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14 Cards in this Set
- Front
- Back
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Cyclophosphamide
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Class: Nitrogen Mustards (Alkylating Agent)
Kenetics: prodrug, faster activ. than ifosfamide (3-4x more potent) SFx: cardio/nephrotoxicity, SIADH Misc: use with Mesna to prevent hemorrhagic cystitis |
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Melphalan
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Class: Nitrogen Mustard (alkylating agent)
Use: pediatric cancers SFx: cumulative marrow damage (use in BMT) |
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Chlorambucil
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Class: Nitrogen Mustard (alkylating agent)
Use: CLL and lymphomas in adults SFx: cumulative marrow damage (use in BMT) *similar to Melphalan except use |
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Mechlorethamine
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Class: Nitrogen Mustards (alkylating agent)
Use: alkylates a wide variety of molecules SFx: vesicant antidote: sodium thiosulfate |
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Carmustine and Lomustine
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Class: Nitrosoureas
Use: Brain tumors (excellent CNS penetration) Resistance: via a DNA protein (Use with inhibitor of DNA protein) |
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Thiotepa
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Class: Ethylenimine (alkylating agent)
Use: BMT prep (prolonged marrow suppression) SFx: metabolites accumulate in skin/dressings, causes skin pigmentation changes |
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Busulfan
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Class: alkyl sulfonates
Kenetics: variable, need blood levels. Children metabolize faster, up dosage. Acetaminophen reduces clearnce, should be avoided. Seizure prophylaxis? |
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Temozolamide
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Class: triazenes (alkylating agent)
SFx: myelosuppression (delayed) Resistance: via high amounts of DNA repair protein |
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Procarbazine
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Class: Methylhydrazine (alkylating agent)
Kinetics: requires metabolic activation SFx: long-term effects--ovarian failure, teratogenic, carcinogenic watch for DDIs |
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Cisplatin
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Class: platinum analogs (alkylating agents)
SFx: Nephrotoxicity/electrolyte disturbances, N/V, peripheral neuropathy, bone marrow suppression, ototoxicity |
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Carboplatin
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Class: platinum analog (alkylating agent)
Kinetics: metabolized by liver, cleared by kidney (adjust for renal and hepatic dysfunction) SFx: Myelosuppression, less nephro/neuro/oto toxicity. |
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Oxaliplatin
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SFx: dose-limiting peripheral neuropathy worse with temperature extremes. Paresthesias, difficulty swallowing.
Misc.: Synergy with 5FU because they both work on thymidylate synthetase. Resistance: no cross-resistance with other platinum analogs |
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List the Folic Acid Analogs
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Methotrexate
Pemetrexed |
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Methotrexate
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Use: many malignancies, IBD, rheumotaologic d/o, termination of ectopic pregnancy
MOA: S-phase specific, inhibits Dihydrofolate acid reductase, inhibits DNA synth with toxic glutamates DDIs: interactions with bactrim (same enzyme) Metabolism: excreted renally, careful with drugs that decrease renal blood flow (ibuprofen) Dose reduction with hepatic dysfunction. Used with leucovorin rescue. SFx: Bone marrow, GI, alopecia, hepato/neuro/nephro toxic. Alkalize urine to prevent precipitation of 7-methotrexate |
