Anti-Neoplastic Chemo

Front 1

smallest number of detectable cancer cells

Back 1

10⁹ (1 gm)

Death at 10^12 10^13

Front 2

CNS toxicities

Back 2

vincristine, vinblastine

Front 3

Cardiac toxicities

Back 3

doxorubicin, daunorubicin (irreversible)

Front 4

Pulmonary toxicities

Back 4

bleomycin (irreversible, 1% fatal)

Front 5

Hypersensitivity toxicities

Back 5

L-asparaginase

Front 6

Carcinogenesis toxicities

Back 6

alkylating agents

Front 7

Alkylating agents

Back 7

alkylate nucleophiles causing DNA cross-linking, inhibition of DNA replication

CCNS

Toxic: Myelosupression, N/V

Front 8

Mechlorethamine

Back 8

Alkylating agent, IV

Toxic: Hyperuricemia (use allopurinol)
Myelosuppresion

Front 9

Cyclophasphamide, Ifosfamide

Back 9

alkylating agents, IV prodrugs

Toxic: hemorrhagic cystitis (give with Mesna and fluid)
Myelosupression

Front 10

Most effective alkylating agent

Can be given orally

May cause hemorrhagic cystitis

Back 10

Cyclophosphamide

Front 11

thiopenta

Back 11

alkylating agent

myelosuppression

Front 12

Carmustine, Lomustine, Semustine

Class, method of delivery, S/E

Back 12

Alkylating agenst, nitrosoureas

Camustine IV
Lomustine IV, PO
Simustine PO

Severe Myelosuppresion

Front 13

Dacarbazine

Back 13

Monofunctional Alklating agent IV

Myelosuppression

Front 14

Cisplatin

Back 14

Platinum complex alkylating agent

No myelosuppresion, but renal, oto and neurotoxic

Use hydration and diuretics

Front 15

Carboplatin

Back 15

Not at renal, oto and neurotoxic, but more myelosuppresion

Front 16

Antimetabolites

Back 16

analogs of normal cell components

CCS mechanism

Myelosuppression

Methotrexate, Mercaptopurine, 5-FU, Cytarabine

Front 17

Methotrexate

Back 17

Anti-metabolite, IV/PO

folic acid analogue block DHFR

Myelouppression>GI>skin

Leucovorin reverses effect

Front 18

Leocovorin

Back 18

Reverse effects of methotrexate

Front 19

6-mercaptopurine, 6-thioguanin

Back 19

anti-metabolite, PO

purine analogue

myelosppresion, N/V, hyperuricemia

give with allopurinol

Front 20

5-Fluorouracil

Back 20

IV antimetabolite

blocks thymidylate synthase

N/V, ulceration of oral and GI mucosa, myelosuppresion, anorexia

Front 21

Cytarabine

Back 21

IV antimetabolite

N/V myelosuppression, hepatototix, neurotoxic

Front 22

Doxorubicin and Daunorubicin

Back 22

IV antibiotic

inhibits DNA synthesis and breaks DNA

Cardiac toxicity, alopecia, radiation recall, myelosuppression

Front 23

dactinomycin

Back 23

IV antibiotic

inhibs DNA, RNA synthesase

usual + dermatitis, ulcers, recall

Front 24

Bleocmycins

Back 24

IM, IV multi glycoprotein antibiotic

minimal myelosuppression, acute N/V, pulmonary fibrosis, ulcers

Front 25

Mitomycin

Back 25

CCNS alkylatinn agent

SEVERE myelosuppression, N/V

Front 26

Vincristine

Back 26

IV alkaloid

CCS drug that bind tubulin

peripheral neuopathy

Front 27

Vinblastine

Back 27

IV alkaloid

myelosuppression, no as much neuotoxicity and stomatitis as vincristine

Front 28

Paclitaxel

Back 28

IV alkaloid

myelosuppression, sensory neuropathy

Front 29

etoposide

Back 29

bind tubulin

usual + hypotension and hepatotoxicity

Front 30

Tamoxifen

Back 30

anti estrogen, CCNS

incrase in endometrial cancer, tumor flare

Front 31

Leuoprolide, Goserelin

Back 31

agonist of pituitar GnRH receptor causing down reg, and reduced FSH and LH secretion

Hormonal castration

tumor flare, hot flashes

Front 32

hydroxyurea

Back 32

PO inhibitor of Ribonucleoside diphosphate reductase

Good CNS penetration

myelosuppression, N/V diarrhea

Front 33

L-asparaginase

Back 33

IV inhibitor or protein synthesis

hepatotoxic, anaphylazis (10%)