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Elliot Step 1 > Heme Onc Drugs > Flashcards

Heme Onc Drugs Flashcards

(69 cards)

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1
Q

MOA of heparin?

A

Cofactor for actvation of antithrombin; decreases thrombin and decreases factor X

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2
Q

Drug decreases antithrombin?

A

Heparin

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3
Q

Anticoagulant that does not cross placenta?

A

Heparin

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4
Q

Antidote for heparin?

A

Protamine sulfate

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5
Q

Benefit of LMW heparin?

A

Enoxaparin and dalteparin act more on factor 10 and have better bioavailability and longer half life

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6
Q

Heparin induced thrombocytopenia?

A

Development of IgG AB against heparin bound to platelet factor 4–>thrombosis and thrombocytopenia

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7
Q

Alternative to heparin for anti coagulating patients with HIT?

A

Lepirudin and bivalirudin–>anticoagulant used by leeches; inhibits thrombin

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8
Q

Lepirudin and bivalirudin moa?

A

Block thrombin( anticoagulant used by leeches)

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9
Q

Warfarin gamma carboxylates which clotting factors?

A

2,7,9,10, C, S– and CAN cross the placenta

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10
Q

Which pathways does warfarin act on?

A

Extrinsic and PT

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11
Q

Enoxaparin and Dalteparin?

A

LMW heparin– primarily block X

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12
Q

Treatment for severe warfarin overdose?

A

Fresh frozen plasma

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13
Q

Alteplase MOA?

A

Anything that ends in “plase” is a thrombolytic–>increased PT and PTT, no chance in platelet count

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14
Q

Alteplase toxicity?

A

aminocaproid acid– inhibitor of fibrinolysis

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15
Q

MOA of aspirin?

A

Irreversibly inhibits COX by acetylation–>increased bleeding time; decreased TXA2 and dec prostoglandins– NO EFFECT ON PT OR PTT

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16
Q

Overdose of aspirin can lead to?

A

respiratory alkalosis and metabolic acidosis; reyes syndrome

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17
Q

Used in coronary stenting?

A

Clopidogrel (ticlopidine, prasugrel, ticagrelor)

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18
Q

ADP receptor inhibitor that causes neutropenia?

A

Ticlopidine

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19
Q

Inhibits platelet aggregation via increase in cAMP and vasodilators?

A

Cilostazol and dipyridamole

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20
Q

Cilostazol and dipyridamole?

A

Phosphodiesterase III inhibitors– increased cAMP in platelets, thus inhibiting aggregation

THEY ARE ALSO VASODILATORS

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21
Q

Side effects of cilostazol ?

A

Facial flushing, abdominal pain, hypotension

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22
Q

What is abciximab made from?

A

Monoclonal antibody Fab fragments– used in percutaneous transluminal coronary angioplasty

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23
Q

May cause thrombocytopenia (blocks activation of platelets)

A

Abciximab

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24
Q

Vinca alkaloids and taxols block?

A

Mitosis

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25
Bleomycin blocks?
G2
26
DNA intercalators?
Dactinomycin and doxorubicin
27
Vinca alkaloids inhibit?
Microtubule formation
28
Paclitaxel inhibits?
microtubule disassembly-- taxes the tubules
29
Blocks DHF to THF?
Methotrexate-- may cause microvesicular changes in the liver
30
Leads to increase in dUMP?
5FU inhibits thymidylate synthase which synthesizes dUMP to dTMP
31
Antidote to myelosuppression caused by methotrexate?
leucovorin
32
Leucovorin?
Antidote to myelosuppresion caused by methotrexate
33
Antidote to 5FU toxicity?
Thymidine (5FU may also cause photosensitivity)
34
Antimetabolite that causes photosensitivity?
5FU
35
Cytarabine toxicity?
panCYTopenia (caused by CYTarabine)-- S phase specific
36
Block de novo purine synthesis (purine analogs)
Azathioprine, 6 thioguanine, and 6MP-- activated by HGPRT
37
Side effects of azathioprine and 6MP
Bone marrow, GI, liver, increased toxicity when used with allpurinol
38
Intercalates DNA? Used in Wilms and Ewings?
Dactinomycin (actinomycin D)--- used for childhood tumors-- children ACT out
39
MOA of doxorubicin?
Generates free radicals-- non covalently intercalates in DNA-->cardiotoxicity (dilated cardiomyopathy); myelosuppresion, alopecia
40
What medication is used with doxorubicin to prevent cardiotoxicity?
Dexrazoxane-- iron chelating agent
41
May cause pulmonary fibrosis
Bleo-- has minimal myelosuppresion (amiodorone; busulfan; methotrexate)
42
Covalently crosslink DNA at guanine N-7? and require bioactivation by liver?
Cyclophosphamide
43
Hemorrhagic cystitis?
Cyclophosphamide (partially prevented with mesna)
44
Alkylating agent that crosses BBB?
Nitrosoureas (carmustine, lomustine, semustine, streptozocin)-- so obviously they can cause CNS toxicity
45
Used for brain tumors?
Nitrosoureas-- can cause CNS toxicity
46
Busulfan? MOA? use? toxicity
Alkylates DNA-- used for CML; pulmonary fibrosis
47
Alkaloids that bind to tubulin in M phase and block polymerization of microtubules?
Vincristine and vinblastine
48
Microtubules inhibitor that may cause neurotoxicity; peripheral neuropathy, areflexia)
Vincristine
49
Vinblastine SE?
Blasts bone marrow-- and causes blisters
50
Prevents mitotis spindle from breaking down?
Paclitaxel-- may lead to hypersensitivity
51
Causes acoustic nerve damage?
Cisplatin-- also causes nephrotoxicity-- use amifostine to prevent nephrotoxicity
52
Amifostine?
Used with Cisplatin to prevent nephrotoxicity
53
Inhibits Topo II?
Etoposide and teniposide-- used for solid tumors
54
Used for testicular, bladder and ovarian cancer?
Cisplatin-- messes up your DNA
55
Inhibits ribonucleotide reductase--> dec pyrimidine synthesis?
Hydroxyurea
56
Prednisone and cancer?
May trigger apoptosis
57
Tamoxifen toxicity?
Partial agonist in endometrium--> endometrial cancer
58
Raloxifene?
Antagonist on breast; agonist on bone; and does not increase endometrial carcinoma
59
Monoclonal antibody against HER2, a tyrosine kinase?
Trastuzumab--- may cause cardiotoxicity
60
Trastuzumab MOA?
Mab against Her2-- tyrosine kinase
61
Toxicity of imatinib?
Fluid retention
62
Used in GI stromal tumors?
Imatinib (c-kit tyrosine kinase)
63
Inhibits BRAF kinase? use?
Melanoma-- Vemurafenib
64
Vemurafenib?
inhibits BRAF kinase-- used for metastatic melanoma
65
Mab agst VEGF?
Bevacizumab-- used in solid tumors
66
Rivaroxabam ?
X inhibitor
67
Apixaban?
X inhibitor
68
Irinotecan?
Inhibits topo I-- used in colon cancer
69
Topotecan?
Inhibits topo I-- used in small lung cell cancer

Elliot Step 1 (32 decks)

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