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Chemo Rx 2 Flashcards

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1
Q

List the sub-classes of the mitotic inhibitor class of chemo rx.

A
  1. vinka alkaloids
  2. -“taxanes”
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2
Q

Mitotic inhibitors are _____ (CCS/CCNS).

A

CCS → halt the M phase

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3
Q

Vinblastine is the most _______ (AE); Vincristine is the most ______(AE)

A
  • myelosuppressive
  • neurotoxic

(mn: Vinblastine BLASTS the bones; Vincristine CRISps the nerves”)

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4
Q

Mechanism of resistance to the mitotic inhibitors is via P-glycoprotein. Which mechanisms are specific to vinka alkaloids? “-taxanes”?

A

vinka: increase Rx efflux

“-taxanes”: mutate B-tubulin

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5
Q

The mitotic inhibitors halt M phase by targeting microtubules, how are the vinka alkaloids and the taxanes different in their MOA?

A
  • vinka: inhibits tubulin polymerization
  • taxanes: promote b-tubulin formation

(mn: “No Assemblies allowed in the vineyard; Taxes are Stable.”)

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6
Q

Which Taxane targets solid tumors? Which target non-small cell, head, neck, ovarian, bladder and breast?

A
  • paclitaxel
  • docetaxel
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7
Q

_______ (vinka alkaloid) targets lymphoma (hodgkins & NHL), breast and testicular cancer.

A

vinblastine

(most myelosuppressive)

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8
Q

_______ (vinka alkaloid) targets ALL, Hodgkin, leukemia & Wilms tumor?

A

Vincristine

(most neurotoxic)

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9
Q

Vinorelbine targets ______ (cancer)

A

solid tumors

(non-small cell lung, breast)

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10
Q

AE of the Taxanes (2)

A
  1. Myelosuppression
  2. hypersensitivity reaction (pre-treat w/corticosteroids & antihistamines)

(Docetaxel → neurotoxicity)

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11
Q

List the 2 sub-classes of the Topoisomerase Inhibitors (reduce supercoiling of DNA)

A
  1. Camptothecins
  2. Podophyllotoxins

(inhibiting the S phase)

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12
Q

What is the difference in the MOA between the Camptothecins and the Podophyllotoxins?

A
  • camptothecin inhibits topoisomerase I
  • podophyllotoxin inhibits topoisomerase II

(both cause strand to break from ⇣ supercoiling)

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13
Q

Which camptothecin treats metastatic colorectal cancer? Which treats ovarian?

A
  • Irinotecan: colorectal
  • Topotecan: ovarian
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14
Q

Which camptothecin has severe diarrhea as an adverse effect in addition to N/V & alopecia?

A

Irinotecan

(tx: metastatic colorectal CA)

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15
Q

Which of the topoisomerase inhibitors needs a dosage adjustment for renal dysfunction?

A

Etoposide (podophyllotoxin sub-class)

(tx: Lung CA & Lymphomas)

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16
Q

Which podophyllotoxin (sub-class of topoisomerase inhibitors) treats Lung CA & lymphoma? Which treats Acute Leukemia?

A
  • Etoposide: Lung & Lymphoma
  • Teniposide: Acute Leukemia
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17
Q

Which of the Antitumor ABX is CCS?

A

Bleomycin

(the other antitumor ABX are CCNS)

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18
Q

List the 3 anthracyclines (sub-class of antitumor ABX)

A
  1. Doxorubicin
  2. Daunorubicin
  3. Mitoxantrone
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19
Q

Doxorubicin & Mitoxantrone target solid tumors, specifically _____.

A

breast cancer

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20
Q

Which anthracyclines both treat AML?

A
  1. Daunorubicin
  2. Mitoxantrone
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21
Q

Doxorubicin treats breast cancer and _____.

(mitoxantrone tx breast CA also)

A

leukemia/lymphoma

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22
Q

Mitoxantrone treats breast CA, and ______(4).

A
  1. prostate
  2. AML
  3. NHL
  4. GE
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23
Q

Which antitumor ABX treats HL, testicular, head, neck and skin CA?

A

Bleomycin

(AE: pulmonary fibrosis & mucocutaneous rxn)

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24
Q

Which 3 Antitumor ABX impair topoisomerase II & generate free radicals to inhibit RNA & DNA synthesis?

Study These Flashcards
A
  1. Doxorubicin
  2. Mitoxantrone
  3. Daunorubicin

(anthracyclines)

25
\_\_\_\_\_\_\_ MOA = reaction w/O2→ superoxide hydroxyl radical
bleomycin (tx: HL, testicular, head, neck & skin CA)
26
Mechanism of resistance to bleomycin
1. increase bleomycin hydrolase 2. ⇡ DNA repair
27
Side effect of ______ is red urine
mitoxantrone | (least cardiotoxic)
28
Mucocutaneous reaction and pulmonary fibrosis are side effects of \_\_\_\_\_\_\_
bleomycin (similar to Hand-foot syndrome - AE of Capecitabine)
29
\_\_\_\_\_\_\_ is the MC acute dose-limiting toxicity of the anthracyclines (subclass of topoisomerase inhibitors)
Myelosuppression
30
Prednisone is converted to prednisolone by \_\_\_\_\_\_\_.
11-B-HSD
31
Prednisone is used to treat \_\_\_\_\_\_(2 types CA)
1. Acute leukemia (ALL) 2. Lymphoma (HL & NHL)
32
\_\_\_\_\_\_ causes lymphocytopenia & decreases lymphoid mass.
Prednisone
33
Which hormonal agent is a SERM (selective estrogen receptor modulator) which inhibits RNA synthesis
Tamoxifen
34
Menopausal sx & endometrial cancer are potential AE of \_\_\_\_\_. Hot flashes & arthralgia are side effects of \_\_\_\_\_\_-
* tamoxifen * aromatase inhibitors (anastrozole, letrozole, exemestane) (tx: breast CA)
35
Which 2 hormonal agents **subclasses** treat breast cancer?
1. Estrogen receptor Antagonist (SERM) 2. Aromatase
36
List the 3 Aromatase inhibitors used to treat breast cancer. (block conversion of testosterone→estrogen)
1. Anastrozole 2. Letrozole 3. Exemestane
37
List the 3 Androgen receptor antagonists (DHT)
1. Flutamide 2. Bicalutamide 3. Enzalutamide
38
List the 2 GnRH agonists
39
Which 2 subclasses of hormonal agents treat prostate cancer?
1. GnRH agonists 2. Androgen receptor (DHT) antagonists
40
\_\_\_\_\_\_\_\_ treats resistant prostate cancer (metastatic castration)
Enzalutamide
41
\_\_\_\_\_\_ (subclass of hormonal agents) cause a surge in LH & FSH followed by inhibition.
GnRH agonists
42
Impotence and gynecomastia are side effects of _____ (subclass of hormonal agents)
GnRH agonists
43
List the 2 protease inhibitors (chemo Rx)
1. Borte**zomib** 2. Carfil**zomib** ("-zomib")
44
Bortezomib & Carfilzomib inhibit _____ → apoptosis
Proteasome
45
\_\_\_\_\_\_\_ treats Multiple Myeloma
Bortezomib & Carfilzomib | ("Bart proteasomal inhibitor zombie")
46
Which 2 classes of chemo Rx causes peripheral neuropathy, thrombocytopenia and heart failure?
1. Proteasome inhibitors (bortezomib & carfilzomib) 2. Taxanes (Vincristine (Vinka alkaloid), also)
47
Which 2 chemo medications are contraindicated which CYP3A4 inhibitors (including grapefruit juice)?
1. Nilotinib 2. Proteasome inhibitors (Bortezomib, Carfilzomib)
48
List 4 monoclonal Ab used to treat cancer
1. Bevacizumab 2. Cetuximab 3. Rituximab 4. Trastuzumab
49
\_\_\_\_\_ (mAb) treats CLL & lymphoma
Rituximab
50
\_\_\_\_\_\_\_ is an Anti-CD20 mAb and may cause a hypersensitivity reaction.
Rituximab | (causes complement activation)
51
\_\_\_\_\_\_\_ is a HER2 growth receptor inhibitor → ADCC. Side effect: CHF.
Trastuzumab
52
\_\_\_\_\_\_ is mAb that treats metastatic colorectal cancer and is a VEGF inhibitor.
Bevacizumab
53
Bevacizumab side effects (5)
1. delayed wound healing 2. thrombosis 3. GI perforation 4. proteinuria 5. HTN
54
\_\_\_\_\_ is used to treat metastatic colorectal cancer, and cancers of the head/neck. Acneiform rash is an indication of efficacy.
Cetuximab (MOA: epidermal growth factor inhibitor)
55
Cetuximab is a ______ inhibitor
epidermal growth factor
56
\_\_\_\_\_\_ is a side effect of the monoclonal Ab class of chemo Rxs.
tumor lysis syndrome → cytokine release causes fever/chills and hypotension (may be fatal if w/o intervention)
57
\_\_\_\_\_\_\_ is a tyrosine kinase inhibitor and is a second line therapy for CML.
Nilotinib
58
\_\_\_\_\_\_\_ is contraindicated in patients who have a long QT, hypomagnesemia, or hypoK+ or who drink grapefruit juice.
Nilotinib | (Grapefruit juice = CYP3A4 inhibitor)
59
Nilotinib may cause CHF, QT prolongation or \_\_\_\_\_\_.
pancreatitis

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