Reading...
Play button
Play button
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;
99 Cards in this Set
- Front
- Back
|
cell cycle activity of chemo Rx
|
|
|
|
Mechanism of CA Rx
|
|
|
|
CA Chemo
|
451 of Katzung
|
|
|
6 mechanism of CA resistance to rx?
|
DNA repair, trapping agents, enzyme morphs, dec activation, inactivation, dec drug accumulation
|
|
|
What is MDR1 inv in?
|
gene for P-gp for accelerated efflux
|
|
|
Appearance of Sx when tumor gets to what # cells
|
10 ^9-10
|
|
|
Repetitive Tx of same method kills equal
|
Fraction of cells; not number
|
|
|
tumors exhibit what type of growth pattern?
|
Gompertzian
|
|
|
Tx during uppermost part of curve improves?
|
Survival, but Sx recur b/t therapy
|
|
|
In middle part of curve, relationship of tumor kill to growth?
|
kill > regrowth -> cure results
|
|
|
most effective approach at which part of curve?
|
bottom
|
|
|
when is surgery feasible?
|
bottom
|
|
|
chemo is used as
|
adjuvant for small mets
|
|
|
Antimetabolites - list: 5
|
5-FU, MTX, cytarabine, mercaptopurine, thioguanine
|
|
|
Which inh dNTP?
|
5-FU, MTX
|
|
|
Substitute for dNTP (DNA polymerization)?
|
cytarabine
|
|
|
Inh purine synth?
|
thioguanine, mercaptopurine
|
|
|
affect RNA processing, fxn?
|
5-FU, MTX, cytarabine
|
|
|
Antimitotics - list: 4
|
Vincristine, vinblastine, paclitaxel, docetazel
|
|
|
Which drug potentiates 5-FU?
|
Leucovorin
|
|
|
M/A of 5-FU?
|
inh thymidylate synthase
|
|
|
5-FU is the primary chemo agents for
|
colon CA
|
|
|
What's 5-FU prodrug?
|
Capecitabine
|
|
|
What toxicity is in the prodrug and not in 5-FU?
|
Hand-foot syndrome (numbess, blistering of palms & soles)
|
|
|
What's the advantage of the prodrug?
|
Less myelosuppression
|
|
|
M/A of MTX?
|
Inh dihydrofolate reductase
|
|
|
Indications for MTX? 4
|
ALL, AML, choriocarcinoma, lung CA
|
|
|
Difference in indication for 6MP v 6TG?
|
MP for children, TG for adults
|
|
|
What supportive therapy MUST you give with these Rx?
|
Allopurinol
|
|
|
What S-specific drug competitively inh dCTP?
|
cytarabine
|
|
|
Indications for cytarabine?
|
AML, AMML
|
|
|
Most severe toxicity?
|
severe myelosuppression
|
|
|
Difference b/t vin- drugs and -taxel drugs?
|
Vin disrupt cytoskeletal structure; Taxel enhance tubulin polymerization
|
|
|
Vinblastine indication? 1
|
Systemic Hodgkin's
|
|
|
Vincristine's indication?
|
Acute leukemia in children
|
|
|
Palcitaxel's indication? 2
|
ovarian CA, advance breast CA
|
|
|
Docetaxel's indication? 3
|
breast, ovary, non-small cell
|
|
|
Which 2 have acute fx?
|
vinblastine, palcitaxel
|
|
|
Which 2 have delayed fx?
|
vincristine, docetaxel
|
|
|
Categories of alkylating agents? 3
|
Nitrogen mustards, nitrosureas, alkylsulfonates
|
|
|
Which 2 categories act in part like alkylators?
|
platinum analagos, carbazines
|
|
|
Major site of alkylation?
|
N7
|
|
|
2 results of alkylation?
|
miscoding by thymine; depurination by guanine excision
|
|
|
Toxicities of all alkylating agents: 6
|
vesicant, acute N/V, myelosuppresion, alopecia, teratogen, carcinogen
|
|
|
What drug is often admin w/ these drugs b/c of their acute fx?
|
Ondansetron b/c of N/V
|
|
|
Nitrogenous mustards: 3
|
cyclophosphamide, chlorambucil, mechlorethamine
|
|
|
What does cyclophosphamide req for activity?
|
P450
|
|
|
What is the other main use for cyclophosphamide?
|
Immune d/o
|
|
|
3 advantages of cyclophosphamide to mechlorethamine?
|
less thrombocytopenia, not vesicant, can be po
|
|
|
What endocrine d/o is associated w/ cyclophosphamide?
|
SIADH
|
|
|
Which nitrogenous mustard has SLOW fx, and SLOW tox?
|
chlorambucil
|
|
|
Which mustard is given for MM?
|
melphalan
|
|
|
Nitrosureas: 3
|
BCNU (carmustine), CCNU (lomustine), methyl-CCNU (semustine)
|
|
|
Because of their lipophilicity, these Rx are used for?
|
Brain tumors
|
|
|
These alkylate at which position?
|
O6
|
|
|
The only alkyl sulfonate?
|
Busulfan
|
|
|
Primarily used for?
|
CML
|
|
|
Most significant tox?
|
Nephrotox from build up of urate (GIVE ALLOPURINOL)
|
|
|
Why does procarbazine SUCK?
|
Strand breaks, Undermines immunity, Carcinogenic, Kills fetus
|
|
|
Platin drugs (in order of generation): 3
|
Cisplatin, carboplatin, oxaliplatin
|
|
|
Which platin is not cross-resistant to other platins?
|
oxaliplatin
|
|
|
What drugs is ALWAYS given with these?
|
Mannitol for renal tox
|
|
|
What's a unique tox?
|
Ototoxicity - tinnitis, hearing loss
|
|
|
Anthracyclines: 2
|
Daunorubicin, doxorubicin
|
|
|
Main difference b/t the two?
|
doxorubicin can also be used for solid tumors
|
|
|
2 indications for daunorubicin?
|
ALL, AML
|
|
|
Other CA Abx: 4
|
dactinomycin, bleomycin, mitoxantrone, mitomycin
|
|
|
Main drug for pediatric tumors?
|
DACTINOMYCIN!!!
|
|
|
Unusual tox of bleomycin? 2
|
pulm, mucocutaneous
|
|
|
Which is cardiotox?
|
Mitoxantrone
|
|
|
What is weird tox of mitoxantrone?
|
Blue discoloration of fingernails, sclera, urine
|
|
|
Which is used with radiation against hypoxic tumor cells?
|
Mitomycin
|
|
|
2 mechanisms of tamoxifen?
|
Blocks binding of ERE, decr IGF-1
|
|
|
Toxicities? 3
|
hot flashes, endometriosis, blood-clotting weirdness
|
|
|
Mechanism of flutamide?
|
Inh androgen-R translocation to nuc
|
|
|
Toxicities? 4
|
dec sex fxn, hot flashes, gynecomastia/mastodynia
|
|
|
Leuprolide and Goserelin mech?
|
Desensitize pit to GnRH -> dec FSH & LH
|
|
|
This makes them great for treating which 2 CA?
|
Prostate, breast
|
|
|
What do you worry about? 3
|
low sex steroid fx: hot flashes, osteoporosis, low muscle mass
|
|
|
What drug inh aromatase?
|
aminoglutethimide
|
|
|
So what do you think this drug is good for?
|
Adrenocarcinomas!
|
|
|
Aspariginase takes advantage of what?
|
Tumors can't make L-asparagine!
|
|
|
Imatinib is specifically for?
|
9;22 bcr-abl CML tyr kinase
|
|
|
Camptothecins: 2
|
Tropotecan, irinotecan
|
|
|
Mech?
|
Inh topoisomerase
|
|
|
Difference b/t the 2?
|
Tropotecan needs good renal; irino needs good liver
|
|
|
ATRA is CURE for?
|
5;17 APL
|
|
|
Mech?
|
Induce maturation
|
|
|
What works similarly?
|
As2O3
|
|
|
What is the cardiotox with this drug?
|
QT prolongation
|
|
|
Let's name some mabs:
|
Cetuximab, trastuzamb, rituximab, bevacizumab
|
|
|
What well tolerated drug may cause acneiform rash?
|
Cetuximab
|
|
|
Mech?
|
EGFR-mab
|
|
|
What makes this good for?
|
Preventing CA 2o to radiation therapy (esp H&N)
|
|
|
What works similarly?
|
Gefitinib, erlotinib
|
|
|
What also works on EGFR but is used for breast CA?
|
Trastuzumab to HER2 (type 2 EGFR)
|
|
|
Mech of bevacizumab?
|
mab to VEGF
|
|
|
Mech of rituximab?
|
mab to CD20
|
|
|
What drug is a rescuer of norm cells from ROS and superoxide?
|
AmifOStine
|
