Step 1: First Aid Cancer Drugs

Front 1

Methotrexate (MTX)
- mechanism
- non-neoplastic uses
- toxicities? Reversible?

Back 1

folic acid analog inhibits DHFR --> \\dTMP --> \\DNA synth and \\protein synth

Abortion, ectopic pregnancy, RA, psoriasis

Myelosuppression reversible by leucovorin (folinic acid). Macrovesicular fatty change i/liver; mucositis; teratogenic.

Front 2

5-FU
- mech
- synergy with what?
- Toxicities? Rescue?

Back 2

Pyrimidine analog bioactv to 5F-dUMP which covalently complexes folic acid. this inhibits thymidylate synthase --> \\dTMP

Synergy w/MTX

BMS, rescue w/ thymidine
Photosensitivity

Front 3

6-MP
- mech
- toxicities
- metabolized by what? added toxicity with what?

Back 3

actv by HGPRTase --> Purine analog --> \\denovo purine synth.

BMS, GI, Liver.

xanthine oxidase; thus trouble to give with allopurinol.

Front 4

6-TG (thioguanine)
- mech
- one clinical use
- toxicities? added tox with allopurinol?

Back 4

actv by HGPRTase --> purine analog that inhibits denovo purine synth

ALL

BMS. Is OK to give w/allopurinol.

Front 5

Cytarabine (ara-C)
- mech
- toxicities?

Back 5

Pyrimidine antagonist --> inhibition of DNA polymerase.

Leukopenia, thrombocytopenia, megaloblastic anemia.

Front 6

What are the 4 antitumor antiBx types?

Back 6

- Dactinomyin (Actinomycin D)
- Doxorubicin, Adriamycin, danunorubicin
- Bleomycin
- Etoposide (VP-16), teniposide

Front 7

Dactinomycin
- mechanism
- used in which group of tumors?
- toxicity?

Back 7

intercalates DNA

childhood tumors (Ewing's, rhabdomyosarcoma, wilm's tumors, etc)

BMS

Front 8

Doxorubicin
- mechanism
- part of which regimen
- toxicity

Back 8

- generates free radicals --> noncovalently intercalate i/DNA --> breaks DNA --> \\replication

ABVD (Adriamycin) for Hodgkin's

Cardiotoxicity, BMS, marked alopecia. Toxic to tissues w/extravasation.

Front 9

Bleomycin
- mechanism (stage specific?)
- part of which regimen
- toxicity

Back 9

Induces free radical formation which causes breaks in DNA strands. G2 specific.

ABVD for Hodgkin's

Pulmonary fibrosis, skin changes. MINIMAL BMS.

Front 10

Etoposide (VP-16), teniposide
- mechanism (stage specific?)
- tx what?
- toxicity

Back 10

Inhibits topo II --> ^^DNA degradation. Late S to G2.

Small cell carcinoma of lung (oat cell)

BMS, GI irritation, alopecia.

Front 11

Cyclophosphamide, ifosfamide
- mechanism? Require actv by what?
- toxicity? can partially prevent w/ what?

Back 11

Covalently X-link DNA. Req actv by liver.

hemorrhagic cystitis partially preventable with mesna. Also BMS.

Front 12

Nitrosoureas
- name some
- mechanism
- clincal use
- toxicities

Back 12

carmustine, lomustine, semustine, streptozocin

Cross BBB --> CNS. Requires bioactivation.

Brain tumors.

CNS toxicity (dizziness, ataxia)

Front 13

Busulfan
- mech
- tx's what?
- non neoplastic use?
- toxicity?

Back 13

alkylates DNA.

CML.

Ablating BM for SCT.

Pulmonary fibrosis & hyperpigmentation.

Front 14

Vincristine, vinblastine
- mech? active phase?
- part of which regimen?
- vincristine tox?
- vinblastine tox?

Back 14

b/tubulin in M-phase blocking polymerization of mt's.

MOPP (Onvocin) for Hodgkin's

neurotoxicity, paralytic ileus

BMS

Front 15

Paclitaxel, Taxols
- mech
- use?
- tox?

Back 15

hyperstabilizes polymerized mt's i/M phase.

Ovarian and breast carcinomas.

BMS and hypersensitivity.

Front 16

Cisplatin, carboplatin
- mechanism
- tox

Back 16

cross link DNA

nephrotox & acoustic nerve damage

Front 17

Hydroxyurea
- mech
- skin cancer use?
- leukemia use?
- other dz use?
- tox?

Back 17

inhibits Ribonucleotide Reductase (S-phase)

melanoma

CML

SSD

BMS, GI upset

Front 18

Trastuzumab (Herceptin)
- mech
- clincal use
- tox

Back 18

monoclonal Ab against Her-2 (erb-B2).

metastatic breast cancer

Cardiotoxicity

Front 19

Imatinib (Gleevec)
- mech
- clinical use
- tox

Back 19

bcr-abl tyrosine kinase inhibitor

CML, GI stromal tumors

Fluid retention