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33 Cards in this Set

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smallest number of detectable cancer cells
10⁹ (1 gm)

Death at 10^12 10^13
CNS toxicities
vincristine, vinblastine
Cardiac toxicities
doxorubicin, daunorubicin (irreversible)
Pulmonary toxicities
bleomycin (irreversible, 1% fatal)
Hypersensitivity toxicities
L-asparaginase
Carcinogenesis toxicities
alkylating agents
Alkylating agents
alkylate nucleophiles causing DNA cross-linking, inhibition of DNA replication

CCNS

Toxic: Myelosupression, N/V
Mechlorethamine
Alkylating agent, IV

Toxic: Hyperuricemia (use allopurinol)
Myelosuppresion
Cyclophasphamide, Ifosfamide
alkylating agents, IV prodrugs

Toxic: hemorrhagic cystitis (give with Mesna and fluid)
Myelosupression
Most effective alkylating agent

Can be given orally

May cause hemorrhagic cystitis
Cyclophosphamide
thiopenta
alkylating agent

myelosuppression
Carmustine, Lomustine, Semustine

Class, method of delivery, S/E
Alkylating agenst, nitrosoureas

Camustine IV
Lomustine IV, PO
Simustine PO

Severe Myelosuppresion
Dacarbazine
Monofunctional Alklating agent IV

Myelosuppression
Cisplatin
Platinum complex alkylating agent

No myelosuppresion, but renal, oto and neurotoxic

Use hydration and diuretics
Carboplatin
Not at renal, oto and neurotoxic, but more myelosuppresion
Antimetabolites
analogs of normal cell components

CCS mechanism

Myelosuppression

Methotrexate, Mercaptopurine, 5-FU, Cytarabine
Methotrexate
Anti-metabolite, IV/PO

folic acid analogue block DHFR

Myelouppression>GI>skin

Leucovorin reverses effect
Leocovorin
Reverse effects of methotrexate
6-mercaptopurine, 6-thioguanin
anti-metabolite, PO

purine analogue

myelosppresion, N/V, hyperuricemia

give with allopurinol
5-Fluorouracil
IV antimetabolite

blocks thymidylate synthase

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

N/V myelosuppression, hepatototix, neurotoxic
Doxorubicin and Daunorubicin
IV antibiotic

inhibits DNA synthesis and breaks DNA

Cardiac toxicity, alopecia, radiation recall, myelosuppression
dactinomycin
IV antibiotic

inhibs DNA, RNA synthesase

usual + dermatitis, ulcers, recall
Bleocmycins
IM, IV multi glycoprotein antibiotic

minimal myelosuppression, acute N/V, pulmonary fibrosis, ulcers
Mitomycin
CCNS alkylatinn agent

SEVERE myelosuppression, N/V
Vincristine
IV alkaloid

CCS drug that bind tubulin

peripheral neuopathy
Vinblastine
IV alkaloid

myelosuppression, no as much neuotoxicity and stomatitis as vincristine
Paclitaxel
IV alkaloid

myelosuppression, sensory neuropathy
etoposide
bind tubulin

usual + hypotension and hepatotoxicity
Tamoxifen
anti estrogen, CCNS

incrase in endometrial cancer, tumor flare
Leuoprolide, Goserelin
agonist of pituitar GnRH receptor causing down reg, and reduced FSH and LH secretion

Hormonal castration

tumor flare, hot flashes
hydroxyurea
PO inhibitor of Ribonucleoside diphosphate reductase

Good CNS penetration

myelosuppression, N/V diarrhea
L-asparaginase
IV inhibitor or protein synthesis

hepatotoxic, anaphylazis (10%)