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MHD2/Pharm Block 5 > Chemotherapy Flashcards > Flashcards

Chemotherapy Flashcards

1
Q

Mechanism of action of Asparaginase

A

Inhibits protein synthesis

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2
Q

Uses of Leuprolide acetate and treatment considerations

A

Leuprolide acetate is used for Prostate Cancer; Considerations include: With first treatment FSH and LH are increased leading to increased testosterone production. This can cause tumor to worsen and increase bone pain (flare reaction). Pretreatment with flultamide can block the flare reaction. Subsequently the GnRH receptors are downregulated leading to decrease FSK and LH and testosterone.

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3
Q

Mechanism of action of 6-mercaptopurine

A

Incorporation into DNA

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4
Q

Mechanism of action of 5-Fluorouracil (5-FU)

A

Incorporation into RNA and DNA. Conversion to 5- DUMP and binding to thymidylate synthetase leads to “thymineless death” of cells

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5
Q

Mechanism of action of Paclitaxel and cell cycle specificity

A

Prevents tubulin disassembly; Specificity: CCS (M-phase)

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6
Q

Uses of Carboplatin and treatment considerations

A

Carboplatin is used for Same spectrum of activity as cis-DDP, but without nephrotoxicity; Considerations include: Dosing based on creatinine clearance and AUC target; myelosuppression

Easy to administer

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7
Q

Uses of Tamoxifen and treatment considerations

A

Tamoxifen is used for ER+ breast cancer Chemoprevention; Considerations include: Increased incidence of endometrial cancer and blood clots

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8
Q

Mechanism of action of Hydroxyurea

A

Inhibits ribonucelotide reductase leading to inhibition of DNA synthesis

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9
Q

Mechanism of action of Tamoxifen

A

Binds to estrogen receptor (selective estrogen receptor modulator)

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10
Q

Uses of Bevacizumab and treatment considerations

A

Bevacizumab is used for Lung cancer and metastatic colorectal cancer; Considerations include: Hypertension Proteinuria Posterior reversible encephalopathy syndrome

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11
Q

Mechanism of action of Trastuzumab

A

Binds to Her-2-neu recetor (epidermal growth factor receptor)

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12
Q

Mechanism of action of Flutamide

A

Inhibits uptake and binding of testosterone to prostate cancer cells

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13
Q

Mechanism of action of Cytarabine

A

Converted to triphosphate and inhibits DNA polymerase; incorporation into DNA and inhibits chain elongation

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14
Q

Uses of Ifosfamide and treatment considerations

A

Ifosfamide is used for Testicular cancer, soft tissue sarcoma; Considerations include: Hematuria, myelosuppression Coadminister with mesna

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15
Q

Uses of Trastuzumab and treatment considerations

A
  • Trastuzumab is used for Her-2neu overexpressed breast cancer and gastric cancer
  • Considerations include: Measure Her-2Neu overexpression in breast cancer and gastric cancer
  • Cardiac toxicity
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16
Q

Uses of Anastrozole and treatment considerations

A

Anastrozole is used for Hormone receptor positive breast cancer; Considerations include: Arthralgias, bone pain, bone loss

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17
Q

Mechanism of action of Imatinib mesylate

A

Tyrosine kinase inhibitor

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18
Q

Uses of Hydroxyurea and treatment considerations

A

Hydroxyurea is used to emergently decrease high white blood cell counts in acute myeloid leukemia.; Considerations include: Can rapidly decrease blast count in patients with leukemia and high white blood cell count. High white counts in myeloid leukemias can produce leukostasis in capillaries and lead to organ damage and death.

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19
Q

Uses of Irinotecan and treatment considerations

A

Irinotecan is used for GI tract cancers;

Considerations include:

  • Myelosuppression
  • Acute cholinergic diarrhea treated with atropine
  • Late secretory diarrhea
  • Dose reduction for jaundice
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20
Q

Uses of Crizotinib and treatment considerations

A

Crizotinib is used for If anaplastic lymphoma kinase is rearranged crizotinib is treatment of choice for metastatic adenocarcinoma of lung; Considerations include: Intestitial lung disease Perform mutational analysis on adenocarcinoma of lung.

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21
Q

Uses of Cytarabine and treatment considerations

A

Cytarabine is used for Acute myeloid leukemia (3 + 7 regimen: 3 days of doxorubicin or daunorubicin and 7 days of continuious infusion of cytarabine)

Considerations include:

  • Schedule dependent cytotoxicity
  • High dose strategy (cerebellar toxicity)
  • Hepatic toxicity Myelosuppression
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22
Q

Mechanism of action of Bleomycin and cell cycle specificity

A

Binds to DNA and causes breaks in DNA via free radical damage

Specificity: CCS for G2-M phase

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23
Q

Mechanism of action of Oxaliplatin and cell cycle specificity

A

Aklyates DNA; Specificity: CCNS

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24
Q

Uses of Bleomycin and treatment considerations

A

Bleomycin is used for Testicular cancer;

Considerations include:

  • Pulmonary toxicity is a cumulative toxicity
  • No myelosuppression
  • Avoid high inspired concentrations of oxygen
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25
Q

Mechanism of action of Erlotinib

A

Small molecule inhibitor of the tyrosine kinase domain associated with epidermal growth factor receptor

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26
Q

Mechanism of action of Ifosfamide and cell cycle specificity

A

Alkylates N-7 of guanine; Specificity: CCNS

27
Q

Mechanism of action of Arsenic trioxide

A

arsenic trioxide therapy allows myeloid differentiation to continue and apoptosis to occur

28
Q

Uses of All trans retinoic acid (tretinoin) and treatment considerations

A

All trans retinoic acid (tretinoin) is used for Acute promyelocytic leukemia; Considerations include: Differenitation syndrome (retinoic acid syndrome):fevers, pulmonary infiltrates, dyspnea and pleural/pericardial effusions.

29
Q

Uses of Doxorubicin and treatment considerations

A

Doxorubicin is used for Breast cancer, leukemia, sarcoma, Hodgkin’s and non-Hodgkin’s lymphoma; Considerations include: Myelsuppression Schedule dependent cumulative cardiac toxicity Vesicant Dose reduction for jaundice

30
Q

Mechanism of action of Etoposide and cell cycle specificity

A

Topoisomerase II inhibitor and produces double stranded breaks in the DNA

Specificity: CCS, G1-S

31
Q

Mechanism of action of Vincristine and cell cycle specificity

A

Prevents polymerization of tubulin; Specificity: CCS (M phase)

32
Q

Uses of Temozolomide and treatment considerations

A

Temozolomide is used for Brain tumors; Considerations include: Myelosuppression Pneumocystis pneumonia

33
Q

Mechanism of action of Cyclophosphamide and cell cycle specificity

A

Alkylates N-7 of guanine (DNA alkylating agent); Specificity: CCNS

34
Q

Mechanism of action of Irinotecan and cell cycle specificity

A

Toposiomerase I inhibitor (single strand breaks in DNA); Specificity: CCNS

35
Q

Mechanism of action of Methotrexate and cell cycle specificity

A

Binds to and inhibits dihydrofolate reductase; Specificity: CCS, S phase

36
Q

Mechanism of action of Carboplatin and cell cycle specificity

A

Alkylates DNA; Specificity: CCNS

37
Q

Mechanism of action of Doxorubicin and cell cycle specificity

A

Topoisomerase II inhibitor inhibitor and produces double stranded breaks in the DNA; Specificity: CCNS

38
Q

Uses of Paclitaxel and treatment considerations

A

Paclitaxel is used for Ovarian, gastroesophageal, breast and non-small cell lung cancers; Considerations include: Dose reduce for hepatic dysfunction Sensory neuropathy Myelosuppression Infusion reactions due to reaction to solvent. Premedicate with steroids Vesicant

39
Q

Uses of Cyclophosphamide and treatment considerations

A

Cyclophosphamide is used for Lymphoma, breast cancer; Considerations include: Bioactivation Hematuria Myelosuppression

40
Q

Uses of 6-mercaptopurine and treatment considerations

A

6-mercaptopurine is used for Acute lymphoblastic leukemia; Considerations include: Must reduce dose by 50-75 % if given to patient also on allopurinol Myelosuppression

41
Q

Uses of Etoposide and treatment considerations

A

Etoposide is used for Small cell lung cancer Testicular cancer Lymphoma; Considerations include: Dose reduce for hepatic or renal dysfunction Myelosuppression Drug is leukemogenic

42
Q

Uses of 5-Fluorouracil (5-FU) and treatment considerations

A

5-Fluorouracil (5-FU) is used for Gastrointestinal cancer; breast cancer; head and neck cancer; radiation sensitizer

Considerations include:

  • Coadministration with leucovorin enhances cytotoxicity and toxicity of 5-FU
  • Stomatitis and diarrhea
  • Dihydropyrimidine deficiency will produce severe toxicity if 5-FU administered
  • Hand-Foot syndrome
  • Oral prodrug of 5-FU: capecitabine
43
Q

Uses of Oxaliplatin and treatment considerations

A

Oxaliplatin is used for GI (colorectal, gastric and pancreas); Considerations include: Acute cold induced neuropathy Chronic sensory neuropathy

44
Q

Mechanism of action of Bevacizumab

A

Binds to vascular endothelial growth factor

45
Q

Mechanism of action of Leuprolide acetate

A

GnRH receptor agonist

46
Q

Mechanism of action of All trans retinoic acid (tretinoin)

A

Induces terminal differentiation of the leukemia cells

47
Q

Uses of Asparaginase and treatment considerations

A

Asparaginase is used for Acute lymphoblastic leukemia; Considerations include: Allergic reactions, pancreatitis and clots due to reduction in antithrombin III levels. Elevation of liver enzymes

48
Q

Mechanism of action of Temozolomide and cell cycle specificity

A

Alkylates DNA; Specificity: CCNS

49
Q

Uses of Arsenic trioxide and treatment considerations

A

Arsenic trioxide is used for Acute promyelocytic leukemia; Considerations include: Prolonged QT interval Differentiation syndrome (see all transretinoic acid)

50
Q

Mechanism of action of Crizotinib

A

Binds to anaplastic lymphoma kinase

51
Q

Uses of Prednisone Dexamethasone and treatment considerations

A

Prednisone in high doses for lymphoma and multiple myeloma Dexamethasone: reduce cerebral edema and initial treatment for spinal cord compression Dexamethasone: in combination with other agents to treat chemotherapy related emesis

52
Q

Mechanism of action of Vinblastine and cell cycle specificity

A

Prevents tubulin polymerization

Specificity: CCS (M-phase)

53
Q

Uses of Flutamide and treatment considerations

A

Flutamide is used for Prostate cancer

Considerations include: Diarrhea, elevation of liver enzymes Can block a “flare reaction

54
Q

Uses of Vinblastine and treatment considerations

A

Vinblastine is used for Lung and breast cancer; Considerations include: Dose reduction for jaundice Myelosuppression Vesicant

55
Q

Uses of Imatinib mesylate and treatment considerations

A

Imatinib mesylate is used for Chronic myelogenous leukemia and gastrointestinal stromal tumor; Considerations include: Metabolized by CYP3A4 system Edema and musculoskeletal pain

56
Q

Mechanism of action of Cetuximab

A

Inhibits epidermal growth factor receptor

57
Q

Uses of Erlotinib and treatment considerations

A

Erlotinib is used if the tumor has an “activating mutation” of epidermal growth factor receptor, erlotinib and NOT chemotherapy is the treatment of choice for metastatic adenocarcinoma of lung.; Considerations include: Rash Metabolized by CYP3A4 system Perform mutational analysis of epidermal growth receptor in adenocarcinoma of lung

58
Q

Mechanism of action of Cis- diaminedichloroplatinum (II) (cis-DDP) and cell cycle specificity

A

Alkylates DNA; Specificity: CCNS

59
Q

Uses of Vincristine and treatment considerations

A

Vincristine is used for Non-Hodgkin’s lymphoma, Acute lymphoblastic leukemia; Considerations include: Neuropathies (sensory and autonomic); Vesicant No myelosuppression Dose reduction in presence of jaundice

60
Q

Uses of Methotrexate and treatment considerations

A

Methotrexate is used for Leukemia, Lymphoma, Rheumatoid arthritis, and Psoriasis

Considerations include:

  • Dose reductions necessary in renal insufficiency
  • Approved for intrathecal administration
  • High dose strategy with leucovorin (tetrahydrofolate rescue)
  • Volume of distribution is total body water
  • Solubility increases in alkaline pH
  • Enhanced toxicity if given with drugs that displace methotrexate from albumin binding site and/or decrease excretion of drug in urine
  • High dose strategy is NOT myelosuppressive
61
Q

Uses of Cis- diaminedichloroplatinum (II) (cis-DDP) and treatment considerations

A

Cis- diaminedichloroplatinum (II) (cis-DDP) is used for Testicular cancer Bladder cancer Head and neck cancer Ovarian cancer Small cell and non small cell lung cancer; Considerations include: Administer with hydration and mannitol diuresis Dose reduction for renal insufficiency

62
Q

Mechanism of action of Anastrozole

A

Aromatase inhibitor

63
Q

Uses of Cetuximab and treatment considerations

A

Cetuximab is used for Lung cancer Useful in metastatic wildtype K-RAS and N-RAS colorectal cancers ; Considerations include: Rash and hypomagnesemia Perform K-RAS and N-ras mutational analysis on colorectal cancers

MHD2/Pharm Block 5 (5 decks)

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