Bhl Week 3: Pharmacology Of Hematologic Malignancies

Front 1

Which group of chemo agents target DNA synthesis?

Back 1

Antimetabolites

Front 2

Which group of chemo agents target DNA transcription and duplication?

Back 2

Intercalating agents

Front 3

Which chemo agents target the mitotic spindle?

Back 3

vinca alkaloids and taxoids

Front 4

What is the mode of action of the anthracyclines?

Back 4

Inhibits topoisomerase II
(prevents the religation of DNA during DNA replication causing DNA strand breaks)

Front 5

Which chemo agents turn urine red?

Back 5

Anthracyclines

Front 6

What is the MOA of Etoposide (VP-16)?

Back 6

Topoisomerase II inhibitor

Front 7

What are some toxicities associated with anthracyclines?

Back 7

1. Potent vesicants
2. Dose limiting myelosuppression
3. Nausea, vomiting
4. Alopecia
5. Turns urine RED

Front 8

What toxicity is associated with etoposide?

Back 8

Dose limiting myelosuppression (primarily leukopenia)

Front 9

Name 2 vinca alkyloids.

Back 9

1. Vinblastine
2. Vincristine

Front 10

What sort of toxicity is associated with the vinca alkyloids?

Back 10

They are potent vesicans
(apply warm pack and administer hyaluronidase)

Front 11

What toxicities are associated with vinblastine?

Back 11

1. Dose limiting leukopenia and thrombocytopenia
2. Neurologic toxicity
3. Constipation/ cramps

Front 12

What toxicities are associated with vincristine?

Back 12

1. Neurologic toxicity
2. Constipation
3. Paralytic ileus

Front 13

In general, what is the maximum dose of vincristine?

Back 13

2 mg weekly

Front 14

What is the MOA of Methotrexate?

Back 14

Inhibits DHFR that prevents the conversion of dihydrofolate (FH2) to tetrahydrofolate (FH4)

Front 15

What toxicities are associated with methotrexate?

Back 15

1. Dose limiting leukopenia, thrombocytopenia
2. Renal tubular necrosis (high doses)

(Also: pulmonary pneumonitis, alopecia, stomatitis, and mucositis)

Front 16

What can be done to decrease risk of kidney damage as a result of methotrexate therapy?

Back 16

Vigorous hydration and alkylation of the urine

Front 17

List 5 purine analogues.

Back 17

1. Mercaptopurine
2. Thioguanine
3. Fludarabine
4. Pentostatin
5. Cladrabine

Front 18

What is an adverse effect of the purine analogues?

Back 18

Increase risk of infection

Front 19

List 2 pyrimidine analogues.

Back 19

1. Gemcitabine
2. Cytarabine

Front 20

Which purine analogue inhibits ribonucleotide reductase and DNA polymerase?

Back 20

Fludarabine

Front 21

Which purine analogues just inhibit ribonucleotide reductase?

Back 21

1. Pentostatin
2. Cladrabine

Front 22

Which purine analogues are converted in the body to the ribonucleotide form, which incorporate in the DNA to prevent purine synthesis?

Back 22

1. Mercaptopurine
2. Thioguanine

Front 23

Which chemo agent is an analogue of CTP and used extensively for acute leukemias?

Back 23

Cytosine Arabinose (araC)

Front 24

Which medications are often given to prevent tumor lysis syndrome?

Back 24

1. Ara-C
2. Allopurinol

Front 25

Which chemo agent is a purine nucleoside analog?

Back 25

Clofarabine

Front 26

Which therapy is used for relapsed or refractory low-grade or follicular CD20+ B-cell NHL?

Back 26

Rituximab (Rituxan)

Front 27

Which therapy is used for patients with B-CLL who were treated with alkylating agents and have not responded to fludarabine?

Back 27

Alemtuzumab

Front 28

Alemtuzumabe targets which antigen?

Back 28

CD52

Front 29

What is the usual first line of treatment for B-CCL?

Back 29

Alkylating agents-- Fludarabine

Front 30

What is the MOA of Alemtuzumab?

Back 30

Lyses lymphocytes via complement fixation --> apoptosis

Front 31

Rituximab targets which antigen?

Back 31

CD20 on B-cells

Front 32

Gemtuzumab targets which antigen?

Back 32

CD33 on myeloid cells

Front 33

What is the mode of action of Imatinib (Gleevec)?

Back 33

Inhibits BCR-ABL fusion tyrosine kinase
(inhibits the binding site for 1. 1. ATP to the Abl kinase, thus blocking the phosphorylation of tyrosine residues on substrate protein)

2. Inhibits c-Kit and platelet -derived growth factor receptor

Front 34

Which therapy is the initial or salvage therapy for CML?

This medication can also be used for treating..?

Back 34

Imatinib (Gleevec)

*Also used to treat GIST (gastrointestinal stromal tumors)

Front 35

Which medication is a proteasome inhibitor?

Back 35

Bortezomib

Front 36

What is the MOA of ATRA (Tretinoin)?

Which condition is this used for?

Back 36

Allows for differentiation of leukemic cell

*APL