Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
56 Cards in this Set
- Front
- Back
How do alkylating agents work?
|
Cross link DNA
They are NOT phase specific Cells must be proliferating |
|
Nitrogen Mustard are alkylating agents.
Name the important ones (5) |
Mechlorethamine
Cyclophosphamide Ifosfamide Melphalan Chlorambucil |
|
Cyclophosphamide indications (3)
|
NHL
breast and ovarian carcinoma also an immunosupressant |
|
Cyclophosphamide SE
|
hemmorhagic cystitis
myelosuppression |
|
How do you avoid hemorrhagic cystitis?
|
MESNA and adequate hydration
|
|
What is the MOA of busulfan?
Clinical use? Major SE? |
alkylating agent
CML pulmonary fibrosis and hyperpigmentation |
|
Nitrosoureas are alkylating agents.
Name 4 of them. |
Carmustine
Lomustine Semustine Streptozocin |
|
Nitrosoureas CI?
Major SE? |
Brain tumors (we must preserve the brain)
Streptozocin - pancreaitic islet cell tumor CNS toxicity |
|
What type of agent is cisplatin?
Indication? SE? |
Alkylating agent
Testicular, bladder, ovary, lung Nephrotoxicity and ototoxicity |
|
What type of agent is cisplatin?
Indication? SE? |
Alkylating agent
Testicular, bladder, ovary, lung Nephrotoxicity and ototoxicity |
|
The Mopp regimen is used for Hodgkins, what comprises MOPP?
|
Mechlorethamine -alkylating agent
Oncovin (vincristine)- vinca alkaloid procarbazine - alkylating agent prednisone |
|
Name an acute SE of procarbazine
|
disulfiram-like effect
|
|
Are antimetabolites phase specific?
|
Yes, S phase
|
|
Methotrexate (MTX)
MOA (be specific) |
folic acid analog
inhibits dihydrofolate reductase thus decreasing dTMP |
|
Whate rescues normal cells from MTX toxicity?
|
Leucovorin
|
|
Neoplastic use of MTX (4)
|
leukemia (childhood ALL)
lymphoma sarcoma choriocarcinoma |
|
Non-Neoplastic use of MTX (4)
|
psoriasis
RA abortion ectopic pregnancy |
|
MTX SE (2)
|
myelosuprresion (reversible with Luke)
hepatotoxicity (macrovesicular fatty change) |
|
5-FU is an anti-metabolite
MOA? |
complexes w/ THF
inhibits thymidyalte synthetase decreses dTMP |
|
5-FU clinical use? (2)
SE? (2) |
metastatic colon cancer
basal cell carcinoma (topical) myelosuppression (LUKE will actually increase GI toxicity so never use) photosensitivity |
|
What is cytarabine (Ara-C)?
MOA? |
an anitmetabolite
pyrimidine analog inhibits DNA polymerase |
|
Cytarabine clinical use?
SE? |
AML (w/ daunorubicin)
Leukopenia Thrombocytopenia Megaloblastic anemia |
|
6-mercaptopurine (6-MP)
Clinical use (be specific)? SE? |
leukemia (main. of child ALL; not useful with CLL)
NHL myelosuppresson cholestatic jaundice |
|
What increases 6-MP toxicity and why?
|
allopurinol
both metabolized by xanthine oxidase |
|
Name some anitmetabolites used against hairy cell leukemia (3)
|
Pentostatin
Fludarabine Cladribine |
|
Name two non-neoplastic agents that are related to purine analogs and their clinical uses?
|
Azathiopurine - immunosuprression w/ transplants
Allopurinol - hyperuricemia/gout (an inhibitor of xanthine oxidase) |
|
When is allopurinaol useful in neoplastic disease?
|
tumor lysis syndrome
(rapid cell lysis leads to release of purines which could lead to renal stones/failure) |
|
Vincristine and Vinblastine
(Vinca alkaloids) phase specfic? MOA? |
M phase
bind tubulin and inhibit MT polymerization |
|
Clinical uses of Vinblastine and Vincristine
|
MOPP for lymphoma
Wilms choriocarcinoma |
|
SE of vincristine? (3)
SE of vinblastine? |
neurotoxicity
peripheral neuropathy paralytic ileus myelosuppression |
|
Etoposide phase?
MOA? |
G2 phase
inhibits topoisomerase II thus double strand breaks remain |
|
Etoposide use?
|
Oat cell carcinoma of lung and prostrate
testicular carcinoma |
|
Paclitaxel (Taxol) phase?
source? MOA? |
M phase
Yew tree stabilizes MT in mititic apparatus thus preventing depolymerization |
|
What is the only antibiotic neoplastic that is phase specific?
|
Bleomycin
(G2 and M phase) |
|
Dactinomycin (Actinomycin D) MOA?
uses? (4) |
intercalates and inhibits RNA poly
Wilms Ewings Rhabdomyosarcoma Kaposi |
|
Doxorubucin (Adriamycin) MOA?
SE? |
intercalates and form strand breaks
Cardiotoxicity (rubicin sisters will break your heart) |
|
Clinical uses of Doxorubucin? (6)
|
Hodgkins
myelomas sarcomas solid tumors (breast, kidney, lung) |
|
Hodgkins can be treated with the ABVD regimen which is?
|
Adriamycin (doxorubucin)
Bleomycin Vinblastine Dacarbazine |
|
Bleomycin MOA?
Use? SE? |
intercalates and causes strand breaks
testicular cancer pulmonary fibrosis |
|
Name a chemotherapeutic agent increases the cardiotoxicity of doxorubicin?
|
Mitomycin
|
|
Prednisone MOA?
Use? |
suppress mitosis and possibly induce apoptosis
MOPP CLL breast carcimoma (decreases estrogen) |
|
Prednisone SE (9)
|
Cushing-like symptoms
immunosuprression cataracts acne osteoporosis HTN peptic ulcers hyperglycemia psychosis |
|
Use of hydroxyprogesterone, medoxyprogesterone, and megestrol? (3)
|
endometrial carcimoma
breast cancer prostrate cancer |
|
Use of androgens (testosterone and fluoxymesterone)?
|
estrogen receptor positive breast carcinoma (only in pre and post-meno)
|
|
Flutamide and bicalutamide MOA?
use? |
androgen receptor antagonist
prostate cancer |
|
Leuprolide and goserelin MOA?
Use? |
analog of LH-RH and blocks GnRH thus decreasing androgen synthesis
prostrate carcinoma |
|
ethinyl estradiol, DES, estramustine use?
|
advanced prostrate carcinoma
|
|
Tamoxifen/Raloxifene MOA?
use? |
partial agonist of estrogen receptor
breast cancer |
|
Tamoxifen/Raloxifene MOA?
use? |
partial agonist of estrogen receptor
breast cancer |
|
Tamoxifen/Raloxifene SE? (2)
|
induce endometrial carcinoma
hot flashes |
|
anastrozole MOA?
use? |
inhibits aromatase
tamoxifen R breast carcinoma |
|
IFN use (3)
SE? |
hairy cell leukemia
Karposi genital warts flu-like syndrome |
|
adesleukin is what?
use? (2) SE? |
IL-2
metastatic melanoma renal cell carcinoma severe HTN and cardiovascular toxicity (life threatening) |
|
L-Asparaginase use and w/ what other agents?
|
ALL
vincristine prednisone |
|
hydroxyurea MOA?
phase? use? |
inhibits ribonucleotide reductase thus deoxyribonucleotides cant be produced
S phase CML |
|
Topotecan and Irinotecan MOA?
use (different for each one? |
inhibit topoisomerase I
used after 1st line treatment failure for: topotecan - ovarian carcinoma irinotecan - colorectal carcinoma |