Pharm

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second line for breast cancer and endometrial cancer:

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Progestines:

hydroxyprogesterone
medroxyprogesterone
megestrol

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Progestins:

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Stimulate appetite and restore sense of well beings in cancer patients.

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DOXORUBICIN

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Anthracyclines: Antotumor antibiotic,

widely used anticancer drug

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Anthracyclines:

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cause cardiac toxicities via free radical mechanism.
red color urine

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radiation recall reacation

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Anthracyclines

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inhibit topoisomerase II

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Anthracyclines and epipodophyllotoxins.

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Anthracyclines

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causes mylosuppression.

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Bleomycin

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Anthracyclines:

arrest cell in G2 phase, it is a mix of teo peptides A2 and B2.

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Only one that is cell cycle specific.

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Anthracyclines: Bleomycin

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Ae: pulmonary fibrosis, little mylosuppresion.

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Bleomycin.

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Mitomycin

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Anto-tumor antiobiotics:
cross links DNA -targets hypoxic tumor cells.
Toxic: hemolytic uremic syndrome.

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Plicamycin

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Anti-tumor antibiotics:
decreses Ca2+ (action on osteoclasts).

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Mechlorethamine

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Nitrogen mustards: Alkylating agents:

Powerful vesicant, only IV, crosses links DNA.

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cyclophosphamide

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Nitrogen mustards: Alkylating agents:

most widely used ACROLEIN (metabolite responsible for hemmoragic cystitis).
activated to 4 hydroxy cyclophos..by CYP2B.

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Chlorambucil

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Nitrogen mustards: Alkylating agents:
Slowest acting niotrogen mustared in use.

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THiotepa
Altretamine

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both cross links DNA

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Vinca Alkloids: microtubule inhibitors

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binds to beta tubulin portion that overlaps with GTP binding domain.

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Vincristine

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Vinca Alkloids: microtubule inhibitors:

mainly neurologic toxicity

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Vinblastine

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Vinca Alkloids: microtubule inhibitors:

mainly mylosuppresion.

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vinorelbine

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Vinca Alkloids: microtubule inhibitors:
mainly mylosuppresion.

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taxanes

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microtubule inhibitorsbinds to Beta tubulin subunit that
differs from vica alkloids . Inhibit polymerization and depolarization.

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Paclitaxel

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taxanes: microtubule inhibitors
hypersensitivity

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epothilones

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microtubule inhibitors:
Ixabepilone:
binds directly to beta tubulin _stabilizes microtubule and arresting cells proloferation. Binds to site different from taxanes, so is effective aginst taxanes resisit cells.

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CAMPTOTHECINS

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S phase specific drugs: Inhibit topoisomerase I---dna samage---celll arrest at G2 phase --celll death.

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cell cycle specific drugs

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Antimetabolites
bleomycin
microtubule inhibitors
epipodoiphyllotoxins
camptothecins

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cell cycle non specific agenys

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alkylatimg agents
platinum cor complexes
antitumor antibiotics.

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Doxorubicin

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causes cardiotoxicity

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P-glycoprotein

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most important efflux pumb responsible for multiple drug resistence.

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other efflux pumps responsible for MDR

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Mulitple reisitence associated proreins (MRP)
lung resistence related protein (LRP)
breast cancer rteisitence protein (BCRP)

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cyclophosphamide and ifosphamide

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causes hemmoragic cyctitris

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Bleomycin causes

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pulmonary fibrosis

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leucovorin

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rescues the bone marrow from methotrexate

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mesna

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reduces hemmoragic cyctitis caused by ifosfamide and cyclophosphamide

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dexrazoxane

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reduces anthracycline induced cardiotoxicity.

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methotrexate

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inhibits DHFR: Syn of dTMP and purine neuclotides decreases.

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methotrexate

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renal damage
hepatic fibrosis and cirrohosis
pneumonitis
neurologic toxicities

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pemetrexed

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weak inhibitor of DHFR but potent inhibitor of thymidylate synthase.

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hand and foot syndrome

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5 Fluorouracil

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5-FU/Leucovorin

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first line chemo for colorectal cancer.

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inhibition of topoisomerase II
intercalation in DNA
generation of free radicals
binding to cell membranes to alter fludity and ion transport

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Anthracyclines

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treatment of hypercalcemia and calciuria

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picamycin

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severe nausea and vommititng
severe bone marrow depression
immunosuppressive

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Mechlorethamine

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inaaproprite ADH secretion

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cyclophosphamide

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IV, and greater plate;let suppression, urinary tract suppresssion

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ifosfamide

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high affinity for beta cell sof the islets oif langerhans and used for insulin secreating islet cell carcinoima of pancreas

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streptozocin;
Nitrosoureas

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non siminomatous testicular cancers

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cisplatin

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nephrotoxicity
ototoxicity
perpheral neuropathy

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cisplatin

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Amifostine is cytoprptective agent used to reduce renal toxocoty associated with

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cisplatin

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unique acute neurotoxicity that is assocoated with exposure to cold tempoeratures

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oxiplatin

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mititoic arrest in metaphase

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vinca alkaloids/ microtubule inhibitors.

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pacific yew

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paclitaxel

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european yew

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docetaxel

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paclitaxel and polyethoxylated caster oil

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hypersentivity reaction

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treatment of acute leukemia in children and adults

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Glucocorticoids are lympholytic and suppress mitosis in lymphpcyres.

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pure antagonists: antiestrogen

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fulvestrant

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gonadortropin releasing hormone agonists

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Goserelin
leuprolide
nafarelin
buserelin
triptorelin

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Arsenic trioxide

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T(15:17) chrosomal translocation
it induces diff and apopotosis

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Arsenic trioxide

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QT prolongation, arrthymias, fever, rash, fluid retension, weight gain, dyspnea.

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Asparaginase

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pancreatitis,
seizures,
coma due to ammonia toxicity,
liver abnormalities, decrease in clotting facors,
hypersentivity

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Kills cells in S phase and inhibits ribonucleotide reductase

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hydeoxyurea

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Appproved for the treatment of Philadelphia chromosome, AIDS realted kaposi sarcoma, hairy cell leukemia

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interferon 2 alpha

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hemolytic uremic syndrome is most severre side effect of

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Mitomycin(Antitumor antibiotics)

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hemolytic anemia
plumonary reactions
disulfiram like reactions are side effect of

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procarbazine: Methyhydrazines(alkalting agents)

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aminoglutethimide (aromatase inhibitor acts by)

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inhibiting first step of the adrenal steroid synthesis. very non specific
lots of side effcets