Chemo Drugs 3: ABX antitumor agents

Question 1

Doxorubicin
RED drug

class/MoA
sch X X
Cross resistance/Reverse
Toxicity/prevention
inc risk
dose red
Use

Answer 1

Class: ABX antitumor agent
MoA: TopII inh- intercalation dsDNA break
CCNS (sch independent cytotox)
Cross resistance: topII inh and tubulin inh (plant alk) via P-GLYCOPROTEIN EFFLUX pump
Reverse resist: continuous infusions, quinine, verapamil, cyclosporine
cum sch DEPENDENT CARDIAC toxicity= congestive cardiomyopathy know EF prior
inc risk: irradiation, uncHTN
DEXRAZOXANE: cardioprotective iron chelator
dose red: jaundice
Use: breast and lymphoma

Question 2

Irinotecan

Class/MoA
Met and syn
AE and Tx
dose red
USe

Answer 2

Class: ABX antitumor agent
MoA: TopI inh- ssDNA break
CCNS
Met: liver UGTIAI
UGTIAI*28 underexpress = no bilirubin metab = GILBERT'S SYN
Acute: cholinergic DIARRHEA Tx atropine
Late: secretory D Tx imodium
dose red: jaundice
Use: GI tract

Question 3

Bleomycin

Class/MoA
CCS
Toxicity/Monitor/avoid
AE
dose red
Use

Answer 3

Class: ABX antitumor agent
MoA: free radical DNA breaks
CCS: G2-M ph
cum PULM toxicity DL - prior PFTs monitor CO diffusion. AVOID high [O2]
AE: hyperpigment, palm hyperkeratosis, anaphylactoid rxns
dose red: liver
Use: Testicular

Question 4

Prednisone

Class/MoA
AE
Use

Answer 4

Class: Hormonal Agent
MoA: Steroid receptor ag
AE: Cushings effects, euphoria, alt sleep, ulcers/perforations, cataracts
Use: lymphoma and multiple myeloma

Question 5

Dexamethasone

Class/MoA
AE
Use

Answer 5

Class: Hormonal Agent
MoA: Steroid receptor ag
AE: Cushings effects, euphoria, alt sleep, ulcers/perforations, cataracts
Use: reduce cerebral edema (brain mets), spinal cord compression
potentiates ondansetron (help Tx chemo emesis)

Question 6

Tamoxifen

Class/MoA
Risk
favorable
Use

Answer 6

Class: Hormonal Agent
MoA: SEstrogenRM
inc RISK ENDOMETIRAL CA
favor: lipid profile and dec bone loss postmenopause
Use: Breast

Question 7

Anastrozole

Class/MoA
AE
Use

Answer 7

Class: Hormonal Agent
MoA: Aromatase inh
lowers plasma estrogen quickly
AE: arthralgia/bone pain
Use: ER+ breast CA

Question 8

Flutamide

Class/MoA
Use

Answer 8

Class: Hormonal Agent
MoA: Inh bind/uptake testosterone
BLOCKS flare rxn
Use: Prostate, ADT

Question 9

Leuprolide acetate

Class/MoA
Use

Answer 9

Class: Hormonal Agent
MoA: GnRH rec. agonist
first: FLARE RXN inc FSH/LH -> inc testosterone = worse tumor/bone pain
Later: GnRHR dec = dec FSH/LH and testosterone
Use: Prostate