Chemo Drugs Reduced 3 Flashcards Preview

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Flashcards in Chemo Drugs Reduced 3 Deck (10):
1

Doxorubicin

Topoisomerase 2 Intercalator
Intercalates in DNA leads to breaks in DNA
Cell cycle nonspecific

Excreted as thiol adduct in bile
-Dose reduction in presence of Jaundice
Myelosuppression is dose limiting

Cumulative toxicity: Cardiomyopathy
-obtain ejection fraction prior to instituting therapy
-max life dose: 400

-shorter infusion times more toxic than longer*****schedule dependent toxicity******

-pretreat with dexrazoxane (iron chelator) may help

2

P glycoprotein membrane bound efflux pump is causes MDR is what 2 drug classes?

Topo 1 and 2 Inhibitors
Tubulin inhibitors

Mitomycin C
Actinomycin D

3

Irinotecan

Topo 1 inhibitor
Hepatic metabolism
-reduce dose in presence of jaundice

Early Diarrhea: cholinergic-treat with atropine
Late Diarrhea: secretory-treat imodium, hydration

UGT1A128 decreases glucuronidation and increases myelosuppression and diarrhea-Gilbert's syndrome

Treat: colon cancer

4

Bleomycin

Cell cycle specific (G2?)
Free radical damage to DNA

50% excreted in urine
-dose reduction necessary for renal insufficiency

liver and kidney inactivate drug (bleomycin hydrolase)
lungs and skin cannot inactivate drug
-skin pigmentation

Pulmonary toxicity dose limiting *** cumulative toxicity
-monitor with pulm function test-baseline prior to administration
-avoid high oxygen concentrations
-test dose for anaphylactoid reactions

Treat: Testicular Cancer

5

Prednisone

Treat: myeloproliferative or lymphoproliferative disorders
-multiple myeloma, Hodgkin's and non hodgkin's and some leukemias

Side effects: Weight gain, hypertension, edema, carb intolerance, suppression of pit-adrenal axis, weakness, euphoria, increased appetite

6

Dexamethasone

less mineralocorticoid activity than prednisone
-used in treatment of cerebral edema or spinal cord edema due to spinal cord compression

7

Tamoxifen

SERM
-can prevent breast cancer in high risk of developing breast cancer who take drug for 5 years
-must measure estrogen receptors on all breast cancer specimens

Side effects: hot flashes, thrombosis, endometrial cancer
-decrease rate of bone loss in postmenopausal women

-

8

Aromatase Inhibitors
Anastrozole, letrozole, exemestane

-rapidly decrease estrogen levels

Side effects: arthralgias, bone pain,bone loss, hot flashes

9

Flutamide and bicalutamide

inhibit cancer cell uptake of testosterone

10

Leuprolide acetate

Gonadotropin releasing hormone agonist
-decrease levels of testosterone by decreasing FSH and LH

-initial stimulation of FSH and LH lead to possible flare so pretreat with flutamide or bicalutamide

Side effects: weakness, decreased libido, erectile dysfunction, loss of muscle mass, gynecomastia, change in body fat distribution