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60 Cards in this Set

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Name the alkylating agents for chemo.
cyclophosphamide
cisplatin
Name the antimetabolites used for chemotherapy.
MTX
5-FU
cytarabine (Ara-C)
Which ABX are used for chemotherapy?
doxorubicin
bleomycin
Which vinca alkaloids are used for chemotherapy?
vinblastine/vincristine
paclitaxel
What type of drug is cyclophosphamide?
alkylating agent
What is the most common SE of cyclophosphamide?
hemorrhagic cystitis
Why is cyclophosphamide bladder toxic?
acrolein
How do the alkylating agents work?
they prevent cell division by cross-linking DNA strands and decreasing DNA synthesis
What is a major nononcologic indication for use of cyclophosphamide?
wegener's granulomatosis
What needs to be monitored in pts taking cyclophosphamide?
CBC q2wks
BMP " "
LFTs qmonth
UA " "
What are the cytochrome interactions of cyclophosphamide?
3A4 substrate
What drugs (beside 3A4 drugs) interfere with cyclophosphamide?
succinyl choline - may lead to prolonged neuromuscular blockade because cyclo reduces pseudocholinesterace activity

Anticholinergics b/c they delay bladder emptying
What re the ADRs of cyclophosphamide?
alopecia
N/V
infertility
leukopenia
hemorrhagic cystitis (bladder CA possible)
What are the 3 main cancers we use cisplatinum to treat?
bladder, testicular, and ovarian
What should be monitored in cisplatinum therapy but not cyclophosphamide?
audiography
What drugs cause SNHL?
furosemide
cisplatin
aspirin
gent
tobra
vanco
What electrolytes must be watched closely with cisplatinum therapy?
Mg
Ca
K
How does ototoxicity from cisplatin manifest?
high frequency loss
How does MTX work?
folate antimetabolite --> inhibiting DNA synthesis
MTX should not be given with which antibiotic?
bactram (TMP-SMX)
What drugs may interact with MTX? (most are theoretical)
cyclosporin (may inc toxicity of each)

hepatotoxic agents like AZA or sulfasalazine
Which chemo drug is an abortifacient?
MTX
What are common unique toxicities of MTX
stomatitis
macular punctate extremity rash
fever
macrocytosis/heme abnormalities
What factors can give you macrocytosis?
liver disease
hypothyroid
drugs (MTX, AZT)
alcohol
folate or B12 deficiency
When do ADRs typically occur from MTX?
w/in 24-48 hrs of dose
Is pulmonary toxicity seen with high dose or low dose MTX?
both
5-fluorouracil is a _____
antimetabolite
How does 5-FU work?
pyrimidine antimetabolite that interferes with DNA synthesis by blocking methylation of deoxyuridylic acid
What is 5 FU often used for?
topically for AK or superficial BCCs
What are the drug interactions of 5-FU?
may potentiate warfarin
How does cytarabine work?
gets incorporated into DNA -> inhibiting synthesis

at high doses it inhibits DNA polymerase
What is cytarabine used for?
AML
ALL
CML
lymphomas
What unique lab parameter needs to be monitored in cytarabine therapy?
serum uric acid
What are the ADRs associated with cytarabine?
drug fever
alopecia
N/V/D
mucositis
myelosuppression
cytarabine syndrome
cerebellar toxicity
Name 2 toxic effects that occur with cytarabine only.
cytarabine syndrome - Characterized by fever, myalgia, bone pain, chest pain, maculopapular rash, conjunctivitis, & malaise

cerebellar toxicity
How does doxorubicin work?
inhibits DNA and RNA synthesis by intercalation between base pairs - inhibits topo II

and is an iron chelator
What is one of the main indications for use of doxorubicin?
sarcomas
What needs to be monitored in doxorubicin therapy but no other chemo?
ECG, +/- ECHO
What are the cytochrome interactions of doxorubicin?
2D6 and 3A4 substrate
What drug should not be given with doxorubicin? Why?
cyclophosphamide - enhances cardiac toxicity and may decrease clearance leading to coma/seizures/enhanced myelosuppression
What are the main ADRs of doxorubicin?
Cardiotoxicity
potent vesicant
radiation recall
mucosiis
myelosuppression
Which drug can cause radiation recall 5-7d post administration?
doxorubicin
What is the main treatment indication for bleomycin?
testicular CA
and hodkins/NHL
Why do you need to do pfts for pts on bleomycin
can cause acute or chronic interstitial pneumonitis -> pulmonary fibrosis
With which chemo drug is a scleroderma like rash possible? (erythema, rash, striae, induration, hyperkeratosis, vesiculation, and peeling of the skin, particularly palmar / plantar surfaces
bleomycin
what drugs work by stopping cell division to block growth?
vinca (plant) alkaloids
Aka antimicrotubule agent or antimitotic agent
vinca alkaloid = taxane = mitotic inhibitor etc
Name the vinca alkaloids
vinblastine
vincristine
vindesine
vinorelbine
( and the taxanes)
Name the 2 taxanes
docetaxel
paclitaxel
what is paclitaxel used for?
metastatic br CA and stent coating
how does vinblastin work?
Binds tubulin and inhibits microtubule formation, therefore, arresting the cell at metaphase by disrupting the formation of the mitotic spindle
What is the main indication for vinblastine?
hodgkins/NHL
What 2 drugs do you need to monitor serum uric acid?
vinblastine
cytarabine


(but cyclophosphamide can exacerbate gout)
What are the cytochrome interactions of vinblastine?
3A4 substrate
What is the dose limiting toxicity of vinblastine?
myelosuppression
What is the MOA of paclitaxel?
Promotes microtubule assembly by enhancing the action of tubulin dimers, stabilizing existing microtubules, and inhibiting their disassembly  interferes with late G2 mitotic phase  cell replication inhibited
what are the indications for paclitaxel?
breast cancer
SCLC and NSCLC
ovarian CA
What are the cytochrome interactions of paclitaxel?
2C9 and 3A4 substrate (just like (doxorubicin was 2D6 and 3A4)
What is a common reason to have to stop paclitaxel and give steroids? when is it most common?
hypersensitivity rxn; first hour of infusion
What side effect is unique to paclitaxel?
***peripheral neuropathy
hypersensitivity rxn
arthralgia/myalgia
rhythm abnormalities