MOA of Drugs and SE

Question 1

Cyclophosphamide

Answer 1

Alkylating agent: Cross links DNA to impede marrow formation

SE: marrow aphasia, haemorrhagic cystitis, cardiomyopathy and hair loss

Question 2

Chlorambucil

Answer 2

Alkylating agent: cross links DNA to impede RNA formation

SEs: marrow aphasia, hepatic toxicity, dermatitis, alopecia

Question 3

Busulphan

Answer 3

Alkylating agent: cross links DNA to impede RNA formation

SEs: marrow aphasia, pulmonary fibrosis, hyperpigmentation, seizures, hepatic toxicity and alopecia

Question 4

Melphalan

Answer 4

Alkylating agent: cross links DNA to impede RNA formation

SEs: marrow aphasia, alopecia

Question 5

Bendamustine

Answer 5

Alkylating agent: cross links DNA to impede RNA formation.
Also purine nucleoside analogue

SE: myelosuppression

Question 6

Hudroxycarbamide

Answer 6

Antimetabolite: inhibitor ribonucleotide reductase

SE: pigmentation, nail dystrophy, skin keratosis, epitheliomas.

Question 7

Methotrexate

Answer 7

Antimetabolite: inhibit pyramidine or purine synthesis or incorporation into dna

SEs: mouth ulcers, gut toxicity

Question 8

Cytosine arabinoside/cytarabine (ara-c)

Answer 8

Antimetabolite: inhibits dna synthesis

SEs: cerebellar toxicity and conjunctivitis

Question 9

6 mercaptopurine/thioguanine

Answer 9

Antimetabolite: purine analogue

SEs: jaundice and gut toxicity

Question 10

Clofarabine

Answer 10

Antimetabolite: purine analogue

SEs: myelosupression

Question 11

Fludarabine, 2-CDA, deoxycoformycin (pentostatin)

Answer 11

Antimetabolite: purine analogues: inhibit adenosine deaminase or purine Pathways

SEs: immunsupression (low CD4 counts), renal and neurotoxicity

Question 12

Daunorubicin, idarubicin, mitoxantrone

Answer 12

Cytotoxic antibiotics: Anthracyclines
Bind DNA and interfere with mitosis

SEs: cardiac toxicity and hair loss

Question 13

Bleomycin

Answer 13

Cytotoxic antibiotics: inducer DNA breaks

SEs: pulmonary fibrosis, skin pigmentation

Question 14

Amasacrine (m-AMSA)

Answer 14

Cytotoxic antibiotics: topoisomerase inhibitor

SEs: hair loss and mucositis

Question 15

Vincristine and vinblastine

Answer 15

Cytotoxic antibiotics: spindle damage

SEs: neuropathy (peripheral/bladder/gut)

Question 16

Etoposide

Answer 16

Cytotoxic antibiotics: mitotic inhibitor

SEs: hair loss and oral ulceration

Question 17

Azacitidine and decitabine

Answer 17

Epigenetic modifier: hypomethylating agent
Inhibit DNA methyltransferase

SEs: myelosuppression and injection site reactions

Question 18

Pabinostat and romidepsin

Answer 18

Epigenetic modifier: histone deacetylase

SEs: fatigue and thrombocytopaenia

Question 19

Imatinib, dasatinib, nilotunib, bosutinib, ponatinib, asciminib

Answer 19

Signal transduction inhibitors: inihibiy ABL tyrosine kinase

SEs: myelosuppression, fluid retention, pancreatitis, GI disturbance, thrombosis (ponatonib

Question 20

Midostaurin, gilteritnib, crenolanib, quizartinib, sorafenib

Answer 20

Signal transduction inhibitors: Flt3 kinase inhibitor

SEs: myelosuppression, GI upset and QTc prolongation

Question 21

Ibrutinib, acalbrutinib, zanabrutinib

Answer 21

Signal transduction inhibitors: BTK protein inhibitor

SEs: bleeding, disease flare, arrhythmias/AF

Question 22

Idelalisib, duvelisib, copanlisib

Answer 22

Signal transduction inhibitors: inhibit PI3K delta

SEs: colitis, atrial dysrhythmias

Question 23

Ruxolitinib, pacritnib, fedratinib, momelitnib

Answer 23

Signal transduction inhibitors: inhibit JAK2

SEs: marrow suppression anaemia/thrombocytopenia, cytokine storm on withdrawal

Question 24

Crizotinib

Answer 24

Signal transduction inhibitors: inhibit ALK

SEs: visual disturbance, hepatic enzyme elevation, GI effects

Question 25

Gladesgib

Answer 25

Signal transduction inhibitors: inhibit hedgehog pathway SEs: marrow suppression, myalgia, nausea, embryo-fetal toxicity

Question 26

ATRA

Answer 26

Induces differentiation SEs: deranged LFTs, pleural effusion, differentiation syndrome, leucocytosis

Question 27

Arsenic trioxide

Answer 27

Induces differentiation or apoptosis SEs: prolonged qtc, neuropathy, deranged lfts, hyperleucocytosis

Question 28

A- interferon

Answer 28

ActIvation of RNAase and natural killer activity SEs: flu like symptoms thrombocytopenia, leucopenia, weight loss

Question 29

Enasidenib, ivosidenib

Answer 29

Inhibit mutated Isometric dehydrogenase (IDHI) SEs: differentiation syndrome, cytopaenias

Question 30

Venetoclax

Answer 30

Inhibit BCL2 signalling SEs: tumour lysis, QTc

Question 31

Omacetaxine

Answer 31

Inhibits protein translation SEs: injection site reactions, GI effects, myelosuppression

Question 32

Bortezemib, ixazomib, carfilozomib

Answer 32

Proteosome inhibitor SEs: neuropathy

Question 33

L asparginase, peg-asparginase

Answer 33

Deprive cells of asparginase SEs: hypersensitivity, low albumin and coagulation factors, pancreatitis

Question 34

Thalidomide, lenalidomide, pomalidomide

Answer 34

Immunomodulation, alteration of protein degradation SEs: neuropathy, constipation, thrombosis, teratogenic

Question 35

Rituximab, ofatumumab, obinutuzumab

Answer 35

Anti- CD20 induces apoptosis SEs: infusion reaction, immunosuppression

Question 36

Alemtuzumab

Answer 36

Anti CD52 lysis of target cells by complement fixation SEs: infusion reactions, immunosuppression

Question 37

Ibritumomab - zevalin

Answer 37

Anti-CD20 with Y radioisotope SEs: myelosuppression, nausea

Question 38

Myelotarg

Answer 38

Anti CD33, kills myeloid cells SEs: myelosuppression, hepatic sinusoidal occlusive syndrome VOD

Question 39

Inotuzumab - besponsa

Answer 39

Anti- CD22 kills neoplastic B cells SEs: CRS, VOD

Question 40

Tagraxofusp - elzonristm

Answer 40

Anti CD123 kills myeloid or BPCDN SEs: oedema, capillary leak syndrome, nausea, fever, hepatotoxicity, hypoalbunaemia, myelosuppression

Question 41

Blinatumomab

Answer 41

Bispecific CD20/CD3 SEs: ICANS, CRS

Question 42

Brentuximab

Answer 42

Anti CD30 SEs: myelosuppr3ssion, neuropathy

Question 43

Daratumumab

Answer 43

Anti- CD38 SEs: infusion reactions, myelosuppression, difficulty matching for transfusion

Question 44

Eltozumab

Answer 44

Anti SLAMF7, kills malignant plasma cells SEs: fatigue, GI effects, neuropathy, myelosuppression