• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/6

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

6 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
General MOA/side effects
MOA-alkylation of DNA/RNA/proteins. This interes with DN replication and transcription. This is cell cycle nonspecific but effective only during synthesis

Common toxicities-Myelosuppression-neutropenia, thrombocytopenia and anemia are all dose related, nadir 7-14 days, duration 7-10 days
GI-N/V, stomatitis, diarrhea
Infertility
Secondary Malignancy-increased risk for malignancy due to altering of DNA bonds. Usually manefests 5-10 years later as secondary leukemia
Nitrogen Mustards
Cyclophosphamide
Ifosfamide
Melphalan
Mechlorethamine
Bendamustine
Cyclophosphamide-broad spectrum prodrug that is activated hepatically. Given IV or oral and can be used as immunosuppressant in MS and rheumatoid. Is metabolized into acrolein and phosporamide musturd which are cytotoxic as well as other inactive products. Toxicity causes SIADH, cardiotoxicity, and pulmonary fibroses. Exposure to acrolein causes hemorrhagic cystitis, vigorous hydration is usually sufficient to prevent however in extreme cases MESNA (binds with acrolein) can be used.

Ifosfamide-similar structurally to cyclophosphamide, also a prodrug that is activated hepatically but is metabolized slower and requires a higher dose because less drug is actively metabolized. Produces ifosfarmide mustard and also acrolein. Toxicity causes neurotoxicity such as confusion and hallucination and ultimately coma from encephalopathy. This is treated with methelyne blue, also causes nephrotoxicity. Like cyclophosphamide hemorrhagic cystitis can occur, however there is more acrolein produced at therapeutic dose so MESNA is always given prophylactically with ifosfamide.

Melphalan is commonly used for multiple myeloma, and also from breast and ovarian cancer. Can causes delayed N/V

Mechlorthamine is used in hodgkin lymphoma and can cause vesicant if extravasated on skin

bendamustine can cause N/V, fever, myelosuppression and rarely hypersensitivity.
Nitrosoureas
Carmustine
Lomustine
both are liphophilic

carmustane is given IV or as a biodegradable wafer put in the brain for CNS malignancy due to its lipophilicity. Used to treat hodgkins disease, meningeal leukemia, and brain tumors. Can cause phlebitis and pulmonary toxicity 6 months to a year after (not many drugs cause this)

Lomustane is given orally. Side effects include N/V

side effects of both are myelosuppression-delayed up to 30 days.
Alkyl Sulfate
Busulfan
used for chronic myelogenous leukemia or stem cell transplant conditioning. It is given either IV or orally. Toxicity includes-pulmonary fibrosis with chronic low doses (not many drugs cause this), seizure (phenytoin prophylaxis), veno-occlusive disease (obstructive liver disease).

Requires therapeutic drug monitoring to decrease toxicity and ensure optimal drug concentration.
Others
Procarbazine
Dacarbazine
Temozolamide
Procarbazine is a weak MAOi

Dacarbazine is used as a methylating agent/ It is used for malignant melanomas, hodgkins disease, and adult asrcoma

Temozolamide is the oral equivalent of dacarbazine, highly lipophilic and has high bioavailability. Used in treatment of CNS lymphomas and metastasis of solid tumor.
Platinum Agents
Cisplatin
Carboplatin
Oxiplatin

*amisfostine
MOA-similar to alkylating agents, cause DNA crosslinking and prevent replication.

Cisplatin is the most frequently used. Along with carboplatin are commonly used in testicular cancer, bladder cancer, head and neck cancer, ovarian ancer, and lung cancer. Toxicity causes nephrotoxicity which is dose limiting and leats to electrolyte wastinc, also causes peripheral neuropath, otoxociity and N/V (gold standard worst of all chemo).

Carboplatin was made to reduce toxic potential of cisplatin. This is dosed using AUC (area under the curve). DOSE=AUC*(GFR+25). AUC is usally 4-8. Toxicity causes myelosuppression and delayed hypersensitivity after 6-7 cycles, and N/V

Oxiplatin used for colon cancer. Toxicity causes peripheral neuropathy that is worse in the cold and pharyngolaryngeal dysesthesia (feeling that you can't breathe, check O2 sat)

Amifostine is used to prevent nephrotocicity from cisplatine and xerostomia from XRT of head/neck. Works as a free radical scavenger. This however also may undo the effects of the platinum agent essentially partially negating cisplatin. Toxicity-hypotension, N/V, sneezing, hiccups, hypocalcemia. Duse to toxicity and undoing effects of cisplatin it is not commonly used