Cancer Drugs

Question 1

What is the MOA of Cyclophosphamide?

Answer 1

Alkylate DNA

Question 2

What are the toxicities of Cyclophosphamide?

Answer 2

Forms acrolein –> hemorrhagic cystitis

Question 3

What are special considerations of Cyclophosphamide?

Answer 3

MESNA/hydration to prevent/treat HC

Question 4

What is the MOA of Carmustine?

Answer 4

Alkylate DNA

Question 5

What are special considerations of Carmustine?

Answer 5

Crosses BBB

Question 6

What is the MOA of Cisplatin?

Answer 6

Alkylate DNA

Question 7

What are toxicities of Cisplatin?

Answer 7

• Renal toxicity

- Acoustic nerve damage

Question 8

What are special considerations of Cisplatin

Answer 8

Give Amifostine (for renal tox)

Question 9

What is the MOA for Doxorubicin?

Answer 9

Alkylate DNA

Question 10

What are the toxicities of Doxorubicin?

Answer 10

Cardiotoxic due to free radicals produced; toxicity increased by iron

Question 11

What are special considerations for Doxorubicin?

Answer 11

Give Dexrazoxane (iron chelator to decrease toxicity)

Question 12

What is the MOA of Methotrexate?

Answer 12

Antimetabolites (S Phase)

Inhibits DHFR
Blocks DNA, RNA, protein synthesis

Question 13

What are toxicities of Methotrexate?

Answer 13

• Mucositis
• Thrombocytopenia
• Nephrotoxicity

Question 14

What are special considerations of Methotrexate?

Answer 14

Leucovorin rescue (bypasses inhibited reductase)

Question 15

What is the MOA of 6-Mercaptopurine?

Answer 15

Antimetabolites (S Phase)

Converted by HGPRT to a ribonucleotide which inhibits synthesis of purine nucleotides: DNA, RNA

Question 16

What are toxicities of 6-Mercaptopurine?

Answer 16

• Bone marrow suppression
• Jaundice
• Allopurinol = fatal blood dyscrasias

Question 17

What are special considerations with 6-Mercaptopurine?

Answer 17

Leucovorin rescue

Avoid use with allopurinol or reduce dose

Question 18

What is the MOA for 5-Fluorouracil?

Answer 18

Antimetabolites (S Phase)

Inhibits thymidylate synthase (TS) – blocks DNA synthesis

Question 19

What are toxicities of 5-Fluorouracil?

Answer 19

Oral, GI ulcerations

Question 20

What are special considerations with 5-Fluorouracil?

Answer 20

Leucovorin enhances response

Question 21

What is the MOA for Paclitaxel?

Answer 21

Mitosis Inhibitors (M Phase)

Binds beta-tubulin

Question 22

What are toxicities of Paclitaxel?

Answer 22

• Myelosuppression (severe)
• Anemia
• Peripheral neuropathy

Question 23

What is the MOA for Vincristine?

Answer 23

Mitosis Inhibitors (M Phase)

Bind to tubulin –> cell cycle arrest

Question 24

What are toxicities of Vincristine?

Answer 24

Neurotoxicity

Question 25

What is the MOA for Vincblastine?

Answer 25

Mitosis Inhibitors (M Phase) Bind to tubulin --> cell cycle arrest

Question 26

What are the toxicities for Vincblastine?

Answer 26

Myelosuppression

Question 27

What is the MOA for Bleomycin?

Answer 27

G2-M Phase Binds directly to DNA

Question 28

What are toxicities of Bleomycin?

Answer 28

- Hypersensitivity | - Pulmonary fibrosis

Question 29

What are special considerations with Bleomycin

Answer 29

Has low myelosuppression

Question 30

What is the MOA for Imatinib (Gleevac)?

Answer 30

Tyrosine Kinase Inhibitor Inhibits Bcr-Abl

Question 31

What are toxicities of Imatinib (Gleevac)?

Answer 31

Edema

Question 32

What are special considerations with Imatinib (Gleevac)?

Answer 32

Leukemias; test for mutation

Question 33

What is the MOA for Cetuximab?

Answer 33

Epidermal Growth Factor Inhibitor Antibody that binds EGF receptor to inhibit tyrosine kinase --> growth inhibition/apoptosis

Question 34

What are toxicities of Cetuximab?

Answer 34

- Acneiform skin rash | - Hypomagnesemia

Question 35

What are special considerations with Cetuximab?

Answer 35

Test for EGFR expression and mutations

Question 36

What is the MOA for Erlotinib?

Answer 36

Epidermal Growth Factor Inhibitor Blocks ATP binding to EGF receptor --> growth inhibition/apoptosis

Question 37

What are toxicities for Erlotinib?

Answer 37

Rash, diarrhea, anorexia

Question 38

What are special considerations with Erlotinib?

Answer 38

Test for EGFR expression and mutations

Question 39

What is the MOA for Bevacizumab?

Answer 39

Epidermal Growth Factor Inhibitor Prevents binding to VEGF receptor --> inhibits angiogenesis --> slows blood supply/tumor growth

Question 40

What are toxicities of Bevacizumab?

Answer 40

- Bleeding | - Thromboembolism