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Copy of HEME ONC Drugs - Rides Flashcards

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1
Q

Mineral/Vitamin: Ferrous Sulfate

A

1) Use: Iron defiecnt anemia
2) Class/MOA:
3) Side effects/ADEs: Constipation
4) Fun Facts

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2
Q

Mineral/Vitamin: Iron dextran = Iron sucrose

A

1) Use: FE Deficency Anemia
2) Class/MOA:
3) Side effects/ADEs: anaphalazis
4) Fun Facts

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3
Q

Mineral/Vitamin: Folic Acid

A

1) Use: PND, traumatic cardiac hemolytic anemia, folate defiency (alcoholism)
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

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4
Q

Mineral/Vitamin: Vitamin B12

A

1) Use: Pernicious Anemia
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

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5
Q

Desferrioxamine (Deferoozamine or Desferal)

A

1) Use: Thalasemias, or other disease with regular blood transfusions - helps avoid iron overload (causes cirrhosis, CHF, DM)
2) Class/MOA: IRON CHELATOR (NOT ORAL!)
3) Side effects/ADEs:
4) Fun Facts

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6
Q

Deferasirox (EXJADE)

A

1) Use: Thalasemias, or other disease with regular blood transfusions - helps avoid iron overload (causes cirrhosis, CHF, DM)
2) Class/MOA: Iron Cheltors ORAL
3) Side effects/ADEs:
4) Fun Facts

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7
Q

Epoeitin

A

1) Use: anemia
2) Class/MOA: GROWTH FACTOR EPO = increases RBC
3) Side effects/ADEs:
4) Fun Facts

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8
Q

Filgrastim (G-CSF; Neupogen); Sargramostim (GM-CSF; Leukine); Peg-Filgrastim (Neulasta)

A

1) Use: GROWTH FACTOR any chemo that causes neutropenia; meylosuppressive therapy
2) Class/MOA: stimulates proliferation, matruation and efficacy of NEUTROPHILS via JAK/STAT tyrosine kinase pathway
3) Side effects/ADEs:
4) Fun Facts: same as G-CSF

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9
Q

IL-11 (Oprelvekin, Neumega) Rx: thrombocytopenia

A

1) Use: GROWTH FACTOR thrombocytopenia
2) Class/MOA: stimulates the growth of primative MEGAKARYOCYTE progenitors - increase megakaryocytes, increase peripheral platelets
3) Side effects/ADEs: fatigue, headache, CVE
4) Fun Facts:

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10
Q

Growth Factor: Romiplostim (Nplade) - Thrombopoeitin analog - Rx for chronic ITP

A

1) Use: GROWTH FACTOR thrombocytopenia
2) Class/MOA: same as IL-12: stimulates growth of primative megakarycytic progenitors, increasing megakaryocytes, increasing platelets
3) Side effects/ADEs: fatigue, headache, CVE
4) Fun Facts

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11
Q

Asprinin

A

1) Use: PLATELET INHIBITOR (dec aggregation), antipyretic, analgesic, antiinflamm
2) Class/MOA: covalently Actylates and irreversibly inhibits COX-1 and COX-2 to prevent conversion of arachadonic acid to thromboxane A2. Platelets cannot synth new enzyme (effects last until new platelets produced-inc bleeding time, dec prostaglandins. No change in pt or ptt)
3) Side effects/ADEs: Gastric ulcertation, tinnitus (cn viii). chronic use–> acute renal failure, interstitial nephritis, upper GI bleeding, hyperventilation (od–> resp alk + met acidosis), Reye’s Syndr (in kids w/ viral infect)

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12
Q

Ticlopidine, Clopidogrel (Plavix), prasurgrel, ticagrelor

A

1) Use: PLATELET INHIBITOR, ACS, coronary stenting, dec incidence/recurrence of thrombotic stroke
2) Class/MOA: Inhibit platelet aggregation by irreversibly blocking ADP RECEPTORS | inhibit fibrinogen binding by preventing glycoprotein Iib/Iiia from binding to fibrinogen
3) neutropenia (ticlopidine)

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13
Q

Abciximab (Rheopro), Eptidibatide (Integrilin) and Tirofibiban (Aggrastat)

A

1) Use: PLATELET INHIBITOR; ACS, per cutaneous trains luminal coronary angioplasty
2) Class/MOA: Monoclonal antibody that binds to the GLYCOPROTEIN RECEPTOR Ib/IIIa on activated platelets, preventing aggregation
3) Side effects/ADEs: bleeding, thrombocytopenia
Abciximab=made from monoclonal Ab Fab fragments

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14
Q

Dipyridamole, cilostazol

A

1) Use: PLATELET INHIBITOR ; intermittent clay dictation, coronary vasodilation, prevention of stroke/tias (+aspirin), angina prophylaxis
2) Class/MOA: pde iii inhib; increase cAMP in platelets = decrease ADENOSINE uptake/cyclic nucleotide PDE = decreased aggregation; vasodilator
3) Side effects/ADEs: serious bleeding risk, nausea, headache, facial flushing, hypotension, abd pain
4) Fun Facts

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15
Q

Heparin

A

1) Use: immediate ANTICOAG for PE, stroke, ACS, MI, DVT | used during pregnancy (does not cross placenta)| follow PTT
2) Class/MOA: INHIBITS THROMBIN ACTION | cofactor for activation of ANTI-THROMBIN, decrease thrombin (iia) and Xa, short 1/2 life
3) Side effects/ADEs: Bleeding, thrombocytopenai (HIT), osteoporosis, drug-drug interactions.
Protamine sulfate=antidote (+ charged molecule to bind - charged, large, acidic polymer heparin)
Iv, sQ

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16
Q

Enoxaparin (LMWH, Lovenox), dalteparin

A

1) Use: Anticoagulation
2) Class/MOA: Cofactor for activation of ANTITHROMBIN and Xa (work better on Xa), better bioavailibilty and 2-4 times longer 1/2 life - can be administered subQ and without lab monitoring
3) Side effects/ADEs: can’t reverse esily

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17
Q

Lepirudin, Bilirudin

A

1) Use:
2) Class/MOA: Hirudin derivatives; directly INHIBITS THROMBIN
3) Side effects/ADEs:
4) Fun Facts: used as an alternative to heparin for anticoagulating patients with HIT

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18
Q

Argatroban

A

1) Use: HIT, patient with kidney dysfunction
2) Class/MOA: directly INHIBITS THROMBIN
3) Side effects/ADEs: falsely elevates INR levels
4) Fun Facts: irreversible

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19
Q

Warfarin

A

1) Use: Chronic anticoagulation (post-stemi, dvt prophylaxis, stroke prevention in a fib) | not used in pregnat women (can cross placenta–>bone deformities, abortion, ophthalmologic abnormalities)| follow PT/INR values (affects extrinsic (7)); long 1/2 life
2) Class/MOA: interfears with normal synthesis and gamma carboxylation of K dependent clotting factors through blocking epoxied reductase| INHIBIT THROMBIN GENERATION
3) Side effects/ADEs: skin/tissue necrosis, drug-drug interactions
Metabolized by cyp450.
Reversal=vit k + FFp
Small lipid soluble molecule
Oral

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20
Q

Alteplase (tPA), retrplase (rPA), tenecteplase (TNK-tPA)

A

1) Use: early CVA, acute early MI, direct thrombolysis of severe PE
2) Class/MOA: thrombolytics; directly or indirectly converts plasminogen to plasmin, which cleaves thrombin & fibrin clots. Inc pt & ptt, no change in platelet count.
3) Side effects/ADEs: bleeding (contraindicated in pts with active bleeding, hx of intracranial bleeding, recent surgery, known bleeding disorder, severe hypotension)
Tx tox w: aminocaproic acid (fibrinolysis inhib)
4) Fun Facts

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21
Q

Protamine Sulfate

A

1) Use: REVERSES HEPRIN
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

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22
Q

DDAVP (Desmopressin)

A

1) Use: vWF disease
2) Class/MOA: RELEASES vWF stored in endothelium
3) Side effects/ADEs:
4) Fun Facts

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23
Q

Vitamin K

A

1) Use: REVERSES Warfarin
2) Class/MOA:
3) Side effects/ADEs:
4) Fun Facts

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24
Q

Novo VII

A

1) Use: potent means to stop bleeding!
2) Class/MOA: BASICALLY FACTOR VII | binds activated platelets and catalysex X-> Xa, which turns activated factor II -> Iia (thrombin)
3) Side effects/ADEs: thrombosis
4) Fun Facts

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25
Aminocaproid Acid (AMICAR)
TREATMENT OF BLEEDING all anti fibrinolytic - a drug to stop a clot from breaking down
26
Cyclophoasphamide, Ifosphasmide
1) Use: NHL, breast/ovarian carcinomas, solid tumors, leukemias, some brain cancer| immunosupressant 2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Covalently links X-link (interstrand) DNA at guanine N-7 | requires bioactivation by the liver 3) Side effects/ADEs: Myelosupression, hemorrhagic cystitis, partially prevented with Mesna (think group of Mesna binds toxic metabolite)
27
Busulfan
1) Use: CML - ablate bone marrow before BM transplant 2) Class/MOA: ANTINEOPLASTIC AGENT | ALYKATING AGENT | alkylates DNA 3) Side effects/ADEs: Pulmonary fibrosis, hyperpigmentation 4) Fun Facts
28
Bendamustine
1) Use: Refractory CLL, low NHL 2) Class/MOA: ANTINEOPLASTIC AGENT | Alkylating agent - Nitrogen Mustard 3) Side effects/ADEs: NO allopecia, liver irritation, fatigue, rash 4) Fun Facts
29
Nitrosoureas (BCNU - Carmustine) & (CCNU - Lomustine), semustine, streptozocin
1) Use: Brain tumors (including glioblastoma multifome) 2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Require bioactivation | cross BBB --> CNS 3) Side effects/ADEs: CNS tocicity (dizziness, ataxia) 4) Fun Facts
30
Cisplatin, Carboplatin
1) Use: Testicular, bladder, ovary and lung carcinomas 2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Cross-link DNA 3) Side effects/ADEs: Nephrotoxicity and acoustic nerve damage 4) Fun Facts: prevent nephroxocitiy with amifostine (free radical scavenger) & chloride diuresis
31
Methotrexate (mtx)
1) Use: Cancers (leukemias, lymphomas, choriocarcinoma, sarcoma) non-neoplastics (abortion, ectopic pregancy, RA, psoriasis) 2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | FOLIC ACID ANALOG that inhibits dihydrofolate reductase--> dec dTMP--> dec DNA & protein synth 3) muesli suppression (reversible w/ leucovorin (folinic acid)); macro vesicular fatty change in liver; mucositis
32
AZathiprine 6-mercaptopurine (6-mp) and 6-thioguanine (6-tg)
1) Use: Leukemias, lymphomas (not CLL or HD) 2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PURINE (thiol) ANALOG | Purine analog = decreased de novo purine syntehsis | activated by HGPRT 3) Side effects/ADEs: BM, GI, Liver | metabolized by xanthene oxidase; thus inc tox w/ allopurinol
33
5-Flurouracil (5-fu)
1) Use: Colon cancer and other solid tumors, basal cell carcinoma (topical), synergy with MTX 2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANALOG | bioactivated to 5F-dUMP, which covalently complexes folic acid | this complex inhibits thymidylate synthase--> dec dtMP--> dec DNA & protein synth 3) myelosuppresaion (not reversible w/ leucovorin); photosensitivity Od tx w/ thymidine
34
5-azacitidine
1) Use: MDS 2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANALOG, also restore function of tumor supressor gene 3) Side effects/ADEs: 4) Fun Facts
35
Cytarabine (Ara-C=arabinofuranos cytidine)
1) Use: AML, ALL, high grade non-Hodgkin's lymphoma 2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANTAGONIST/analog? inhibition of DNA polymerase 3) Side effects/ADEs: Leukopenia, thrombocytopenia, megaloblastic anemia 4) Fun Facts
36
Dactinomycin (Antinomycin D)
1) Use: Wilms tumor, Ewig's sarcoma, rahbdomyosarcoma, childhood tumors (kids ACT out!) 2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Intercalates in DNA 3) Side effects/ADEs: Myelosupression 4) Fun Facts
37
Doxorubicin (Adriamycin), Daunorubicin
1) Use: HD, myelomas, sarcomas and solid tumors, leukemias, lymphomas 2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Generates free radicles | noncovalently intercalates in DNA = BREAKS IN DNA = decreased replicatoin 3) Side effects/ADEs: cardiotoxicity; myelosupression, alopecia; toxic to tissues following extravasation; dexrazoxane (iron cheating agent) used to prevent cardiotoxicity
38
Bleomycin
1) Use: Testicular cancer, HD 2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL AGENT | Induces free radical formation; which causes BREAKS IN DNA strands 3) Side effects/ADEs: Pulomonary firbosis, skin changes, minimal myelosupression 4) Fun Facts
39
Vincristine, Vinblastine
1) Use: HD, Wilms, Choriocarcinoma, solid tumor, leukemia, lymphoma 2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Alkaloids that BIND TO TUBULIN in M-phase and block polyermization of MICROTUBULES so that mitotic spindle can't form 3) Side effects/ADEs: vincristine- neurotoxicity (areflexia, peripheral neuritis)| vinblastine blasts bone marrow (suppression)
40
Etoposide, teniposide
1) Use: Small Cell Cardinoma of the lung and prostate, testicular Carcinoma, solid tumors, leukemia, lymphoma 2) Class/MOA: ANTINEOPLASTIC AGENT: NATURAL PRODUCT: Inhibits TOPOisomerase II = increase in DNA degradation 3) Side effects/ADEs: myelosupression, GI irritation, alopecia 4) F
41
Paclitaxel, other taxols
1) Use: Ovarian and breast carcinomas 2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT hyperstablizes polymerized microtubules in M phase so that MITOTIC SPINDLE spindle can't break down (anaphase can't occur) 3) Side effects/ADEs: myelosuppresion & hypersensitivity
42
Hydroxurea
1) Use: Melanoma, CML, sickle cell (inc hbf) 2) Class/MOA: ANTINEOPLASTIC AGENT Inhibits RIBONUCULOTIDE REDUCTASE = decrease in DNA synthesis (s phase specific) 3) Side effects/ADEs: BM supression, GI upset 4) Fun Facts
43
Thalidomide and Lenolidamide
1) Use: MM 2) Class/MOA: ANTINEOPLASTIC AGENT | SUPRESS ANGIONEOGENESIS, immunomodulate, pro-apoptottic? 3) Side effects/ADEs: Birth defects 4) Fun Facts
44
Tamoxifin, Raloxifene
1) Use: Breast cancer (tx & prevention) & osteoporosis prevention 2) Class/MOA: SERM - receptor antagonists in the breast, and agonist in bone | block the binding of estogren to estrogen receptor positive cells 3) Side effects/ADEs: T: partial agonist in endometrium increase risk of endometrial carcinoma; hot flashes; r: endometrial antagonist
45
Anastrolzole
1) Use: postmenopausal women with breast cancer 2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONES : AROMATASE INHIBITOR 3) Side effects/ADEs: 4) Fun Facts
46
Flutamide
1) Use: prostate carcinoma 2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONES a nonsteroidal competitive inhibitor of androgens at the testosterone inhibitor 3) Side effects/ADEs: 4) Fun Facts
47
Fulvestrant
1) Use: advanced breast cancer 2) Class/MOA: ANTINEOPLASTIC AGENT | HORMONES | binds E receptor, accelerates destruction 3) Side effects/ADEs: E withdrawl, muscle wasting and gynecomastia 4) Fun Facts
48
Leuprolide
1) Use: Infertility, prostate cancer, uterine fibrosis 2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONE: GnRH analog with agonist properties when used in pulsatile fasion; antagonist properties wihen used in continous fashion 3) Side effects/ADEs: antiandrog
49
Ketoconazole
1) Use: PCOS to prevent hirtuism, 2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONE inhibits STEROID syntehsis (inhibits desmolase) 3) Side effects/ADEs: Gynecomastia and amenorrhea 4) Fun Facts
50
Rituximab (Rituxan)
1) Use: NHL, RA (with MTX) 2) Class/MOA: ANTINEOPLASTIC AGENT: MONOCLONAL ANTIBODY TO CD-20, which is found on most B-cell neoplasms 3) Side effects/ADEs: 4) Fun Facts
51
Ibritumomab Tiuxetan (Zevalin)
1) Use: HD 2) Class/MOA: ANTINEOPLASTIC AGENT | MONOCLONAL ANTIBODY 3) Side effects/ADEs: infusion reactions 4) Fun Facts
52
Gemtuzumab Ogozamiin (Mylotarg)
Anti-CD33
53
Trastuxumab (Herceptin)
1) Use: her 2 + Metastatic breast cancer 2) Class/MOA: monoclonal Ab against HER-2 (c-erb-B2=tyrosine kinase) helps kill breast cancer cells that overexpress HER-2, possibly through antibody dependent cytotoxicity 3) Side effects/ADEs: Cardiotoxicity 4) Fun Facts
54
Cetuzimab (Erbitux)
1) Use: Metestatic Breast Cancer 2) Class/MOA: ANTINEOPLASTIC AGENT MONOCLONAL ANTIBODY TO HER-2 (erb-B2) | helps kill breast cancer cells that overexpress HER-2 possibly through antibody-dependent cytotoxicity 3) Side effects/ADEs: cardiotoxicity 4) F
55
Bevacizumab (Avastin)
1) Use: Mets lung, colon, breast, renal cell, glioblastoma (solid tumors) 2) Class/MOA: ANTINEOPLASTIC AGENT radioimmunotherapy, monoclonal ab against VEGF & prevents interaction with its R - decreased endothelial cell prolifeation and decreased new blood vessel formation
56
Erlotinib (Tarceva)
1) Use: 2) Class/MOA: ANTINEOPLASTIC AGENT small molecule, inhibits EGFR - TK1 inhibitor, preents posphorylation, prevents phosphorylation of tyrosine kinase 3) Side effects/ADEs: Skin rash, fatigue, Diarrhea $$$ 4) Fun Facts
57
Bortexomib (Velcade)
1) Use: MM 2) Class/MOA: ANTINEOPLASTIC AGENT Small molecule, PROTEASE inhibitor - decrased NFKB activation (cells explode because they ant breakdown proteins they contain 3) Side effects/ADEs: Neruropathy, htormbocytopenia, fever, diarrhea, $$$$ 4) Fun
58
Imatinib (Gleevec)
1) Use: CML, GI stromal tumors 2) Class/MOA: ANTINEOPLASTIC AGENT PHILDELPHIA CHRphilidelphia chromosome bcr-abl tyrosine kinase inhibitor 3) Side effects/ADEs: fluid retention 4) Fun Facts
59
Prednisone, predisolone
1) used in cll, NHL (part of combo chemo regimine). Immunosuppressant (autoimmune diseases) 2) may trigger apoptosis. May even work in non dividing cells 3) Cushing like symptoms; immunosupppression, cataracts, acne, osteoporosis, HTn, peptic ulcers, hyperglycemia, psychosis
60
Vemurafenib
1) metastic melanoma | 2) small molecule inhibitor of forms of b-raf kinase w/ v600e mutation

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