128
MOA of pentostatin
Inhibits ADA
129
Use of Plicamycin
Hypercalcemia of malignancyMetastatic testicular Ca
130
Hydroxy urea is DOC for
Sickle cell anemiaEssential thrombocytosisPolycythemia Vera
131
Second drug of choice in essential thrombocytosis
Anagrelide
132
Route of administration of hydroxy urea
Oral
133
Adverse effects of tretinoin
Vit A toxicity- headache,dryness,rash,pruritis,conjunctivitisRetinoic acid syndrome- pleural or pericardial effusion,pulmonary infiltrates,feverHypercholesterolemia Hypertriglyceridemia Abdominal pain and diarrhoea
134
Adverse effects of arsenic trioxide
HyperglycaemiaProlonged QT interval
135
Adverse effects of thalidomide
TeratogenicityConstipationPeripheral neuropathyRashHypothyroidismIncreased risk of DVT
136
IMiD and selCID
Immunomodulatory derivatives of thalidomideSelective cytokine inhibitory drugs
137
MOA of thalidomide
Inhibition of angiogenesis Inhibition of TNF AIncreased production of IL-10Reduces phagocytosisAlteration of adhesion molecule expression
138
Use of thalidomide
MMENLskin manifestations of SLEHIV associated wasting CrohnConditioning before stem cell transplantationMDSkaposi sarcomaPrimary brain malignanciesRecurrent aphthous ulcersTBGVHD
139
Histone deacetylase inhibitors
VorinostatRomidepsin
140
Use of histone deacetylase inhibitors
Cutaneous T cell lymphoma
141
Recombinant IL-2
Aldesleukin
142
Use of aldesleukin
RCCmalignant melanoma
143
Use of neoadjuvant chemotherapy
BladderBreastColorectalStomachEsophagusLung
144
Recombinant IL-11
OprelevkinUsed to prevent thrombocytopenia
145
Rx for radiation induced xerostomia
PilocarpinePalifermin
146
Induction Rx for ALL
Intrathecal MTXasparaginaseDaunorubicinPrednisoloneVincristineMAD PV
147
Drugs used during consolidation phase of ALL
Hyper CVAD alternated with cytarabine+MTXcyclophosphamide VincristineAdriamycinDexamethasone
148
Rx of choice for AML
Cytarabine+Daunorubicin/idarubicin
149
Rx of choice for CLL
FludarabineCyclophosphamide Rituximab FCR
150
Rx of choice for Hodgkin
ABVDadriamycinBleomycinVinblastineDacarbazine
151
Rx of choice for non hodgkin lymphoma
R-CHOPRituximabCyclophosphamide Hydroxydaunorubicin(doxorubicin)Oncovin(vincristine)Prednisone
152
Rx of choice for multiple myeloma
BortezomibDexamethasone Lenalidomide
153
Rx of choice for waldenstrom macroblobinemia
FCR
154
Rx of choice for non small cell lung Ca
CisplatinVinorelbine+/- bevacizumab
155
Rx of choice of small cell lung Ca
Cisplatin+etoposide
156
Rx of choice of mesothelioma
Cisplatin+pemetrexed
157
Rx of choice for head and neck cancer
Cisplatin+5FU
158
Rx of choice for esophageal Ca
Cisplatin+5FU
159
Rx of choice of ovarian cancer
Paclitaxel+carboplatin
160
Rx of choice cervical Ca
Paclitaxel+cisplatin
161
Adjuvant chemotherapy for Ca breast
DoxorubicinCyclophosphamide Docetaxel
162
Rx of choice of uterine cancer
Progestin/tamoxifen/Aromatase inhibitorsCisplatin+doxorubicin+paclitaxel
163
Rx of choice for choriocarcinoma
MTX/dactinomycin
164
Rx of choice of testicular Ca
BEPBleomycin+etoposide+cisplatin
165
Rx of choice for kidney cancer
Sunitinib
166
Rx of choice for bladder cancer
Gemcitabine+cisplatin
167
Rx of choice for astrocytoma/GBM
Temozolamide
168
Rx of choice for neuroblastoma
Cyclophosphamide DoxorubicinCisplatinEtoposide
169
Rx of choice for thyroid Ca
I131Sorafenib
170
Rx of choice for stomach cancer
EpirubicinCisplatin5FU
171
Rx of choice for pancreatic Ca
GemcitabineGemcitabine+cisplatin/erlotinib
172
Rx of choice for colon cancer
FOLFOX6+/- bevacizumabFOLFIRI+/- bevacizumabFOLinic acid+5FU+OXaliplatinFOLinic acid+5FU+IRInotecan
173
Rx of choice for rectal cancer
Radiotherapy5FU
174
Rx of choice for anal Ca
RT+5FU+mitomycin C
175
Rx of choice for insulinoma
Interferon/Streptozocin
176
Rx of choice for osteosarcoma
DoxorubicinCisplatinIfosfamide High dose MTXAny two of above drugs
177
Rx of choice for soft tissue sarcoma
MAIDMesnaAdriamycinIfosfamide Dacarbazine
178
Rx of choice for melanoma
Dacarbazine/temozolamide/IL2
179
Rx of choice for HCC
Sorafenib
180
Rx of choice for kaposi sarcoma
Liposomal doxorubicin/Daunorubicin
181
Rx of choice for adrenal Ca
Mitotane
182
Rx of choice for carcinoid
Streptozocin+5FU
183
Other name for Amifostine
Ethyol
184
Dose limiting side effect of Amifostine
Hypotension
185
Route of administration of Amifostine
SC
186
OER
Oxygen enhancement ratioAmount of radiation dose required before and after radiation

Hematology (9 decks)

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