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27 Cards in this Set
- Front
- Back
S- phase specific antimetabolite. Folic acid analog -->inhibits Dihydrofolate reductase-->no dTMP for DNA synth
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Methotrexate
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Methotrexate toxicity
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Myelosupression (leucovorin rescue-->provides folate), Fatty change in liver, mucositis
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ara-C (cytarabine)
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Inhibits DNA polymerase
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Cytarabine toxicity
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Leukopenia, thrombocytopenia, Megaloblastic anemia
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5-FU mech. of action and toxicity
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S-phase specific pyrimadine analog-->inhibits thymidylate synthase-->no dTMP for DNA synth.
Toxicity: Myelosuppresion; photosensitivity |
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6-MP (6-mercaptopurine) mechanism of action and toxicity
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Blocks de novo purine synthesis.
Toxicity: BM tox, GI, hepatotoxicity. metabolized by xanthine oxidase (allopurinol toxicity) |
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Which chemo agents affect Nucleotide Synthesis?
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5-FU, 6-MP, MTX
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Cyclophosphamide
Ifosfamide mechanism of action, uses, toxicity |
Alkylating agent, x-links DNA @ guanine. Bioactivation via liver.
uses: NHL, breast and ovarian carcinomas toxicity: Myelosuppression. Hemmorhagic cystitis (prevent with Mesna and hydration), stomatitis |
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Cisplatin, Carboplatin
uses, mechanism of action, toxicity |
X-link DNA.
uses: lung carcinomas, breast, testicular, ovary toxicity: ototoxicity, neurotoxicity |
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Doxorubicin, daunorubicin
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gen free radicals-->breaks DNA.
Hodgkin's lymphoma, myeloma, solid tumors toxicity: cardiotoxicity, myelosuppresion, alopecia |
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Hydroxyurea
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S-phjase specific: Inhibits Ribonucleotide Reductase, --> decreased DNA synthesis
USES: melanoma, CML, sickle cell (incr HbF) toxicity: myelosuppression, GI upset |
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Drugs affecting DNA
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Alkylating agents, cisplatin, dactinomycin, doxorubicin, Etoposide
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Etoposide (VP-16)
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G2-phase -->inhibits topoisomerase II and increased DNA degredation
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Tamoxifen, raloxifene
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SERMs-estrogen receptor antagonists in breast, agonists in bone, prevent osteoporosis
toxicity: partial agonist of endometrium-->cancer |
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Bleomycin
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Induces formation free radicals-->strand breals
toxicity: pulmonary fibrosis, skin changes, minimal myelosupression |
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Trastuzumazab
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mechanism: monoclonal Ab against Her-neu in some breast cancer
Cardiotoxic |
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Imatinib (Gleevec)
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tyrosine kinase inhibitor of Bcr-Abl on 9:22 Phil. Chromosome in CML
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Vincristine, Vinblastine
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mech: M-phase-->binds tubulin inhibits mictotubule formation
toxicity: neurotoxicity, myelosuppresion, BM suppresion |
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Paclitaxel
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hyperstabilizes tubulin
Myelosuppresion |
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t(8:14)
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c-myc next to heavy chain gene; Burkitt's lymphoma
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t(15;17)
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M3 tye AML (promyelocytic) --> responds to retinoic acid
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t(11;14)
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Mantle cell lymphoma
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t(14;18)
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Follicular lymphoma (bcl-2 activation)
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Multiple Myeloma
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C: hyperCalcemia
R: renal insufficiency A: anemia B: Bone/Back Pain |
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Reed-Sternberg cells
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"Owl eyes" tumor giant cells in Hodgkin's disease
-CD30+ and CD15+ B-cell origin |
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How does Hodgkin's lymphoma present?
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multiple peripheral nodes; extranodal involvement;
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How differentiate CML from leukemoid rxn?
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leukemoid rxn = high alkaline phosphatase
CML = low alk phos |