Boards Hem Onc Pharm

Front 1

The following thrombolytics do what?

Streptokinase
Urokinase
tPA
APSAC

Back 1

Convert Plasminogen --> Plasmin to break down a fibrin mesh clot

Front 2

Clopidogrel

Back 2

Antag ADP receptor on PLT

Front 3

Ticlopidine

***ALSO MAJOR AE?***

Back 3

Antag ADP receptor on PLT

Neutropenia

Front 4

Abciximab

Back 4

Inhibs GpIIb / IIIa on PLT

Front 5

ASA in PLT

Back 5

Inhibs COX on PLT -->
No TXA2 -->
No upreg of GpIIb / IIIa on PLT

Front 6

Lepirudin

Back 6

Inhibs Thrombin (IIa)

Front 7

Bivalirudin

Back 7

Inhibs Thrombin (IIa)

Front 8

Heparin

Back 8

Co-factor for Anti-thrombin -->
Inhib of Thrombin (IIa)

Front 9

Warfarin

Back 9

Inhib Vit K Dep Clotting Factors

2, 7, 9, 10, PRO C, PRO S

Front 10

Cilostazol

Back 10

Inhibs PDE in PLT-->
Inc cAMP in PLT -->
Dec Ca in PLT -->
No PLT Agg

Front 11

Dipyridamole

Back 11

Inhibs PDE in PLT-->
Inc cAMP in PLT -->
Dec Ca in PLT -->
No PLT Agg

Front 12

3 Rx that Inhib M phase of cell cycle?

Back 12

Vincristine
Vinblastine
Paclitaxel

Front 13

Inhib Thymidylate Synthase

Back 13

5-FU

Front 14

Inhib DHF Reductase

Back 14

MTX

Front 15

Inhib S phase of cell cycle IN ADDITION to MTX and 5-FU?

Back 15

6-MP
6-TG
Cytarabine
Etoposide

Front 16

Rx that Inhibs both the S and G2 phase of the cell cycle?

Back 16

Etoposide

Front 17

Rx that inhibs G2 phase only of cell cycle?

Back 17

Bleomycin

Front 18

Back 18

Front 19

HEM / ONC

Back 19

HEM / ONC

Front 20

Heparin:
MOA?

Heparin used in short term or long term?

Is heparin safe for preggos? Why or why not?

What must you monitor in pts on heparin?

Back 20

Cofactor for anti-thrombin -->
Dec thrombin and Xa

Short term

Yes, bc does NOT cross placenta

PTT

Front 21

2 AEs of heparin?

Antidote against heparin?

Back 21

HIT (Heparin Induced THROMBOCYTOPENIA) syndrome
&
Osteoporosis

Protamine sulfate

Front 22

What is the name of the drug that is a LMW heparin?

Major MOA of enoxaparin?

1 Major advantage of enoxaparin over heparin?

Back 22

Enoxaparin

Xa

Does NOT need lab monitoring (PT)

Front 23

What is HIT syndrome?

Back 23

Heparin binds to CF IV -->
AB binds to and activates PLTs --> PLT Clearance -->
HYPERCOAGULABLE, THROMBOCYTOPENIC state

Front 24

2 drugs that directly inhibit thrombin
and are an alternative to heparin for anticoagulating pts w/ HIT syndrome

Back 24

Lepirudin
Bivalirudin

Front 25

Warfarin (Coumadin) has what MOA?

Back 25

Inhibits synth and gamma-carboxylation of Vit K dependent clotting factors
II, VII, IX, X
AND
Anti-clotting factors
PRO C and PRO S

Front 26

Warfarin (Coumadin) will have what effect on what lab value?

Back 26

Inc PT

Front 27

What drug for slower reversal of warfarin FX?

What drug for rapid reversal of warfarin?

Back 27

Vit K

Fresh Frozen Plasma

Front 28

2 Instances of chronic anticoagulation for you to use warfarin?

Should warfarin (coumadin) be used in preggos? Why or why not?

Back 28

Post STEMI, Venous thromboembolism p-lax

No, crosses placenta

Front 29

Warfarin (coumadin) is also used for what arrhythmia to p-lax clots?

2 Lab values to check in pts on warfarin (coumadin)

Is warfarin (coumadin) rapid or slow acting (onset)?

Back 29

A-fib

PT / INR

Slow acting (onset)

Front 30

List 4 thrombolytics

Back 30

Streptokinase
Urokinase
tPA (alteplase)
APSAC (anistreplase)

Front 31

MOA of thrombolytics?

Thrombolytics will effect what 2 lab values?

2 CU of thrombolytics?

CI'ed in active bleed, TF treat toxicity w/ what?

Back 31

Stim conversionof plasminogen to plasmin -->
Cleavage of fibrin clots

Inc PT and PTT

Early MI, Early ischemic Stroke

aminocaprionic acid

Front 32

MOA of ASA?

Effect of ASA on BT, PT, PTT?

Which part of clotting mech does ASA effect?

Back 32

Inhibs COX1 and COX2

Inc Bleeding Time (PLTS)
NO effect on PT or PTT

PLT aggregation

Front 33

4 AEs of ASA?

Back 33

Gastric ulcer --> Bleed
Reyes syndrome
Tinitus from VIII dysfnctn

Front 34

2 MOAs of clopidogrel and ticlopidine?

Ticlopidine has what effect on what WBC type?

Back 34

blocks ADP receptors
Binds glucoPRO IIb / IIIa

Dec PMNs (Neutropenia)

Front 35

Which 2 clotting drugs are PDE III inhibs --> Inc cAMP and thus inhibit PLT aggregation, WHILE vasodilating?

Back 35

Cilostazol
Dipyridamole

Front 36

Which 2 anti-clotting drugs are used for intermittent claudication, p-lax stroke and TIA, p-lax anging and cause coronary vasodilaiton?

Back 36

Cilostazol,
Dipyridamole

Front 37

Which anti-PLT drug is a monoclonal Ab that binds to teh glycoPRO receptor IIb / IIIa on PLTs -->
P-lax of PLT aggregation?

2 AEs of abciximab?

Back 37

Abciximab

Bleeding & Thrombocytopenia

Front 38

1) Which anti-CA Rx is a folic acid analog that inhibits dihydrofolate reductase?

2) 3 Non-CA CU?

3) 2 MTX AEs?

4) This Myelosuppression is reversible w/ what?

Back 38

1) MTX

2) Abortion, Ectopic Preggo, RA

3) Myelosuppression
Lung Fibrosis

4) Folinic Acid (Leucovorin Rescue)

Front 39

1) Which CA drug is a pyrimidine analog that inhibits thymidylate synthase?

2) 2 CU?

3) 5-FU can cause BM suppression. Can it be overcome w/ folinic acid (leucovorin rescue)

4) How to tx OD?

Back 39

1) 5-FU (5-fluorouracil)

2) Basal cell carcinoma
Actinic Keratosis (not a CA, but used for it)

3) NO

4) Thymidine

Front 40

1) Which CA drug is a purine (thiol) analog?

2) It is metabolized by xanthine oxidase, TF, its toxicity is increased w/ aministration of what?

Back 40

1) 6-MP

2) Allopurinol

Front 41

1) 6-TG (6-thioguanine) is pretty much the same as 6-MP, except their is one major difference. What's that difference?

Back 41

1) Pts can be given allopurinol

Front 42

Which CA drug is a pyrimidine analog that inhibits DNA polymerase?

Back 42

Cytarabine

Front 43

1) What's the MOA of Dactinomycin (Anti-tumor ABX)?

2) Dactinomycin can be used for what 3 tumors?

Back 43

1) Intercalates in DNA

2) Wilms tumor
Ewing's sarcoma
Rhabdomyosarcoma
(all are kids tumors so think kids ACT out)

Front 44

1) MOA of anti-tumor drug Doxorubicin (adriamycin), and daunorubicin

2) AE?
A) Can be combined w/ what to p-lax cardiotoxicity?

Back 44

1) Generate free rads that intercalate in DNA

2) CARDIOTOXIC
A) Dexrazoxane

Front 45

1) Which anti-tumor drug induces free rad formation -->
DNA strand breaks?

2) Used for what CA?

3) AE?

Back 45

1) Bleomycin

2) Testicular CA

3) Pulm Fibrosis

Front 46

1) Which 2 anti-tumor drugs inhib Topoisomerase II -->
Inc DNA Degradation

2) CU?

Back 46

1) Etoposide and Teniposide

2) SC Carcinoma of Lung
Testicular Carcinoma

Front 47

1) What are 2 alkylating agents that covalently X-link (interstrand) DNA

2) Major AE?

Back 47

1) Cyclophosphamide, Ifosfamide
(remember, also immunosuppressants)

2) Hemorrhagic Cystitis partially p-laxed w/ mesna

Front 48

1) Which alkylating drugs cross blood brain barrier into CNS?

2) Good for?

3) AE?

Back 48

1) Nitrosureas
(carmustine, lomustine, semustine)

2) Brain tumors

3) CNS Tox

Front 49

1) MOA of busulfan?

2) AE?

Back 49

1) Alkylates DNA

2) Pulmonary Fibrosis

Front 50

1) 2 drugs that block polymerization of microtubules?

2) 4 CAs used for?

3) AE of vincristine?

Back 50

1) Vincristine, Vinblastine

2) Hodgkin's Lymphoma
Wilms tumor
Choriocarcinoma
ALL

3) Neurotoxic
BM Suppression

Front 51

1) What group of microtubule inhibitors HYPERSTABILIZE microtubules in M-phase, TF inhibiting mitotic spindle break down?

2) 2 CU?

Back 51

1) Taxols like Paclitaxel

2) Ovarian and Breast Carcinomas

Front 52

Cisplatin & Carboplatin

1) MOA?

2) 2 CA?

3) AE?

Back 52

1) Cross-link DNA

2) Bladder, Testicular, Ovary

3) Nephrotoxic, Ototoxic

Front 53

Hydroxyurea

1) MOA?

2) CU?

Back 53

1) Inhibs ribonucleotide reductase -->
Dec DNA Synth

2) Sickle Cell bc inc HbF

Front 54

REMEMBER, PREDNISONE CAN BE USED FOR CA BC IT STIMS APOPTOSIS - SEE NOTES ON PREDNISONE USE

Back 54

REMEMBER, PREDNISONE CAN BE USED FOR CA BC IT STIMS APOPTOSIS - SEE NOTES ON PREDNISONE USE

Front 55

Tamoxifen, Raloxifene

1) MOA?

2) CU?

3) AE of tamoxifen?

4) AE of Raloxifene?

Back 55

1) SERMS -
Receptor ANTAGS in breast and
Receptor AGONISTS in Bone

2) Tx Br CA
P-lax osteoporosis

3) Inc risk endometrial carcinoma bc an endometrial AGONIST!

4) NONE- no increase risk endometrial carcinoma bc it is an endometrial antag!

Front 56

Trastuzamab (Herceptin)

1) MOA?

2) CU?

3) AE?

Back 56

1) Monoclonal ab against HER-2 (a tyrosine kinase)

2) Kills Br CA cells that overexpress Her-2

3) Cardiotoxic

Front 57

Imatinib

1) MOA?

2) CU?

Back 57

1) bcr-abl tyrosine kinase inhibitor

2) CML

Front 58

Rituximab

1) MOA?

2) CU?

Back 58

1) Monoclonal Ab against CD20 on b-cell neoplasms

2) Lymphoma and RA

Front 59

LOOK AT CHEMO-TOX MAN

Back 59

LOOK AT CHEMO-TOX MAN