First Aid Onc Pharm

Front 1

which cancer drugs are cell cycle specific (5)

Back 1

antimetabolites (MTX, 5-FU, 6-MP), etoposide, bleomycin, vinca alkaloids, paclitaxel

Front 2

which cancer drugs are cell cycle nonspeficic (2)

Back 2

alkylating agents, antibiotics

Front 3

MOA of MTX

Back 3

S-phase specific antimetabolite. Inhibits duhydrofolate reductase (b/c is folate acid analog)

Front 4

Clinical uses of MTX

Back 4

leukemias, lymphomas, choriocarcinomas, sarcomas, abortion, ectopic preggers, RA, psoriasis

Front 5

toxicities of MTX

Back 5

myelosuppression (use leucovorin for "rescue"), macrovesicular fatty change in liver

Front 6

MOA 5-FU

Back 6

S-phase specific antimetabolite. Bioactivated form (5F-dUMP complexes with folic acid and inhits thymidylate synthase

Front 7

Clinical use of 5-FU

Back 7

colon cancer and other solid tumors, basal cell carcinoma (topical). Synergy with MTX

Front 8

toxicity of 5-FU

Back 8

myelosuppression which is NOT reversible with leucovorin (vs MTX); photosensitivity

Front 9

MOA 6-MP

Back 9

blocks de novo purine synthesis

Front 10

what activates 6-MP?

Back 10

HGPRTase

Front 11

Toxicities of 6-MP

Back 11

done marrow, GI, liver; metabolized by xanthine oxidase so increased toxicity with allopurinol

Front 12

MOA cytarabine (ara-C)

Back 12

inhibits DNA polymerase

Front 13

Clinical use of ara-C?

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AML

Front 14

toxicities of ara-C

Back 14

leukopenia, thrombocytopenia, megaloblastic anemia

Front 15

MOA of cyclophosphamide/ifosfamide

Back 15

(alkylaying agts) covalently x-link DNA at guanine N-7; require bioactivation by liver

Front 16

Clinical use of cyclophosphamide/ifosfamide

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non-Hodgkin's lymphoma, breast and ovarian carcinomas

Front 17

toxicities of cyclophosphamide

Back 17

myelosuppressin, hemorrhagic cystitis (use mesna!!)

Front 18

4 nitrosoureas

Back 18

carmustine, lomustine, semustine, streptozocin

Front 19

MOA of nitrosoureas

Back 19

(e.g. carmustine, steptozocin). Alkylate DNA; require bioactivation; CROSS BBB!!

Front 20

toxicities of nitrosoureas

Back 20

CNS (dizziness, ataxia)

Front 21

MOA of cisplatin, carboplatin

Back 21

act like alkylating agents

Front 22

clinical uses of cisplatin?

Back 22

testicular, bladder, ovary, and lung carcinomas

Front 23

toxicity of cisplatin?

Back 23

nephrotoxicity and acoustic nerve damage

Front 24

MOA of busulfan

Back 24

alkylates DNA

Front 25

clinical use of busulfan

Back 25

CML

Front 26

toxicities of busulfan

Back 26

pulmonary fibrosis, hyperpigmentation

Front 27

MOA of doxorubucin, daunurubicin

Back 27

generate free radicals and noncovalently intercalate into DNA

Front 28

Clinical uses of doxorubucin, daunorubicin

Back 28

part of ABVD treatment for Hodgkin's; also for myelomas, sarcomas, solid tumors

Front 29

toxicities of doxorubicin, daunorubicin

Back 29

cardiotoxic; myelosuppression, marked alopecia; toxic extravasation

Front 30

MOA dactinomycin

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DNA intercalater

Front 31

clinical uses of dactinomycin

Back 31

Wilm's tumor, Ewing's sarcoma, rhabdomyosarcoma (for childhood tumors!)

Front 32

toxicity of dactinomycin

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myelosuppression

Front 33

MOA of bleomycin

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induces formation of free radicals-->DNA strand breaks

Front 34

Clinical uses of bleomycin

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testicular cancer; part of ABVD for Hodgkin's (along with doxorubicin/daunorubicin)

Front 35

toxicities of bleomycin

Back 35

PULMONARY FIBROSIS, skin changes, MINIMAL myelosuppression

Front 36

MOA of etoposide

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G2 phase specific agt, inhibits topoisomerase II

Front 37

Clinical uses of etoposide

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small cell carcinoma of lung and prostate, testicular carcinoma

Front 38

Toxicities of etoposide

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myelosuppression, GI irritation, alopecia

Front 39

MOA of prednisone

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steroid; may trigger apoptosis?

Front 40

Clinical uses of prednisone

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lots but spefically part of MOPP regimen for Hodgkin's , CLL

Front 41

Toxicities of prednisone

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Cushing-like sxs; immunosuppression, CATARACTS, acne, OSTEOPOROSIS, HTN, peptic ulcers, hyperglycemia, psychosis

Front 42

MOA of tamoxifen, raloxifene

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estrogen R antagonits in breasts, agonists in bone

Front 43

tamoxifen vs raloxifene

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tamoxifen may increase risk of endometrial cancer but raloxifene is an endometrial ANTAGonist

Front 44

MOA of trastuzumab (herceptin)

Back 44

monoclonal Ab against HER-2; helps kill breast cancer cells that overexpress HER-2

Front 45

Clinical use of trastuzumab

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(herceptin) metastatic breast cancer

Front 46

toxicity of trastuzumab

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cardiotoxicity

Front 47

MOA of imatinib?

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(Gleevec) Phl chromosome bcr-abl tyrosine kinase inhibitor

Front 48

Clinical uses of imatinib

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(gleevec) CML, GI stromal tumors

Front 49

toxicity of imatinib

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(gleevec) fluid retention

Front 50

MOA of vincristine, vinblastine

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(vinca alkaloids) M phase specifics, bind tubulin and block polymerization of microtubules

Front 51

Clinical uses of vincristine, vinblastine

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part of MOPP regimen (as is prednisone) for lymphoma, Wilms' tumor, choriocarcinoma

Front 52

toxicity of vincristine

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neurotoxicity, paralytic ileus

Front 53

toxicity of vinblastine

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myelosuppression (vinBLASTine BLASTS bone marrow)

Front 54

MOA of taxols

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(e.g. paclitaxel) M phase specific agents to bind tubulin and disallow microtubule breakdown

Front 55

clinical uses of taxols

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ovarian and breast carcinomas

Front 56

toxicities of taxols

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myelosuppression and hypersensitivity

Front 57

Which cancer drugs are M-phase specific?

Back 57

taxols and vinca alkaloids