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Oncology > Chemo > Flashcards

Chemo Flashcards

1
Q

3 M Phase Specific Drugs

A

Vincristine, vinblastine, taxanes

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2
Q

Phase Non Specific Drugs

A

Alkylating Agents

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3
Q

4 S Phase Specific (& which 2 are self limiting)

A

Cytarabine, hydroxyurea

Self Limiting: 6-MP, Methotrexate

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4
Q

5 Classes of Alkylating Agents

A 
Nitrogen mustards
Nitrosoureas (BCNU, CCNU)
Methane sulfonic acid esters (busulfan)
Triazenes (DTIC)
Ethylamines (thiotepa)
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5
Q

Similar Side Chain in Nitrogen Mustards

A

2 chloro ethyl groups

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6
Q

Alkylating Agents Mech

A

Add Cs to bases (like guanine base) so other elements can’t be added

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7
Q

Main Side Effect for Nitrogen Mustards/Alkylating Agents

A

Myelosuppression, worst around day 10 (have 10 days of BM reserves). So neutropenic fever most at risk then. By 14 recovered enough to do again

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8
Q

5 Nitrogen Mustards

A 
Mechlorethamine
Melphalan
Chlorambucil
Cyclophosphamide
Ifosfamide
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9
Q

3 Other Big Side FX for Ifosfamide

A

Hemorrhagic cystitis
Encephalopathy
Acquired Fanconi’s syndrome

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10
Q

Nitrosoureas Structure

A

Just one chloro ethyl group. Lipophilic so for brain cancers

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11
Q

4 Cancer Types and Alkylating Agent Use

A

Sarcoma - ifosfamide
HL - M in MOPP (mechlorethamine)
Breast - cyclophosphamide
Lymphoma - C in CHOP (cyclophosphamide)

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12
Q

3 Antimetabolite Classes

A

Folate acid analogs (Methotrexate)
Purine analogs
Pyrimidine analogs (5-FU, Xeloda, Cytosine Arabinoside/Ara-C)

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13
Q

Methotrexate Structure

A

Exactly like folate but with H->methyl and -OH->-NH2 replacements

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14
Q

Methotrexate Mech

A

Blocks DHF Reductase, which catalyzes DHF into THF (C carrying version), so blocks both purine and pyrimidine synth

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15
Q

Leukovorin

A

Reduced folic acid used for rescue from methotrexate

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16
Q

Fludarabine

A

Purine analog. Has F bound so too strong to break

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17
Q

5-Fluorouracil

A

Pyrimidine analogue that Has F bound so you can’t attach methyl group to convert U->T, irreversibly blocking thymidylate synthetase. Can’t make TMP

18
Q

Ara-C

A

Pyrimidine analog, put into DNA instead of dCTP. Unstable

19
Q

Methotrexate 3 Side Effects

A 
Renal toxicity (precipitates, so hydrate and alkalinize urine)
Liver toxicity (chronic)
Leukoencephalopathy (can lead to dementia)
20
Q

5-FU 3 Side Effects

A

Myelosuppression, diarrhea, stomatitis

21
Q

Ara-C Side Effect

A

Myelosuppression, but it’s for leukemia so you want

22
Q

Methotrexate RoA (3)

A

PO/IV/IT

23
Q

5FU RoA (2)

A

IV/Topical (GI)

24
Q

Ara-C RoA (3)

A

IV/SQ/IT

25
Q

Xeloda (class, mech/clearance, side effect)

A

Pyrimidine analog, converted to 5-FU in liver so secreted over long time and can cause hand/foot syndrome skin toxicity

26
Q

Gemcitabine SFX

A

Thrombocytopenia

27
Q

Fludarabine 2 SFX

A

T cell depletion (need PCP prophylaxis Bactrim)

Interstitial pneumonia

28
Q

Antimetabolite Phase Specificity and General Contraind

A

S phase specific

Not during pregnancy, esp. 1st trimester

29
Q

2 Classes of Antitumor Antibiotics and 2/1 Drugs in Them

A

Intercalators - Adriamycin, Daunorubicin (H Idarubicin)

Strand Scission - Bleiomycin

30
Q

Adriamycin/Daunorubicin SFX

A

Local necrosis and CARDIOTOXICITY

31
Q

Big Antitumor Antibiotic Side Effect and which one is omitted

A

Skin damage except for bleiomycin so can give subcut

32
Q

Bleiomycin Side Effect

A

Pulmonary fibrosis, dose related, so increased FiO2 in anesthesia very toxic bc of free rads

33
Q

3 Antitumor Antibiotics NOT Cleared by Kidney

A

Adriamycin, Daunorubicin, Mitomycin, (Actinomycin D cleared by kidney and biliary)

34
Q

Vinca alkaloids

A

Disrupt MT function so most effective at metaphase arrest (but also at risk for neurotoxicity (cristine) bc neurons need MTs and myelosuppression (blastine))

35
Q

Etoposide

A

Podophyllotoxin plant alkyloid that blocks Topoisomerase II

36
Q

Taxanes

A

Derived from yew tree and block tubulin polymers stabilizing MTs

37
Q

Paclitaxel SFX

A

Neuropathy worse w/ short infusion schedules

38
Q

Docetaxel SFX

A

Capillary leak syndrome

39
Q

Irinotecan

A

Topoisomerase I inhibitor that requires conjugation to glucuronide so can’t give with elevated BR or anything

40
Q

Cisplatin

A

Only one without carbon, binds DNA and forms adducts. Good for BRCA bc impaired repair but very nephrotoxic

Oncology (11 decks)

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