Flashcards in Chapter 38: Pharm of Cancer Deck (31)
1
This drug inhibits thymidylate synthase, thus decreasing availability of dTMP = "thymineless death"
Fluorouracil (5-FU)
2
What is the orally available prodrug of 5-FU?
Capecitabine
3
GI cancers, breast cancer, skin cancer like basal cell carcinoma can be treated by this inhibitor of thymidylate synthase....
5-FU
4
What are the major adverse effects of 5-FU?
myelosuppression
photosensitivity
(atherosclerosis, cerebellar syndrome, vision changes, alopecia, GI probs)
5
6-MP effectiveness and toxicity is increased by ______?
allopurinol
6
6-MP MOA?
inhibit IMP dehydrogenase to prevent formation of GMP/AMP by IMP
7
6-MP and Azathioprine have the same MOA - which one is used mainly for immunosuppression and which is used mainly for ALL/AML?
Immunosupression - azathioprine
ALL/AML - 6-MP
8
What drug inhibits ribonucleotide reductase? (thus decreasing DNA synthesis...S phase specificty)
Hydroxyurea
9
What does hydroxyurea do in the treatment of sickle cell disease?
increases HbF
10
Drug used in the treatment of myeloprolierative disorders like essential thrombocytosis or polycythemia vera
hydroxyurea
11
What are the major adverse effects of hydroxyurea?
myelosuppression
GI disturbance
12
MOA of cyclophosphamide
covalently binds DNA...
directly modify DNA structure - alkylating agent
13
What are the major adverse effects of cyclophosphamide?
Myelosuppression, hemorrhagic cystitis (BLADDER!!!)
14
An alkylating agent that is one of the most versatile nitrogen mustards in clinical use. It is a prodrug that must be first activated by hepatic P-450 to produce its active metabolites.
Cyclophosphamide
15
What potentiates the action of 5-FU?
Folinic acid
16
Super versatile, broad spectrum agent used to treat autoimmune disease, leukemias, lymphomas, mycosis fungoides, neuroblastoma, malignant histiocytosis, and more.
cyclophosphamide
17
Alkylating agent that directly binds DNA and is used for the treatment of brain cancer
Carmustine
18
Agents that cross link intra-strand guanine bases used in the tx of genitourinary cancers (including testicular), lung cancer....
Cisplatin
Carboplatin
19
What are the major adverse effects of cisplatin and carboplatin? Which of these is exclusive to cisplatin?
Myelosuppresion, peripheral neuropathy, ototoxicity, nephrotoxicity
Nephrotoxicity - cisplatin only
20
How do you limit the nephrotoxicity of cisplatin?
co admin with amifostine
21
Bleomycin MOA?
Binds oxygen and chelates iron ....binds DNA --> STRAND BREAKS via generating oxidative intermediates
22
What is the dose limiting side effect of bleomycin?
pulmonary fibrosis
irreversible
23
What types of cancers is bleomycin used to treat? Why?
Potentially curable cancers because pulmonary fibrosis effect can be so bad
testicular cancer, hodgkins disease, non hodg lymphoma, squamous cell carcinoma
24
Doxorubicin and daunorubicin made adverse effect? MOA?
heart failure
inhibit top II - G2 phase of cell cycle
25
What top I inhibitor can cause life threatening diarrhea?
TECANS -
irinoTECAN
topoTECAN
26
In giving doxorubicin to a pt with hepatic dysfxn, what must you keep in mind?
reduce dosing bc drug is excreted in bile
27
Vinblastine MOA and dose limiting effect?
binds tubulin subunits and prevents microtubule polymerization
bone marrow suppression is dose limiting
28
Vincristine MOA and dose limiting effect?
binds tubulin subunits and prevents microtubule polymerization
peripheral neuropathy is dose limiting
29
Which drugs come from the peri-winkle plant?
vincristine & vinblastine
30
What drug inhibits microtubule DEpolymerization? What is this drug's dose limiting effect?
paclitaxel
peripher neuropathy - stocking/glove sensory loss
31