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24 Cards in this Set
- Front
- Back
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MOA anthracyclines
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Intercalate with DNA
INhibit TOPOISOMERASE II DSB Drug-Fe-DNA causes ROS leading to SSB |
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5 Anthracycline Toxicies
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Dose limiting: LEUCOPENIA
Cardiotoxicity (ROS) Acute ECG changes (arrhythmia) Delayed progressive cardiomyopathy VESICANT Discolorations ALOPECIA |
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Anthracycline Rescue Agent
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Dexrazoxane is a Fe chelator
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Dactnomycin MOA
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MOA: binds to DsDNA, inhibits RNA synth. At higher concentrations, it inhibits DNA synthesis
Dact gets Stacked! |
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1 Dactinomycin SE
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BM depression (dose limiting)
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Bleomycin
MOA |
Bleo-FE-DNA generates ROS causing DSB and SSB.
it BLASTS the DNA |
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Bleomycin
SE |
SE: pulmonary tox is dose limiting
Mucositis is most common Bleo is MARROW SPARING! Hyperpigmentation |
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Mitomycin (tox like Bleo)
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alkylator
Delayed myelosuppression pulmonary fibrosis HUS (MAHA, renal failure) |
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Arsenic trioxide
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degrades PML-RAR alpha (leukemia)
QT prolongation HIGH emetogenicity Differentiation syndrome |
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Retinoid
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Degrades RAR fusion protein to induce cellular growth and differentiation of promyelocytes
Differentiation Syndrome: dyspnea, fever, weight gain, dry skin, pleural/pericardial effusion) |
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MOA vinca alkaloids and eribulin Mesylate
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bind to tubulin, dimers cannot aggregate (depolymerization)
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MOA of Taxanes and Epothilones
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Stabilize microtubules forming abnormal bundles
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Vincristine Toxicity
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DL: peripheral neuropathy and neurologic toxicities
Autonomic neuropathy NO myelosuppresion Christine's a little CRazy |
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Vinca alkaloids toxicity (not vincristine)
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BM suppression, less neurotox than vincristine
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Toxicities of Taxanes
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BM suppression
Neutropenia Peripheral neuropathies leading to Myopathies |
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Paclitaxel SE and TX
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Hypersensitivity from Cremophore EL
Tx: dexamethasone, diphenhydramine, H2 antagonist |
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Docetaxel SE
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Interstitial pneumonitis
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What's cool about Cabazitaxel
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poor afinity to PGP, so used for patients who have failed docetaxel
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Epothilones: what are they and why should I care?
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more potent than taxanes, similar toxicities
great for taxane resistant tumors |
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Eribulin Mesylate SE
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eliminated in feces unchanged
Neutropenia P neuropathy like taxanes fatibue, anemia, alopecia, constipation QT prolongation |
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Epipodophyllotoxines (Etoposide, Teniposide) SE
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Myelosuppression
Etoposide: Hypotension, leukemias |
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Campotheicins:
Irinotecan Topotecan |
INH topoisomerase 1 --> SSB
BM depression Mucositis |
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Irinotecan SE
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Early and late Diarrhea
"run to the can" |
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Resistance in Campothecins
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accompanied by corss resistance to several drugs, "atypical" multidrug resistant phenotype.
altered or decreased topoisomerase activity |
