Chemotherapy Drugs

Question 1

Drug that acts as a mitotic spindle poison causing depolymerization of microtubles leading to destabilization; comes from periwinkle plant

Answer 1

Vinca Alkaloids

• Vincristine
• Vinblastine

Question 2

What are the adverse effects of vinca alkaloids?

Answer 2

1) Neuro toxicity (Jaw pain, foot drop, constipation, paralytic ileus)
2) Vincristine cause SIADH
3) Bone marrow hypoplasia
4) Lethal if given IT
5) Vesicant

Question 3

Drug that catalyzes the hydrolysis of asparagine to aspartic acid resulting in the inhibition of protein synthesis in tumor cells dependent upon aspargine?

Answer 3

1-Asparaginase

Question 4

Drug that inhibits tyrosine kinase enzyme abl-bcr and induces apoptosis to cells positive for abl-bcr

Answer 4

Imatinib

Question 5

What is Imatinib used to treat?

Answer 5

Imatinib is used to treat chronic myeloid leukemia which is caused by the translocation of 9:22 abl-bcr

Question 6

How does Rituximab work?

Answer 6

Rituximab is a monoclonal antibody that is selective for CD20 which is found on B-cells; once activated it causes complement dependent cytotoxicity

Question 7

Drugs that inhibit topoisomerase II generating free radicals and causing DNA breakage

Answer 7

Antrhacylines

• Daunorubicin
• Doxorubicine (adriamycin)

Question 8

Toxicity of antrhacylcines (doxurubicin/adriamycin)

Answer 8

1) Dilated Cardiomyopathy and congestive heart failure
2) Severe vesicants (blistering)
3) Myelosuppresion
4) Stomatitis- inflammation of mucous lining in mouth

Question 9

What drugs bind to tubulin and stabilize mitotic spindles causing inhibition of mitosis?

Answer 9

Taxanes

1) Paciltaxel
2) Docetaxel

Question 10

What drug forms ternary complex with DNA and topoisomerase II preventing ligation of DNA strands?

Answer 10

Etoposide

Question 11

How does cyclophosphamide work?

Answer 11

Cyclophosphamide is a classic alkylating agent that alkylates the 7th position nitrogen of guanine in DNA

Question 12

Drug that inhibits replication by acting as a chain terminator; pyrimidine analog

Answer 12

Cytarabine

Question 13

Drug that inhibits the conversion of folic acid to tetrahydrofolic acid by acting as a folic acid analog for dihydrofolate reductase; results in defective thymidine synthesis; S phase specific

Answer 13

Methotrexate

Question 14

Drug that inhibits purine nucleotide synthesis and metabolism; thiopurine analog

Answer 14

6-Mercaptopurine

Question 15

MOA of Leucovorin

Answer 15

1) Supplies reduced amount of folate that enables for purine synthesis to occur
2) Used for methotrexate toxicity

Question 16

MOA of Cisplatin

Answer 16

Platinum alkylating compound that causes cross linking of DNA which causes damage

Question 17

Drug that binds to Ferrous iron and DNA causing single and double free radicals

Answer 17

Bleomycin

Question 18

What are the toxic effects of bleomycin?

Answer 18

1) Pulmonary fibrosis (think: BLAB)
2) Raynaud’s phenomenon
3) Palmar-plantar erythema
4) Mucositis

Question 19

What are the toxic effects of rituximab?

Answer 19

1) Infusion related bronchospasm, hypotension

2) Leukopenia

Question 20

What is apspariginase used to treat?

Answer 20

Acute Lymphoblastic leukemia

Question 21

What is the treatment for acute promyelocytic leukemia?

Answer 21

Tretinoin

Question 22

Toxicity of Methotrexate

Answer 22

1) Myelosuppresion (neutropenia in particular)
2) Renal Toxicity
3) Hepatic
4) CNS (seizures, changes in mental status)
5) GI (mucositis in particular)
6) Teratogenic

Question 23

What drug can have full doses of other chemotherapeutic with it?

Answer 23

Imatinib

Question 24

What is a side effect of ATRA?

Answer 24

Pseudotumor cerebri

Question 25

Drug that inhibits thymidylate synthase resulting in decreased DNA and protein synthesis

Answer 25

5-Fluoruracil

Question 26

What is given for a 5-fluoruracil toxicity

Answer 26

thymidine

Question 27

MOA of busulfan

Answer 27

Alkylates DNA

Question 28

Adverse effects of busulfan

Answer 28

1) Pulmonary fibrosis | 2) hyperpigmentation

Question 29

Monoclonal antibody against CD20

Answer 29

Rituximab

Question 30

bcr-abl tyrosine kinase inhibitor

Answer 30

Imatinib

Question 31

Monoclonal antibody against HER-2

Answer 31

Trastuzumab

Question 32

Hemorrhagic cystitis caused by chemotherapeutic drug

Answer 32

Cyclophosphamide

Question 33

What must you be aware of when treating with chemotherapeutics?

Answer 33

Tumor lysis syndrome 1) Leads to increased amounts of K and Nucleotides 2) Results in arrhythmias and elevated uric acid levels

Question 34

What drugs can be used to reduce tumor lysis syndrome?

Answer 34

1) Allopurinol (xanthine oxidase inhibitor) | 2) Rasburicase (acts like urate oxidase -breaks down uric acid)

Question 35

Drug selective for HER2

Answer 35

Trastuzumab

Question 36

Drug selective for IgE

Answer 36

Omalizumab

Question 37

Drug selective for CD20

Answer 37

Rituximab

Question 38

Drugs selective for TNF-alpha

Answer 38

1) Infliximab | 2) Adalimumab

Question 39

What do you use to prevent nephrotoxicity when using cisplatin

Answer 39

Amifostine

Question 40

What drug do you give to prevent hemorrhagic cystitis in pt. receiving cyclophosphamide?

Answer 40

Mesna | - Binds to acrolein

Question 41

What is the cause of hemorrhagic cystits by cyclophosphamide?

Answer 41

Metabolism of cyclophosphamide to acrolein