What is pharmacodynamics?
How drugs affect the body
How are the vinca drugs excreted?
Why are alkylating not a preferential treatment in pediatrics patients?
There many secondary malignancies that arise as a result of alkylating agent chemo. (This concern is inversely proportional to age of patient)
What are the acute adverse effects of mechlorethamine?
Are alkylating agents CCNS or CCS? What type of cells are more sensitive to alkylating agents?
CCNS; replicating cells
Cardiotoxicity is the signature adverse effect of what drug?
Anthracyclines: doxorubicin and daunorubicin
Topo I in inhibited by what drug?
What does 5-FU inhibit? What required to aid in this inhibition?
Thymidylate synthase; enhanced by leucovorin (folinic acid) - inactivation requires both 5-FU and folinic acid
How can methotrexate be administered?
Orally, IV, or intrathecally
How is cis-platin administered? and cleared?
Intravenous, cleared in urine
Most alkylating agents are bifunctional. What is meant by bifunctional?
They are able to bind and cross-link adjacent bases or they can bind and cross-link bases on opposite strands
What inactivates SN-38 (the active metabolite of irinotecan)?
Glucouronidation by UGT1A1
How have STIs (single transduction inhibitors) transformed cancer?
From "curable" disease to a "manageable" disease
What drug blocks growth factor signaling in chronic myelogenous leukemia (CML)?
(Buzz association: CML = philadelphia chromosome)
Imatinib (inhibits Bcr-Abl and other tyr kinases)
When would an alkylating agent be ill-advised?
If the a cell has a p53 mutation (like Li Fraumeni), then inducing DNA damage wouldn't result in apoptosis which is the desired effect.
What are 3 ways to classify drugs?
Chemical structure, mechanism of action, and therapeutic use
What are the four branches of pharmacology?
pharmacokinetics, pharmacodynamics, adverse effects, and pharmaacotherapeutics
What might cause a patient have a fatal myelosuppression incident when administered a standard dose of 6-mercaptopurine?
A defect in one or both TMPT
Though alkylating agents and antitumor antibiotics are CCNS what are they most effective against?
Rapidly proliferating cells
What is used as a "rescue" to prevent the cytotoxicity of methotrexate to normal cells?
Leucovorin (folinic acid)
Patient is given FOLFIRI which is made up of 5-FU, Leucovorin, and Irinotecan. The patient is genotyped and found to be UGT1A1*3*7. What would be the appropriate response to this genotype?
Decreasing irinotecan dosing to decrease the amount of toxic metabolites
What does gefitinib inhibit?
EGF-R tyr kinase
What drug is a cytosine analog and inhibits polymerase and is a chain terminator?
How are doxorubicin and daunorubicin administered?
intravenous, metabolized in liver
What causes the cystitis that results from cyclophosphamide? What drug can be administered to almeloriate these effects?
Which isomerase does irinotecan inhibit?
To which class do doxorubicin daunorubicin belong?
Antitumor antibiotics: anthracyclines; block Topo II
What specific cancer is gefitinib indicated for? What are some factors that can better the outcome?
Non-small cell lung cancer; better when pt is an Asian non-smoking woman
45 year old female pt will be treated with a combination of Doxorubicin, docetaxel, and cyclophosphamide. Desrazoxane may be added in order to?
Protect against doxorubicin cardiotoxicity. Doxorubicin generates free radicals and desrazoxane acts as a free radical scavenger.
sterile hemorrhagic cystitis is the hallmark side effect of what?