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23 Cards in this Set

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chemotherapy that is cell cycle specific (name 2)
antimetabolites
vinca alkaloids
chemotherapy that is cell cycle non-specific (name 2)
alkylating agents
tumor antibiotics
cyclophosphamide
available:
mechanism:
metabolism:
oral, IV
alkylator
liver activation
cyclophosphamide
SE:
alopecia, BMS, N/V, hemorrhagic cystitis [give lots fluid], pulmon, cardiac
metabolite of cyclophosphamide that causes hemorrhagic cystitis
acrolein
ifosphamide
availability:
mechanism:
metabolism:
oral, IV
alkylator
activated in liver
Ifosphamide toxicity
alopecia, BMS, hemorrhagic cystitis, CNS depression, pulm, cardiac
savages metabolite acrolein
mesna = N-acetyl cysteine
ie. nitrosourea
BCNU = carmustine
fxn of nitrosourea
solubility:
toxicity:
bifunctional alkylator,
inhibit DNA repair
lipid soluble
delayed myelosuppression, N/V, pulm fibrosis, renal toxicity, Cerebell ataxia
cisplatin
mechanism:
toxicity:
cross link DNA
peripheral neuropathy, N/V, neuropathy, hypo Mg2+, auditory toxicity
carboplatin
mechanism:
dosing:
toxicity:
cross link DNA
dosing by AUC
BMS, N/V
Oxaplatin
mechanism:
toxicity:
cross link DNA
peripheral neuropathy
antimetabolites
(fxns)
1. competitive inhibitors for inactive analogs
2. S phase specific
3. BMS and mucosal toxicity
4. altern pathways to bypass anti-metabolite
Methotrexate
mechanism:
toxicity:
inhibits DHFR
inhibits purine/pyr synthesis
leukovorin rescues MTX toxicity, BMS, mucositis, hepatic fibrosis, pneumonitis
what is leukovorin?
folinic acid
HDMTX
rational:
toxicity:
toxicity prevention:
bypass MTX resistant mechanisms
tox: lethal dose of MTX, MTX percipitation in kidney
preven: hydration, alkanizing urine, leukovorin rescue
5FU
mechanism
toxicity
mech: pyrimidine analog of uracil, inhibits thy synthetase
toxic: BMS, mucositis
cytosine arabinoside (ARA-C)
mechanism
toxicity
analog of pyr: cytidine, inhibits DNA pol
severe BMS, mucositis
tx acute leukemia
inhibits thymidylate synthease
5FU
inhibits DNA pol
arabinoside cytidine
purine analog
6-mercaptopurine
should you increase the dose of allopurinol in a pt treated w/ mercaptopurine?
no!