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64 Cards in this Set
- Front
- Back
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methotrexate is effective against
what ? |
pediatric and choriocarcinoma
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What will you administer to protect from cytotoxicity?
Is it complete protection? |
Leucovorin ( folate supplement),
no its partial |
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What are the toxic effects of methotrexate?
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mucositis, myelosuppression, Nephratoxocity, inflammatory response in CSF ( not reversed by leucovorn)
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what two things does 5 fluorouracil do?
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mimics uracil thus inhibits synthesis of thymidine from uracil and its a radiosensitizer
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5-FU toxicity?
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Anorexia , nausea, stomatitis, severe mucosal ulceration and diarrhoea, myelosuppression
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what is 6 mercaptopurine?
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analog of adenine, inhibits purine synthesis
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6 mercaptopurine drug interactions?
Toxicity? |
Allopurinol inhibits 6 MP.
gradual bone marrow suppression. |
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what do vincristine and vinblastine do?
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block tubulin polymerization and inhibit mitosis
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What is vincristine used for?
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pediatric leukemias , solid tumors and adult lymphomas
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what is vinblastin used for?
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testicular cancer,lymphomas
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What is the difference in the side effects of vincristine and vinblastin?
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vincristine causes neurotoxicity,
vinblastin not as much |
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Taxanes, what are the two names?
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Paclitaxel and Docetaxel
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TOPO inhibitors:
What is etoposide for? |
testicular cancer ( with cisplatin and bleomycin ), small cell lung carcinoma
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what is teniposide for?
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pediatric ALL
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Which TOPO inhibitor will you give for colorectal, ovarian and small cell lung cancer?
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Topotecan and Irinotecan
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What is MOA of dactinomycin
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potent inhibitor of rapidly proliferating cells
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What is dactinomycin used for ? is it used alone?
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used for pediatric rhabdomyosarcoma and Wilm's tumor in combo with surgery, radiotherapy or vincristine /cyclophosphamide
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Dactinomycin toxicity?
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atrophy of thymus , spleen, lymphatic tissue, subcutaneous extravasation causes marker local inflammation.
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What are the three DNA damaging/intercalating antibiotics ?
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Dactinomycin ( actinomycin D ), Doxorubicin (Adriamycin) and Daunorubicin, Bleomycin
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Whats is Daunorubicin used for?
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AML and ALL
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What is Doxorubicin used for?
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it has a broader spectrum, used for solid tumors like breast cancer
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Side effects of Doxo and Daunorubicin?
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unusual cardiomyopathy related to free radical generation and red urine.
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What do you use to protect against doxo and daunorubicin induced cardiomyopathy
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Dexrazoxane
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What is bleomycin used for ?
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Squamous carcinoma of the head neck and lungs. It is curative for the germ cell tumors of the testes and highly effective for the germ cell tumors of the ovary.
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Is bleomycin myelosuppressive?
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No, neither myelosuppressive nor immunosuppressive
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Toxicity due to bleomycin use?
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Pulmonary fibrosis in 5 to 10% of patients, cutaneous toxicity (hyperkeratosis,ulceration) and fulminant reaction in 1% of lymphoma patients.
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What are the six different antimetabolites?
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Methotrexate, 5-Fluorouracil,6-Mercaptopurine,Fludarabine Phosphate,Cytarabine,Cladribine
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Eg of cell cycle specific drug classes?
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antimetabolites, topoisomerase inhibitors,microtubule inhibitors.
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Eg of cell cycle non specific drug classes?
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Alkylating agents , antibiotics, estrogen/androgen antagonists
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What is the MOA of alkylating agents?
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Highly reactive compounds that cause intra and inter strand crosslinking of DNA and also DNA protein cross linking. Thus prevents DNA replication and transcription of RNA
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Are alkylating agents cell cycle specific?
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No
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What do all alkylating agents induce?
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Leukemia because they are all mutagenic / carcinogenic.
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What are the different classes of alkylating agents?
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1. Nitrogen mustards
2. Nitrosoureas 3. Alkyl Sulfonates : Bisulfan 4. Procarbazine and Dacarbazine |
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What are the four types of Nitrogen mustards?
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Cyclophosphamide, Melphalan,Chlorambucil,
Mechlorethamine |
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Whats is Cyclophosphamide used for?
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Very broad spectrum and effective against Burkitt's lymphoma, adjuvant therapy after surgery for breast cancer
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What are the toxic effects of Cyclophosphamide?
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1. potent immunosuppression
2. GI ulceration 3.Marked alopecia 4. Nausea and vomitting |
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What is melphalan used for?
Does it cause alopecia |
It is useful for multiple myeloma.
No |
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Melphalan toxicity?
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Myelosuppression, Nausea and vomitting infrequent
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What are the two nitrosourea drug types?
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1. Carmustine and Lomustine
2. Streptozocin |
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How is Carmustine and Lomustine given?
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IV and Oral respectively
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How do Carmustine and Lomustine act?
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They penetrate CNS well and thus are effective against astrocytomas and metastatic brain tumors
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What are the toxic effects of carmustine and Lomustine
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Delayed and profound myelosuppression, Pulmonary fibrosis
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What is streptozocin used for?
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Metastatic pancreatic islet cell carcinoma
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What are the toxic effects of Streptozocin?
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1. Hepatic and renal toxicity
2. Minimal bone marrow toxicity 3. Nausea |
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What is busulfan used for?
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used in the treatment of chronic myelogenous leukemia
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toxic effects of busulfan?
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Pulmonary fibrosis, dose limiting myelosuppression
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What are procarbazine and dacarbazine used for?
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Hodgkin's disease
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What is the speciality of procarbazine?
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it lacks cross resistance to other mustard type alkylating agents.
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What are platinum compounds used for?
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cisplatin with bleomycin,etoposide and vinblastin is effective for testicular cancer.
Carboplatin ( with paclitaxel or cyclophosphamide ) for ovarian cancer |
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Side effects for platinum compounds
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Nephrotoxicity, ototoxicity, severe nausea and vomiting.
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How does gleevec work?
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It is an inhibitor of the bcr-abl tyrosine kinase causative for chronic myelogenous leukemia
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What are the two anti-estrogens?
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Tamoxifen and Raloxifene
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How does raloxifene work?
Drawback? |
Inhibits binding of estradiol to the ER.
Ineffective in ER -ve tumor. |
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How do the two types of anti androgens act?
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steroidal anti androgens - inhibit androgen binding to the AR
Non-steroidal antiandrogens - inhibit nuclear translocation of the AR |
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What are the GnRH analogs and when are they used?
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leuprolide and goserelin. Used for medical castration in treatment of prostate cancer and to reduce estrogen to post menopausal levels for control of ER+ breast cancers
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Name two aromatase inhibitors?
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Exemestane and anastrozole, they are useful second line treatment for ER+ Breast cancer
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Which aromatase inhibitor is beneficial? steroidal or imidazole?
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imidazole drugs lack side effects
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What is Gardasil?
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Its a vaccine against HPV which elicits humoral immune response
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What is Rituximab?
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It binds CD20 which is found on 90% of non hodgkin's lymphoma
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What is herceptin? are there any side effects?
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Antibody to human epidermal growth factor receptor her2. Side effect is hypersensitivity.
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what is filgrastim?
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it is granulocyte colony stimulating factor,used for neutropenia.
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what is sargramostin?
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It is granulocyte / monocyte CSF
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What is pamidronate?
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it prevents hypercalcemia and bone resorption associated with mailgnancy
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What is leucovorin?
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It is a folate supplement
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