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26 Cards in this Set

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MOA for alkylating agents?
DNA cross linking and strand breaks cause disruption of replication and apoptosis
MOA for ATRA?
induces maturation of promyelocytes
MOA for antrhacyclines?
non covalent DNA binding causes: stabilize topo II, strand breaks, RNA synth interference
MOA of antimetabolites?
analogues and MTX is block pur/pyr synth
MOA for arsenic/
degrades RAR/PML fusion protein
MOA of taxanes and vincas?
microtubule inhibitors cause metaphase arrest
What is typhlitis?
infx of cecum and proximal asc colon that can be life threatening w/in hrs
How do you prevent neutropenic fever?
give G-CSF (neupogen) and GM-CSF (leukine)
Explain drug resistance via drug efflux?
upregulation of MRP or MDR1 which is a gene on chr 7 that encodes for a pump that can extrude drugs
Where is the drug efflux pump found?
BBB, gut, kidney , hepatobiliary tree
What can combat drug resistance due to efflux pumps?
CCBs, cycloA, phenothiazines, quinidine
Explain drug resistance due to gene amp?
upregulate an enzyme that is normally inhibited by a drug
Explain drug resistance due to increased glutathione.
detoxifies intermediates
Explain drug resistance due to polyglutamation.
decreased polyglut or increased hydrolase favors loss of drug from cell
How do you prepare a pt for BMT?
Total body irradiation plus high dose cyclophos or cyclo+busulfan
How do you prepare a donor for periph stem cell donation?
5-6 days of G-CSF
Side effects for peripheral stem cell donors?
bone pain, paresthesias
Side effects of BMT?
sterility,
Side effect of cyclophosphamide? How prevent?
hemorrhagic cystitis, prevent w/hydration and bladder irrigation
Where are the major targets of GVHD?
skin, GI, bile ducts
Tx for GVHD?
corticosteroids, immunosuppressives
How does a GVHD pt die?
infx due to compromised skin/mucosal barriers
What is the first stage of immunodeficiency in BMT?
neutropenia wks-mth, bact/fung/HSV (propho w/acyclovir)
What is the second stage of immunodeficiency in BMT?
t-cell def 2-12mths, reactivating viruses (CMV propho w/gancyclovir)
What is the third stage of immunodef in BMT?
6mth-sevyears. Humoral def. Encapsulated organisms
What is chronic GVHD?
post 100 days, autoimmune inflammatory fibrotic. Resembles scleroderma and primary biliary cirrhosis