Usmle: Heme-Onc Pharm

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Aspirin

Back 1

irreversibly inhibits COX-1 and COX-2
prevents conversion of arachidonic acid to thromboxane A2
increases bleeding time, no effect on PT or PTT
Toxicity: gastric ulceration, reye's syndrome, tinnitus

Front 2

Clopidogrel, ticlopidine

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inhibits platelet aggregation by irreversibly blocking ADP receptors, preventing glycloprotein IIB/IIIA expression.
Use: decrease platelet aggregatin
Toxicity: neutropenia

Front 3

Abciximab

Back 3

prevents platelet aggregation
antibody that binds glycoprotein receptor IIb/IIIa on activated platelets
Toxicity: bleeding,thrombocytopenia

Front 4

Methotrexate

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S-phase specific: inhibits dihydrofolate reductase, resulting in decreased dTMP and therefore stops DNA and protein synthesis
Rescue: leucovorin (folinic acid)
Use: abortion, ectopic preg, cancers, RA, psoriasis

Front 5

5-fluorouracil

Back 5

S phase specific (antimetabolite)
decreases dTMP, same effect as MTX except inhibits tymidylate synthase.
*No rescue

Front 6

6-mercaptopurine

Back 6

blocks de novo purine synthesis
use: leukemias, lymphomas
Toxcity: increases with allopurinol

Front 7

Cytarabine (ara-C)

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inhibits DNA polymerase
Use: AML, ALL

Front 8

Cyclophosphamide

Back 8

Alkylating agent (requires liver bioactivation)
Use: NH lymphoma

Front 9

Nitrosurea (carmustine, lomustine

Back 9

alkylate DNA and cross BBB
good for brain tumors
toxicity: CNS dizziness, ataxia

Front 10

Cisplatin, carboplatin

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cross-links DNA
Use: testicular, bladder, ovarian cancer
Toxicity: nephrotoxicity, acoustic nerve damage

Front 11

Busulfan

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alkylates DNA
Use: CML
Toxicity: pulmonary fibrosis, hyperpigmentation

Front 12

Doxorubicin, danorubicin

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generates free radicals and intercalates DNA
part of ABVD for hodgkin's
Toxicity: cardiotoxicity

Front 13

Dactinomycin (actinomycin D)

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intercalates DNA
use: CHILDHOOD TUMORS: ewing's sarcoma, wilm's tumor, rhabdomyosarcoma

Front 14

Bleomycin

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free radicals, break DNA strands
Use: testicular cancer, hodgkin's lymphoma (AVBD)
Toxicity: pulmonary fibrosis

Front 15

Hydroxurea

Back 15

inhibits ribonucleotide reductase, which decreases DNA synthesis (S-phase specific)
Use: sickle cell, CML, melanoma

Front 16

etoposide

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G2 phase specific inhibitor of topoisomerase II and increases DNA degradation
Use: small cell CA of lng and prostate

Front 17

prednisone

Back 17

triggers apoptosis (glucocorticoid)
works on non-dividing cells
part of MOPP
Toxicity: cushing's like symptoms, osteoporosis, hypertension, acne, cateracts,

Front 18

tamoxifen, raloxifene

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SERMS: receptor antagonists in breast, agonists in bone, block the binding of estrogen to receptor postive cells.
Use: breast cancer, osteoporosis
*tamoxifen increaes the risk of endmetrial cancer due to partial agonist effects, raloxifine does not

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trastuzumab

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monoclonal antibody against HER-2
breast cancer that is HER-2-neu positive
Toxicity: cardiotoxic

Front 20

imantinib (gleevac)

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tyrosine kinase inhibitor (CML, GI stromal tumors)
bcr-abl

Front 21

vincristine/vinblastine

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M-phase specific blockage of microtubules
part of MOPP (hodgkin's)
Vincristine: neurotoxic
Vinblastine: marrow toxic "BLASTS THE BONE MARROA"

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paclitaxel

Back 22

M-phase specific that binds tubulin and hyperstabilizes microtubles so they can't break down
NO ANAPHASE
Use: ovarian and breast cancers