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70 Cards in this Set
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- Back
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Standard combo tx for ALL
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Prednisone and Vincristine OR
POMP -Predinisone -Oncovin (aka Vincristine) -Methotrexate -Purimethol (6-MP) |
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MOA Prednisone
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steroid that causes lymphocytopenia
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MOA Vincristine
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Binds tubulin and blocks the from forming microtubules
(inhibits mitosis) |
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SE Vincristine
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Peripheral neuropathy
Phlebitis Alopecia Multiple GI problems |
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MOA Methotrexate
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Inhibits dihydrofolate reductase (inhibits folate usage)
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Purimethol aka
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6-MP
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SE Purimethaol (6-MP)
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Stomatitis
SEVERE BM suppression Alopecia N/V Renal & hepatic damage |
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Tx Wilm's tumor
(congenital kidney tumor 2-5 yo) |
Dactinomycin & Vincristine
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DOC combo for Hodgkin's disease
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MOPP
-Mechlorethamine -Oncovin -Prednisone -Procarbazine ABVD -Adriamycin -Bleomycin -Vinblastine -Dacarbazine |
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MOA Bleomycin & adriamycin
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Destroy DNA via ROS
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MOA Dacarbazine
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Alkylating agent
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SE Dacarbazine
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Highly emetogenic
Extreme BM suppression |
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MOA Mechlorethamine
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Alkylates guanines in DNA --> cross-linking in pairs or removal
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SE Mechlorethamine
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Severe N/V
Extreme BM suppression Herpes Zoster (if VZV provirus present) Potential to cause 2nd CA Extreme blisters if on skin or mucus membranes |
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MOA Procarbazine
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Inhibits DNA & RNA synthesis
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SE Procarbazine
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BM suppression
Disulfiram rxn Neurotoxicity |
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MOA cyclophosphamide
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Alkylating agent --> destroys DNA
(Requires biotransformation via P450 for activation) |
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SE Cyclophosphamide
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Alopecia
BM suppression Leukocytosis Amenorrhea Sterility HEMORRHAGIC CYSTITIS (bladder fibrosis) |
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SE Bleomycin
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Pulmonary fibrosis
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MOA Cisplatin
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Platinum compound
Intra- & interstrand cross-linking b/t nucleotides --> ceasing all RNA & DNA synthesis |
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Cisplatin used for
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Solid tumors
(metastatic testicular CA, ovarian CA, bladder CA) |
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SE Cisplatin
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Persistent, intractable V
Nephrotoxicity Ototoxicity PERIPHERAL NEUROPATHY |
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MOA L-asparaginase
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Asparagine --> aspartic acid
(some Ca require asparagine, deprives them) |
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L-asparaginase used to tx
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ALL
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SE L-asparaginase
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HYPERSENSITIVITIES
Decreased clotting factors Liver problems Pancreatitis Seizures Coma |
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6-MP used to tx
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ALL
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Bleomycin used to tx
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GU CA (Testicular CA)
Lymphoma |
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Vincristine used to tx
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Hodgkin's lymphoma
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Vinblastine used to tx
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Testicular CA
Lymphoma |
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Mechlorethamine used to tx
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Hematologic malignancy
(leukemia & lymphoma) |
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Cyclophosphamide used to tx
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Lymphomas & Leukemias
Ovarian & breast CA Childhood malignancies Multiple myeloma |
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2 drugs which are similar to Cisplatin
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Carboplatin - less renal tox, more BM tox
Oxaliplatin - neurtoxic when exposed to cold |
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SE Chlorambucil (similar MOA Mechlorethamine)
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Extremely BM tox
Potential 2nd CA (Others - Melphalan, lomustine, busulfan) |
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Leuprolide & Flutamide used to tx
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Prostate CA
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MOA & SE Leuprolide
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synthetic analog GnRH
Hot flashes |
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MOA & SE Flutamide
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Antagonizes testosterone R
Gynecomastia |
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MOA Hydroxyurea
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Inhibits ribonucleotide reductase
(req. for nucleotide synthesis in WBC) |
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Hydroxyurea used to tx
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Leukemia
(Sickle cell pt - reduces # crises) |
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SE hydroxyurea
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BM tox (managed via titration)
Causes synthesis fetal Hgb (useful in sickle cell pt) |
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MOA ATRA (all-trans-retinoic acid)
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Binds to mutated form retinoic acid R
(causes blasts to differentiate --> mature myeloid cells) |
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ATRA used to tx
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AML subtype 3 (15:17 translocation)
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SE ATRA
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Induces DIC
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MOA Tamoxifen
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Inhibits Estrogen R in breast (esp)
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SE Tamoxifen
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Hot flashes
Increased risk DVT & PE Increased risk endometrial CA |
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Taxanes (2 drugs)
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Paclitaxel
Doxetaxel |
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MOA taxanes
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Inhibit microtubule disassembly --> apoptosis
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Taxanes used to tx
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Breast, Lung, Ovarian CA
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SE Taxanes
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Dose-limiting BM suppression
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PGE2 responsible for
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Sensitizing n. endings to other pain mediators
Fever |
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PGI2 responsible for
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Inhibiting gastric secretions
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PGE2 & PGF2 responsible for
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Stimulate production protective mucus in stomach & small intestine
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MOA Aspirin
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IRREVERSIBLY acetylates cyclooxygenase
(central and peripheral tissue) |
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Effects of ASA
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-decrease inflammation & fever
-decreases coaguation via platelets -analgesic |
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How does ASA reduce coagulation
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Decreases thromboxane (d/t COX inhibition)
Thromboxane - enhanses platelet aggregation (takes 2 wks for reversal of this - new platelets formed) |
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Who is ASA contraindicated in
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GOUT pt
(competes w/ uric acid at renal transporters) |
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Some uses of ASA
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RA
HA, arthralgia, angina, PDA Topically - corns & calluses Prophylactically - Hx MI, stroke, A. fib |
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Overdose of ASA causes
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Uncoupling Ox-Phos
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Effect of ox-phos uncoupling resulting from OD ASA
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Increase CO2 --> hyperventilation --> resp. alkalosis
Kidney response w/ metabolic acidosis |
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Immediate acid-base disturbance ASA
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Metabolic acidosis (acidic nature ASA)
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ASA toxic levels leads to
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Central resp. paralysis --> hypoventilation --> increase CO2 --> Resp. acidosis
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Other SE ASA
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Tinnitus
(mild ASA intox) |
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Special about APAP
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NO peripheral anti-inflammatory action
(CNS cyclooxygenase) |
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APAP used for
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-reducing fever
(good antipyretic w/o risk reye's syndrome in kids) -reducing pain perception -Children w/ viral infection |
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Use of Indomethacin (Etodolac, Sulindac)
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Acute gouty arthritis
Ankylosing spondylitis OA of hip Pain control for uveitis & post-op ophthalmic Fever in Hodgkin's disease |
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SE Indomethacin
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GI distrubances (ulceration)
RARE -Pancreatitis -Fatal hepatitis -Aplastic anemia |
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Other non-selective NSAIDS
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Ibuprofen
Ketorolac Tolmetin Naproxen |
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COX-2 inhibitor? Effect?
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Celecoxib
(decreasing formation PG in inflammatory or injurious conditions) |
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GI SE w/ COX-2 inhibitors
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Less
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Who can you NOT use COX-2 inhibitor in?
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Allergic to sulfa drug
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SE of ALL NSAIDS (except APAP)
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Increase risk of miscarriage
Exacerbate HF & HTN Promote GI d/o (chronic use) Inhibit platelet fnct --> increase bleeding |
