Cancer Drugs Flashcards Preview

USMLE Step 1 > Cancer Drugs > Flashcards

Flashcards in Cancer Drugs Deck (12)
1

Anti-metabolite drugs

  • Folate antagonist
    • Methotrexate
  • Purine Analogs
    • 6-thiopurines
      • 6-mercaptopurine
      • 6-guanopurine (?)
    • Fludarabine ==> CLL tx
    • Cladribine ==> HCL tx
  • Pyrimidine Ananologs
    • 5-FU
    • Capecitabine
    • Cytarabine
    • Gemcitabine

2

Vinblastine: MOA, SE

  • MOA:
    • inhibits MT formation of mitotic spindle
  • SE:
    • alopecia
    • constipation
    • myelosuppression
    • neurotoxicity (rare)

3

Cancer drugs that act in the M phase of the cell cycle

  • vinca alkaloids=inhibit MT fxn/spindle formation
    • vincristine
    • vinblastine
  • paclitaxel 
    • binds to tubulin and hyperstabilizes MTs that have already polymerized ==> prevents spindle breakdown

4

5-fluorouracil: MOA, use

  • anti-metabolite
  • prevents formation of thymidine vua inhibition of thymidylate synthase
  • uses
    • slow-growing solid tumors:
    • breast
    • ovarian
    • pancreatic
    • colorectal
    • gastric carcinomas

5

6-mercaptopurine: MOA, use

  • anti-metabolite
  • inhibits formation of purines
  • use = cancer drug

6

Methotrexate: MOA, use

  • anti-metabolite
  • inhibts dihydrofolate reductase ==> inhibition of DNA synthesis (via same pathway as 5-fluorouracil)
  • use = cancer drug

7

Busulfan: MOA, use

  • DNA alkylating agent (cell cyle nonspecific)
  • use = CML

8

Bleomycin: MOA, use, SE

  • inhibit replication by inducing DNA strand breaks via free radical formation
  • strand breakage interrupts G2 phase of cell cycle (after DNA synthesis)
  • uses: testicular tumors, lymphomas, squamous cell carcinoma
  • SE
    • rales, cough
    • infiltration ==> fibrosis

9

Cyclophosphamide: MOA, uses, SE

  • DNA alkylating agent (cell cycle nonspecific)
    • activated by CYP450
    • ==> apoptosis via DNA crosslinking
  • uses
    • leukemias, lymphomas
    • testicular and gyn cancers
  • SE
    • hemorrhagic cystitis

10

How to prevent major side effect of cycloposphamide

  • prevent hemorrhagic cystitis via:
    • adequate hdration
    • IV injection of mesna

11

Methotrexate rescue

  • folinic acid aka n-formyl-xxxx aka leucovorin
  • acts synergystically with 5FU

12

Common method of chemotherapy resistance

  • human multi-drug resistance gene (MDR1)
  • p-glycoprotein = transmembrane ATP-dependent efflux pump
    • broad specificity for hydrophobic compounds
    • decreases drug entry and increases efflux

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