Heme-Pharm

Front 1

Tx Myelosuppression (EXAM)

Back 1

1. Epoetin alfa
2. OprelveKIN
3. FilgraaSTIM
4. SargramoSTIM

mneum-"STIMulate your KIN to Tx myelosuppression"\
-Also, makes sense that Epoetin alfa Tx myelosuppression b/c sounds like Erythropoetin, which inc RBC

Hint 1

"STIMulate your KIN to Tx myelosuppression"\\\\
-Also, makes sense that Epoetin alfa Tx myelosuppression b/c sounds like Erythropoetin, which inc RBC

Front 2

Alkylating agents

Back 2

1. Mechlorethamine
2. Chlorambucil
3. Melphalan
4. Cyclophosphamide
5. Thiotepa
6. Busulfan
7. CarMUSTINE (BCNU)=Nitrosource
8. LoMUSTINE (CCNU)=Nitrosource
9. Temozolamide
10.Procarbazine
11.Cisplatin (Pt-containing Rx)
12.Carboplatin (Pt-containing Rx)

Front 3

Antimetabolites=Structural analogs of naturally occurring bases which are required for syn of DNA & RNA==>thus, they replaces the real bases and inhibit DNA/RNA syn

Back 3

1. Methotrexate (Leucovorin used in BM rescue)
2. 5-FU (5-Flurouracil)
3. CapecitABINE (oral 5-FU)
4. CytarABINE (Ara-C)
5. GemcitABINE
6. AzacitidINE
7. 6-MercaptopurINE
8. 6-ThioguanINE
9. Pentostatin

Front 4

Antibiotic Drugs

Back 4

1. BleoMYCIN
(DactinoMYCIN--not on test)
3. MitoMYCIN-C
4. Doxorubicin

Hint 4

"blast the lungs"

Front 5

Epipodophyllotoxins

Back 5

Etoposide

Front 6

Camptothecins

Back 6

Topotecan

Front 7

Vinca Alkaloids

Back 7

late G2-early M
1. Vincristine
2. Vinblastine

Front 8

Taxanes

Back 8

Paclitaxel

Hint 8

"PacliTAXel is a TAXane"

Front 9

Immunomodulating Agents

Back 9

1. Levamisole
2. Thalidomide

Hint 9

"Me so (MISO) tired (dormir=DOMIDE)

Front 10

Monoclonal Antibodies

Back 10

1. TrastuzuMAB
2. CetuxiMAB
3. RituxiMAB

"MAB"= Monoclonal AntiBodies

Front 11

Epoetin alfa

Back 11

Tx anemia from myelosuppression
PE: inc [circulating RBCs] in blood
MOA: Erythropoetin, stimulate maturation of precursor RBCs in BM

Front 12

Filgrastim

Back 12

Tx: Leukopenia from myelosupp
PE: inc [circulating neutrophils]

mneum: Phil McGraw (FILGRA--) dressed up as Mickey Mouse (=neutrophils)
MOA: Granulocyte colony stimulating factor

Front 13

Sargramostim

Back 13

Tx: Leukopenia from myelosupp
PE: inc [circulating macrophages]
-mneum: "SARah harGReaves (SARGRA) hates trash, so she increases macrophages"
MOA: Granulocyte macrophage colony stimulating factor

Front 14

Alkylating agents

Back 14

Tx: Solid tumors & hematologic cancers
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 15

Mechlorethamine

Back 15

NS, Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 16

Chlorambucil

Back 16

*NS
S/E: pulm fibrosis
Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 17

Melphalan

Back 17

*NS
S/E: pulm fibrosis, secondary leukemias
Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 18

Cyclophosphamide (EXAM)

Back 18

*NS
S/E: Bladder toxicity (EXAM)
"go thru CYCLEs of urine (bladder toxicity)"

(Acrolein metabolite causes cystitis (BLADDER inflamm), but adequate hydration & frequent urination prevents damage to GU)
Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 19

Thiotepa

Back 19

Injected into urinary bladder (to tx superficial bladder CA), peritoneal cavity & CSF (CNS metastasis)

"Thio" (Aya's dog) has bladder CA.

Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 20

Busulfan

Back 20

*NS
Tx: used prior to BM transplant to kill preexisting BM
S/E: bronze pigmentation, pulm fibrosis

mneum: "Boo (BU) old BM away and get a nice tan/pulm fibrosis (bronze pigmentation)"

Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 21

Carmustine (BCNU)

Back 21

*NS, Go
Tx: primary tumors of CNS
S/E: pulm fibrosis
-mneum: Infiniti G30 (Go) CAR MUST drive over and crush CNS tumors, but inhaling the CARMUST (car exhaust) gives you pulmonary fibrosis
Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 22

Lomustine (CCNU)

Back 22

NS, Go

Tx: primary tumors of CNS
S/E: pulm fibrosis

mneum: like "CARMUSTine"--
mneum: CAR MUST drive over and crush CNS tumors, but inhaling the CARMUST (car exhaust) gives you pulmonary fibrosis

Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 23

temozolamide

Back 23

*NS
Primary & Secondary tumors of CNS (crosses BBB & does not need bioactivation)

mneum: "Tim (TEM) Ozone: Not even the BBB can stop him from fighting primary and secondary CNS tumors!"

Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 24

procarbizine

Back 24

Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 25

Cisplatin

Back 25

-contains Pt (Platinum)--"cisPLATIN"
S/E: renal toxicity
("Platinum wedding rings are nice, but don't wear them on your kidney")

Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 26

Carboplatin

Back 26

-contains Pt (Platinum)--"carboPLATIN"
S/E: renal toxicity

Alkylating agent:
Tx: Solid tumors & hematologic cancers, usu. in combo w/ other antineoplastic drugs
PE:
1. Inhibits synthesis of DNA, RNA, & proteins
2. causes misreading of DNA

MOA: Damage DNA via cross-linking (bifunctional drug w/ 2 reactive grps) or single-strand breaks (monofunctional drugs w/ 1 reactive grp)
S/E: *Myelosupression & immunosuppression = dose-limiting toxicity

Front 27

methotrexate

Back 27

*S

PE: dec syn of purine thymidylate

MOA:
*Forms highly-active polyglutamate compounds which persist in cancer cells:
-The reversible inhibition of Dihydrofolate reductase prevents synthesis of tetrahydrofolate (THF)
-Lack of THF-->decr synthesis of thymidylate & purine nucleotides

mneum: Methotrexate inhibits the "DR" which you need to regenerate the MoTHer Fucker (m-THF=TetaHydroFolate) needed for purine synthesis
S/E: myelosupp (use Leukovorin for BM rescue)

Front 28

5-FU (5-flurouracil)

Back 28

*S
Tx:Topical for actinic keratoses & basal cell CA
MOA: pyrimidine analog;
*its Metabolite, 5-fluoro-2-deoxyuridine 5-phosphate, irreversibly inhibits Thymidylate synthetase==>prevents DNA synthesis==>5-flurouridine triphosphate is incorporated into mRNA & prevents normal translation of mRNA

mneum: "Put your FUTS (5FU-TS)..." TS=thymidylate syn;
also, "FUTS"=hand-FOOT syndrome
S/E: hand-foot syndrome

Front 29

Capecitabine
(oral 5-FU)

Back 29

-spec
Tx: same as 5-FU (actinic keratoses & basal cell CA)
MOA: *converted to 5-FU inside cells by enzyme Thymidine phosphorylase which is expressed more in tumor cells than in normal cells
S/E: hand-foot syndrome

Front 30

cytarabine (ara-C)

Back 30

*S
Tx: induction and relapse of AML
MOA: inhibits DNA poly and is incorporated into DNA and RNA instead of nl nucleotide

Front 31

cytarabine (ara-C)

Back 31

*S
Tx: induction and relapse of AML
MOA: phosphorylated form inhibits DNA poly and is incorporated into DNA and RNA
S/E: CNS toxicity

Front 32

gemcitabine

Back 32

*S
MOA:*Pyrimidine analog
*di & triphosphate form inhibits Ribonucleotide reductase & thus depletes cell of deoxyribonucleotide triphosphates which are needed to synthesize DNA

-mneum: "That "GEM" is such a fake pyramid (pyrimidine analog) and ruins my R&R (inhibits RR=Ribonucleotide Reductase))

S/E: myelosupp

Front 33

azacitidine

Back 33

MOA: *Pyrimidine analog
(background info-methylation of DNA turns off tumor suppressor genes)
*EXAM--azacitidine inhibits DNA methyltransferase (active in CA cells) & thus turns on tumor suppressor genes (EXAM)
-menum: "Sit (CIT) your ass
(AZ) down TO DINE (TIDINE) on DNA methyltransferase (thus inhibiting it) and poop out (produce) tumor supp gene"
S/E: myelosupp

Front 34

6-mercaptopurine (EXAM)

Back 34

*S (S phase)
PE: Net Effect = inhibits purine syn==>inhibition of synthesis of DNA, RNA & glycoproteins

MOA:
*purine analog
*hypoxanthine guanine phosphoribosyl transferase (HGPRT) converts 6-MP & 6-TG to nucleotide form (so these are incorporated instead of nl nucleotides)==>inhibits many enzymes in purine nucleotide pathway.

USMLE: Keeton: If give 6-MP and Allopurinol, must decrease dose of 6-MP because Allopurinol accentuates mercaptopurine toxicity by inhiniyinh xanthidine oxidase, which degrades mercaptopurine.

Front 35

pentostatin

Back 35

MOA: *purine analog
*Irreversible inhibitor of Adenosine deaminase

S/E: myelosupp

Front 36

bleomycin

Back 36

MYCIN-->thus, Ab
*G2
MOA: *Binds to DNA  O2 free-radicals formed -->double/single-stranded breaks (DNA fragmentation-EXAM)--> chromosome abnormalities-->cancer cells stop in G2

S/E: lung toxicity ("bleomycin blasts the lungs and it blasts DNA to fragments in G2")

Front 37

mitomycin

Back 37

*NS
"MYCIN"=Ab
MOA: alkylation x-links DNA, esp in hypoxic tumor cells

S/E: severe myelosupp

Front 38

doxorubicin

Back 38

*NS
Tx:
*Carcinomas (ovary, testicle, thyroid, lung, breast, endometrium)
*Sarcomas (osteosarcoma, Ewing's, neuroblastoma, rhabdomyosarcoma)
*Hematologic cancers (AL's, Hodgkin's Dz, NHL's, Multiple Myeloma)

MOA: *An anthracycline
*Intercalates into DNA==>blocks synth of DNA/RNA
*Inhibits Topoisomerase II==>DNA strand scission
*Alters ion transport through membranes
*Causes generation of semiquinone & O2 free-radicals

EXAM--*S/E: Cardiac toxicity:
Keeton: “Remember, oxygen free radicals damage the heart.” (EXAM)

Mneum: "rub"=red (heart)-->cardiac toxicity"

Front 39

etoposide

Back 39

*late S-G2
MOA:
*Stabilizes bond b/w TOPOisomerase II ("eTOPOside")& DNA==>topo II inhibited==> ds-DNA breaks remain==>DNA degraded

Front 40

topotecan

Back 40

*NS
*Inhibits Topoisomerase I ==>breaks ss-DNA

Front 41

vincristine

Back 41

*M
MOA:
*"Spindle Poisons"
*Bind to free, pre-polymerized (dimerized) tubulin==>tubulin cannot polymerize into the microtubules==>mitotic spindle cannot form

Sleeping Beauty says, "Vinny (the Italian boy) is POISON to my spindle"

Front 42

Paclitaxel

Back 42

*M
MOA:
*"Spindle Poision"
*Promotes assembly of microtubules & stabilizes them to prevent depolymerization
*Phosphorylates Bcl-2 to turn it off  programmed cell death is NOT inhibited

menum: sounds like "Paxil." You're so depressed you try to take "spindle poison" to committ suicide.

Front 43

Tx sickle cell dz

Back 43

Hydroxyurea
*Inhibits the enzyme ribonucleotide reductase
*Depletion of deoxynucleoside triophosphates prevents DNA synthesis
*Sickle-cell Dz: Hydroxyurea turns on HbF gene in adults ==> HbF presence prevents sickling

Front 44

Tx leukemia

Back 44

L-asparaginase
MOA:
*Hydrolyzes serum asparagines, which is an essential aa for leukemia cells (nl cells can synth L-asparagine)

Front 45

Tx CML

Back 45

Imatinib
MOA:
*Blocks the binding of ATP to the abnormal Bcr-Abl tyrosine kinase (the product of the Philadelphia chromosome translocation)==>inhibits its activity

Front 46

Tx Multiple Myeloma

Back 46

Bortezomib
MOA:
*Inhibits activity of the 26S proteasome==>degradation of IkappaB is prevented==>action of NF-kappaB is inhibitied==>apoptosis is enhanced

Front 47

Tx colon cancer

Back 47

Lavamisole (wash yourself ("lavar") of COLon ("sole") cancer"
MOA:
Restores depressed immune function in B/T-cells, monocytes, macrophages
*Potentiates antineoplastic effets of 5-FU in pts w/ colon cancer

Front 48

Tx breast cancer

Back 48

Trastuzumab ("I trust ("TRAST") u ("u") to cure breast cancer.)
("-mab"=Monoclonal Ab)
MOA: *Human Ab
*Blocks epidermal growth factor receptor (EGFR) coded by HER2/neu (ErbB-2) gene

Front 49

Tx colorectal cancer

Back 49

Cetuximab
("-mab"=Monoclonal Ab)
MOA: *Chimeric Ab
*blocks the HER1 EGFR

Front 50

Tx B cell malignancies

Back 50

RituximaB (=malignant B cell wearing a RITz TUX)
("-mab"=Monoclonal Ab)
MOA:
*Chimeric Ab
*Binds to CD20 Ag expressed on all malignant B-lymphocytes

Front 51

TX actinic keratoses & basal cell CA

Back 51

5-FU (topical)
Capecitabine (po)--"Put a CAP on your FU-TS"