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Hem/Onc > Chemo drugs > Flashcards

Chemo drugs Flashcards

1
Q

cell cycle non specific agents

A

alkylating agents, anthracyclines, nitrosureas, platinum agents

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2
Q

cell cycle specific

A

antimetabolites, vincas, taxanes

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3
Q

2 main alkylating agents

A

cyclophosphamide, ifosfamide

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4
Q

alkylating agents MoA

A

direct crosslinking of DNA base pairs

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5
Q

alkylator toxicities

A

myelosuppression, nausea vomiting, 2 malignancies, infertility, *hemorrhagic cystitis from acrolein metabolite (worse w/ ifosfamide, treated w/ Mesna)

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6
Q

3 main Pt compounds

A

cisplatin, carboplatin, oxaliplatin

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7
Q

Pt compound general toxicities

A

peripheral neuropathy, nephrotoxicity, nausea/vomiting, thrombocytopenia, ototoxicity

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8
Q

oxaliplatin toxicity

A

cold sensitivity

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9
Q

cisplatin toxicity

A

extra nephrotoxic, gauranteed nausea vomiting

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10
Q

carboplatin toxicitiy

A

thrombocytopenia

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11
Q

nitrosureas toxicity

A

CNS, pulmonary, myelosuppression, nausea vomiting, phelbitis

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12
Q

general MoA antimetabolites

A

DNA replication/repair analogues, S phase specific

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13
Q

2 main folate antagonists

A

methotrexate, pemtrexed

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14
Q

MTX MoA

A

inhibits DHFR- tumor cells rely on endogenous folate for growth

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15
Q

MTX toxicity

A

mucositis, myelosuppression are characteristic

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16
Q

“rescue” of normal cells w/ MTX?

A

normal cells can use exogenous folate for growth unlike tumors

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17
Q

3 pyrimidine analogues

A

flurouracil and capecitabine (oral prodrug of flurouracil), cytarabine

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18
Q

toxicity of fluorouracil

A

w/ bolus: myelosuppression;
w/ continuous IV:
GI mucositis & diarrhea
Hand foot syndrome (esp w/ capecitabine)

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19
Q

fn of leucovorin w/ 5FU

A

potentiation: raises 5FU binding affinity to thymidylate synthase

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20
Q

fn of leucovorin w/ MTX

A

inhibits MTX, can be given a couple hours after to rescue

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21
Q

MoA of cytarabine

A

pyrimidine analog/antagonist

22
Q

toxicity of cytarabine

A

cerebellar toxicity, conjunctivitis w/ continous infusion and high dose

23
Q

6-mercaptopurine Moa

A

purine analog/antagonist, lowers de novo purine synthesis

24
Q

microtubule inhibitors

A

taxanes (paclitaxel) and vincas (vincristine and vinblastine)

25
Q

Vincas Moa

A

microtubule destruction- M phase specific

26
Q

vinca toxicity

A

cumulative neurotoxicity (peripheral neuropathy), variable myelosuppression: more in vinblastine

27
Q

what never to do w/ vincas

A

adminster intrathecally- fatal!!!!

28
Q

taxane moa

A

microtubule stabilization- M phase specific

29
Q

taxane toxicity

A

myelosuppression, peripheral neuropathy, hypersensitivty

30
Q

topo I fn

A

relaxing supercoil before transcription

31
Q

topo II fn

A

recoil DNA after transcription

32
Q

topo I inhibitors

A

camptothecins: topotecan and irinotecan

33
Q

topo I toxicities

A

myelosuppression, diarrhea (irinotecan)- early tx w/ atropine, late is life threatening and tx w/ loperamide aggressively

34
Q

topo II inhibitors

A

etoposide, teniposide

35
Q

topo II toxicities

A

myelosuppression, 2 malig, mucositis-dose dependent

36
Q

etoposide extra toxicity

A

formulated in agent that causes hypotension

37
Q

anthracycline examples

A

doxorubicin, daunorubicin, idarubicin, epriubicin, mitoxantrone

38
Q

primary and secondary moa of anthracyclines (original purpose?)

A

originally antibiotics;
moa- intercalate DNA and inhibit topo;
secondary is free radical damage and some alkylation

39
Q

anthracycline toxicity

A

dose dependent biventricular heart failure, myelosuppression, mucositis, extravasation

40
Q

most dangerous anthracycline

A

doxorubicin- highest cardiac risk

41
Q

anthracycline extravasation

A

drug administerd into peripheral tissue rather than vessels- can lead to blistering and necrosis

42
Q

bleomycin toxicity

A

pulmonary: interstitial pneumonitis, pulmonary fibrosis, hypersensitivity

43
Q

mechanism of bleomyciin toxicity

A

cytokine release, free radicals, lipid peroxidation, interstitial edema, stumulation of fibroblasts- collagen

44
Q

breast cancer hormonal therapies

A

antiestrogens: tamoxifen, fulvestrant, megestrol acetate
aromatase inhibitors:
anastrozole, letrozole, exemestane

45
Q

hormonal therapy for prostate cancer

A

antiandrogens: flutamide, bicalutamide, nilutamide
LHRH agonists: leuprolide, gosrelin
GnRH antagonist: degarelix
CYP17 inhib: abiratone

46
Q

bevacizumab target/toxcitiy

A

VEGF-R; proteinuria and G perforation

47
Q

cetuximab target/toxicity

A

EGFR; severe hypersensitivity, acneiform rash (can be good Px)

48
Q

imatinib moa

A

tyrosine kinase inhibitor for bcr-abl TK, inhibits prolif and induces apop in bcr-abl cell lines

49
Q

imatinib use/ brand name

A

CML mainly, Gleevac

50
Q

ipilimumab moa

A

CTLA-4 inhibitor- keeps T cells active to fight tumors

Hem/Onc (3 decks)

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