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Flashcards in Heme/Onc Deck (58):
1

Mineral/Vitamin: Ferrous Sulfate

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

2

Mineral/Vitamin: Iron dextran = Iron sucrose

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

3

Mineral/Vitamin: Folic Acid

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

4

Mineral/Vitamin: Vitamin B12

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

5

Desferrioxamine (Deferoozamine or Desferal)

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

6

Deferasirox (EXJADE)

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

7

Epoeitin

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

8

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

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

9

IL-11 (Oprelvekin, Neumega) Rx: thrombocytopenia

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:

10

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

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

11

Asprinin

1) Use: PLATELET INHIBITOR
2) Class/MOA: Actylates and irreversibly inhibits COX-1 and COX-2 to prevent conversion of arachadonic acid to thromboxane A2
3) Side effects/ADEs: increase BT, no effect on PT, PTT | Gastric ulcertation, bleeding, hyperventilation, Reye's Syndr

12

Ticlopidine, Clopidogrel (Plavix)

1) Use: PLATELET INHIBITOR
2) Class/MOA: Inhibit platelet aggregation by irreversibly blocking ADP RECEPTORS | inhibit fibrinogen binding by preventing glycoprotein Iib/I

13

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

1) Use: PLATELET INHIBITOR
2) Class/MOA: Monoclonal antibody that binds to the GLYCOPROTEIN RECEPTOR Ib/IIIa on activated platelets, preventing aggregation
3) Side effects/ADEs: bleeding, thrombocytop

14

Dipyridamole

1) Use: PLATELET INHIBITOR
2) Class/MOA: increase cAMP = decrease ADENOSINE uptake/cyclic nucleotide PDE = decreased aggregation
3) Side effects/ADEs: serious bleeding risk
4) Fun Facts

15

Heparin

1) Use: immediate ANTICOAG for PE, stroke, ACS, MI, DVT | used during pregnancy | follow PTT
2) Class/MOA: INHIBITS THROMBIN ACTION | cofactor for activation of ANTI-THROMBIN, decrease thrombin and Xa, short 1/2 life
3) Side effects/ADEs: Bleeding, thrombocytopenai (HIT),

16

Enoxaparin (LMWH, Lovenox)

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

17

Lepirudin, Bilirudin

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

18

Argatroban

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

19

Warfarin

1) Use: Chronic anticoagulation | not used in pregnat women | follow PT/INR values
2) Class/MOA: interfears with normal synthesis of K depedent clotting factors through blocking | INHIBIT THROMBIN GENERATION
3) Side effects/ADEs: bleeding, teratogenic,

20

Alteplase (tPA)

1) Use: CVA, acute MI, PE
2) Class/MOA: converts plasminogen to plasmin and helps cleave fibrin mesh TPA
3) Side effects/ADEs: bleeding
4) Fun Facts

21

Protamine Sulfate

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

22

DDAVP (Desmopressin)

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

23

Vitamin K

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

24

Novo VII

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

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 | immunosupressant
2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Covalently links X-link (intrastrand) DNA at guanine N-7 | requires bioactivation by the liver
3) Side effects/ADEs: Myelosupression, hemor

27

Busulfan

1) Use: CML - ablate bone marrow before BM transplant
2) Class/MOA: ANTINEOPLASTIC AGENT | ALYKATING AGENT | lkylates 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)

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 (& mesna), 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

31

Methotrexate - Leucivorin (Folinic Acid)

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 dihydroredutase = decrease in dTMP = decrea

32

6-mercaptopurine and 6-thioguanine

1) Use: Leukemias, lymphomas (not CLL or HD)
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PURINE ANALOG | Purine analog = decreased de novo purine syntehsis | activated by HGPRTas
3) Side effects/ADEs: BM, GI, Liver | metabolized by xanthene ox

33

5-Flurouracil

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

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)

1) Use: AML, ALL, high grade non-Hodgkin's lymphoma
2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANTAGONIST 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, rahbdo, 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
2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Generates free radicles | noncovalently intercalates in DNA = BREAKS IN DNA = decreased replicatoin
3) Side effects/ADEs: cardiotoxicity; myelosupress

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
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: neurotoxicity | Blast's

40

Etoposide

1) Use: Small Cell Cardinoma of the lung and prostate, testicular Carcinoma
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

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

42

Hydroxurea

1) Use: Melanoma, CML, sickle cell
2) Class/MOA: ANTINEOPLASTIC AGENT Inhibits RIBONUCULOTIDE REDUCTASE = decrease in DNA synthesis
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 & osteoporosis
2) Class/MOA: SERM - receptor antagonists in the breast, and antagonist in bone | block the binding of estogren to estrogen receptor positive cells
3) Side effects/ADEs: T: increase risk of endometrial carcinoma via

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: Metastatic breast cancer
2) Class/MOA: monoclonal Ab against HER-2 (erb-B2) 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
2) Class/MOA: ANTINEOPLASTIC AGENT radioimmunotherapy, binds VEGF & prevents interaction with its R - decreased endothelial cell prolifeation and decreased new blood vessel formation
3) Side e

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