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34 Cards in this Set

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Indications for 5-Fluorouracil
Solid tumors:
Colon + rectal, breast, head and neck, cervix
What are the toxicities of 5-FU?
Myelosuppresson; Diarrhea; palmar-plantar erythema (uncommon unless w/ continuous infusion); Mucositis; Hyperpigmentation, Increased sensitivity to the sun; Horrible toxicity in patients with enzyme def. like dihydrofluororeducatse def. (rare)
Indications for methotrexate
Osteosarcomas, lymphomas, breast cancer, leptomeningeal disease (can be tolerated in patient's spinal cord)
Rheum: RA and psoriatic arthritis
What are the toxicities of methotrexate?
Mucositis (can be fatal, administer w/ leucovorin to decrease severity); Diarrhea; Arachnoiditis. Accumulates in 3rd space - do not give in ascites or effusion
What is the mechanism of 5-FU?
Anti-metabolite. Inhibition of thymidylate synthetase; incorporation of FUTP into RNA and DNA
What is the mechanism of methotrexate?
Anti-metabolite; inhibits the folic acid pathway , specifically dihydrofluororeductase-mediated conversion of FH2 to FH4, necessary for generation of purines
What are the mechanism and indications for gemcitabine?
Anti-metabolite.
Pancreatic cancer.
What is the mechanism of doxorubicin (adriamycin)?
Topisomerase II inhibitor --> breaks in genomic DNA, intercalates DNA --> blocks DNA synthesis and transcription
What tumors is doxorubicin used for?
Breast (best drug), sarcomas, uterine, lymphomas, leukemias.
What are the toxicities of doxorubicin?
Hair loss (head only); Nausea & vomiting; Potential cardiotoxicity; Myelosuppression; Mucositis; Radiation recall; Hyperpigmentation; Pigmented secretions (rare). Admin in liposomal form (Doxil) helps decrease toxicity (cardiotoxicity, myelosuppression)
What is the mechanism of cisplatin?
Alkylating agent
What are the indications for cisplatin?
*Testicular, *lung, sarcoma, head & neck, cervix, bladder, *ovarian (key drug).
What are the toxicities of cisplatin?
Poorly-tolerated: Nephrotoxicity (give with mannitol); Neurotoxicity --> peripheral neuropathy; Ototoxicity (high frequency loss at high doses); ***Nausea & vomiting (affects everybody); Severe electrolyte imbalances (hypomagnesia, hypokalemia)
What is the mechanism of dacarabazine?
Alkylating agent
What are the indications of dacarbazine?
*Melanomas, sarcomas, Hodgkin's disease (rare)
What are the toxicities of dacarbazine?
Myelosuppression; Nausea & vomiting
What is the mechanism of cyclophosphamide?
Alkylating agent
What are the indications of cyclophosphamide?
Breast, lymphomas, lung (now 2nd line), ovary, bladder

Lupus
What are the toxicities of cyclophosphamide?
Hair loss; Myelosuppression; Nausea & vomiting; **Hemorrhagic cystitis (protected w/ admin of mesna)
What is the mechanism of taxanes?
Stabilizes microtubules. Inhibits depolymerization, which prevents disassembly and stabilizes the spindles into position
What are the indications for taxanes?
Breast, lung, head & neck, ovarian
What are the toxicities of taxanes?
*Peripheral neuropathy; *Complete alopecia, Myelosuppression, Peripheral edema; Hypersensitivity reactions. Different side effects depending on how long or short drug infused.
What is the mechanism of etoposide?
Topoisomerase II inhibitor --> arrests cell in late S-G2 phase
What are the indications for etoposide?
Small cell lung cancer, testicular, lymphoma, AML, Kaposi's, osteosarcoma, neuroblastoma
What is the mechanism of topotecan and irinotecan?
Inhibition of topoisomerase I --> DNA damage
What are the toxicities of Topotecan?
Myelosuppression
What are the toxicities of irinotecan?
Diarrhea
What is the mechanism of vinca alkaloids (vincristine, vinblastine)?
Binds tubulin, inhibiting polymerization --> disrupts mitosis --> cell death
What are the toxicities of vinca alkaloids?
Peripheral neuropathy
Myelosuppression (vinblastine only)
What are the indications of topotecan?
Irinotecan?
Topo - ovarian
Irino - colon
What are the indications for vinca alkaloids?
Leukemia, lymphoma, Wilms, neuroblastoma, brain, rhabdomyosarcoma, breast, bladder cancer
What is the mechanism of hydroxyurea?
Inhibits ribonucleotide reductase --> impaired DNA synthesis
What are the indications for hydroxyurea?
CML, HIV
What is the mechanism of flutamide?
Competative antagonist of androgen receptor.