Cancer Pharm Flashcards
(29 cards)
What is the MOA of alkylating agents?
They form covalent linkages with DNA to prevent them from unwinding and replicating
non cycle specific
What is the acute toxicity associated with alkylating agents
nausea and vomiting within 30-60 mins
Pretreat with a serotonin antagonist
What are the delayed toxicities assoc with alkylating agents
bone marrow depression with leukopenia, thrombocytopenia, nephrotoxicity, alopecia, mycosal ulceration, intestinal denudation
What specific toxicity is associated with cyclophosphamide
hemorrhagic cystitis
What specific toxicity is associated with cisplatin
renal tubular damage, ototoxicity
What specific toxicity is associated with busulfan
pulmonary fibrosis
What are the main categories of antimetabolites
folic acid analogs (methotrexate) pyrimidine analogs (5FU) Purine analogs (6-MP)
MOA of methotrexate
Methotrexate inhibits dihydrofolate reductase
What drug is used in conjunction with high-dose methotrexate therapy to rescue normal cells
leucovorin
MOA of 5-FU
pro-drug
FdUMP blocks synthesis of thymidylate
FdUTP gets incorporated into DNA and interferes with DNA synthesis and function
FUTP gets incorporated into RNA and interferes with RNA processing and mRNA translation
MOA of 6-MP
metabobolized by HGPRT to form monophosphate nucleotide 6-thioinosinic acid
Simultaneous administration of _____ and PO 6-MP results in increased levels of 6-MP and increased toxicity
allopurinol
Pharm effects of antimetabolites
S phase specific
relatively little acute toxicity after initial dose
Common toxicities include diarrhea, myelosuppression, nausea, vom, immunosuppression, thromobocytopenia, leukopenia, hepatotoxicity
MOA of vinca alkaloids (vinblastine and vincristine
bind to B-tubulin and inhibit microtubule assembly (depolarization)
M phase specific
common adverse effects include alopecia and bone marrow suppression
Vinblastine adverse effect
causes myelosuppression to a greater extent than vincristine
Vincristine adverse effect
cumulative neurological toxicities compared to vinblastine
MOA of taxanes
bind to B-tubulin and stabilize microtubule formation
M phase specific
Paclitaxel is the only relevant one right now
clinical relevance of paclitaxel
side effects: hypersensitivity rxns in hands and toes, change in taste
traditional treatment of breast cancer
What do epipodophyllotoxins (etoposide) and anthracycline antibiotics (doxorubicine) inhibit?
topoisomerase II
Effective antitumor antibiotic agents
anthracyclines
dactinomycin
bleomycin
mitomycin
Pharmacology of anthracyclines (doxorubicine)
topoisomerase II inhibitor, DNA intercalation
cell cycle nonspecific
produce free radicals - leads to significant cardiotoxicity
cumulative cardiac damage can lead to dysrhythmias and heart failure
pharmacology of bleomycin
single and double stranded DNA breaks
causes minimal myelosuppression- useful in combination
Can cause significant pulmonary toxicity and usually presents as pneumonitis with cough, dyspnea, dry inspiratory crackles
Pharmacology of L-asparaginase
targeted therapy for ALL
ALL tumor cells lack the enzyme as
G1 specific
MOA of L asparaginase
hydrolyzes circulating L asparagine into aspartic acid and ammonia, effectively inhibiting protein synthesis
