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Cytotoxic Chemotherapy Flashcards

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1
Q

What are the two main classifications of cytotoxic drugs?

A

Cell cycle specific and non-specific.

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2
Q

Which cytotoxic drugs act in the S-phase of the cell cycle?

A

Antimetabolites.

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3
Q

Name a drug that acts in the G2 phase.

A

Bleomycin or Mitoxantrone.

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4
Q

What is the mechanism of action of alkylating agents?

A

Covalently modifies DNA bases, causing crosslinking, erroneous pairing, and strand breakage.

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5
Q

Which nitrogen mustard requires activation in the liver?

A

Cyclophosphamide.

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6
Q

What is a major side effect of cisplatin?

A

Nephrotoxicity, neurotoxicity, and ototoxicity.

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7
Q

Which drug inhibits dihydrofolate reductase and causes ‘thymine-less’ death?

A

Methotrexate.

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8
Q

What is the primary toxicity of 5-Fluorouracil?

A

Myelosuppression, diarrhea, stomatitis, and cardiotoxicity.

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9
Q

Which drugs stabilize microtubules to prevent depolymerization?

A

Taxanes (e.g., Paclitaxel, Docetaxel).

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10
Q

What is the mechanism of action of vinca alkaloids?

A

Bind to tubulin, causing microtubule disaggregation and apoptosis.

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11
Q

Name an antitumor antibiotic with known cardiotoxicity.

A

Doxorubicin.

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12
Q

Which drug is used in colorectal cancer and acts as a prodrug converted to SN-38?

A

Irinotecan.

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13
Q

What is the antidote for methotrexate toxicity?

A

Leucovorin.

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14
Q

Which platinum agent is prominently neurotoxic and used for colon cancer?

A

Oxaliplatin.

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15
Q

What is the main use of busulfan in therapy?

A

Bone marrow ablation for stem cell transplantation.

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16
Q

Which topoisomerase inhibitor is derived from Camptotheca acuminata?

A

Camptothecins (e.g., Irinotecan, Topotecan).

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17
Q

What is the major dose-limiting toxicity of vincristine?

A

Neurotoxicity.

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18
Q

Name a monoclonal antibody targeting CD20 used in lymphoma.

A

Rituximab.

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19
Q

What are the toxicities of PD-1/PD-L1 inhibitors?

A

Autoimmune adverse effects (e.g., pneumonitis, hepatitis).

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20
Q

What is the mechanism of action of antimetabolites?

A

Interfere with purine and pyrimidine synthesis, causing DNA damage during the S-phase.

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21
Q

Which alkylating agent is associated with pulmonary toxicity at high cumulative doses?

A

Carmustine.

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22
Q

Name a triazene drug used for gliomas and its associated toxicity.

A

Temozolomide; myelosuppression.

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23
Q

What toxicity is common with taxanes, and how is it managed?

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A

Hypersensitivity reactions; premedication with steroids/antihistamines is required.

24
Q

What is the mechanism of action of topoisomerase inhibitors?

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A

Inhibit topoisomerase enzymes, causing DNA strand breaks and apoptosis.

25
Which cytotoxic drug is a glycopeptide antibiotic active in G2 phase?
Bleomycin.
26
What severe side effect is associated with high-dose cytarabine (Ara-C)?
Cerebellar toxicity and corneal toxicity.
27
What is the main toxicity of gemcitabine?
Myelosuppression and liver toxicity.
28
What is the mechanism of action of platinum agents?
Form interstrand and intrastrand DNA cross-links, inhibiting DNA synthesis and transcription.
29
Which drug is known for causing stocking-glove neuropathy?
Vincristine.
30
Which cytotoxic drug stabilizes microtubules, preventing dynamic changes necessary for cell division?
Paclitaxel (a taxane).
31
What is the unique feature of mitoxantrone compared to anthracyclines?
Less cardiotoxic but can cause blue discoloration of urine, nails, and sclerae.
32
Name a fluorinated pyrimidine used in colorectal cancer.
Trifluridine (in combination with tipiracil).
33
What is the mechanism of action of anti-PD1/PDL1 inhibitors?
Block PD-1/PD-L1 interactions to enhance immune response against tumors.
34
What is the most common toxicity of EGFR inhibitors?
Acneiform rash.
35
Which hormonal therapy blocks estrogen receptors and increases the risk of endometrial cancer?
Tamoxifen.
36
What is the mechanism of aromatase inhibitors?
Inhibit aromatase, reducing estrogen production in postmenopausal women.
37
Which alkylating agent is the first-line treatment for chronic myeloid leukemia?
Busulfan.
38
Which cytotoxic drug is associated with severe electrolyte imbalances like hypomagnesemia?
Cisplatin.
39
Which monoclonal antibody targets HER2 receptors?
Trastuzumab.
40
What is the mechanism of anti-CTLA4 antibodies?
Inhibit CTLA-4, boosting T-cell proliferation and immune response against tumors.
41
What is the primary use of methotrexate in cancer therapy?
Treatment of gynecologic, breast, lung cancers, and lymphomas.
42
Which cytotoxic drug is used intrathecally for meningeal carcinomatosis?
Thiotepa.
43
What is a dose-limiting toxicity of irinotecan?
Delayed diarrhea and myelosuppression.
44
What is the antidote for doxorubicin-induced cardiotoxicity?
Dexrazoxane.
45
Name a topoisomerase II inhibitor used for small-cell lung cancer.
Etoposide.
46
Which taxane is associated with fluid retention?
Docetaxel.
47
What toxicity is associated with pemetrexed, and how is it mitigated?
Myelosuppression; supplementation with folic acid and vitamin B12.
48
Which monoclonal antibody targets VEGF and affects tumor vasculature?
Bevacizumab.
49
What unique adverse effect is seen with procarbazine?
Disulfiram-like reaction and vivid nightmares.
50
Which cytotoxic agent is highly emetogenic and requires antiemetic prophylaxis?
Cisplatin or Dacarbazine.
51
What is the mechanism of action of cyclophosphamide?
Activated in the liver to form alkylating agents that cross-link DNA strands.
52
Which cytotoxic drug causes hand-foot syndrome as a side effect?
5-Fluorouracil or Capecitabine.
53
What is the main advantage of idarubicin over daunorubicin?
Higher DNA binding capacity and lower cardiotoxicity.
54
Name a monoclonal antibody used in acute lymphoblastic leukemia (ALL).
Blinatumomab.
55
What severe toxicity is associated with rituximab?
Reactivation of latent infections, including hepatitis B.
56
Which cytotoxic drug is contraindicated in patients with creatinine clearance below 45 mL/min?
Pemetrexed.
57
What is the toxicity associated with oxaliplatin's neurotoxic effects?
Cold-induced neuropathy and laryngospasm.

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