Heme & Cancer Pharm

Front 1

Describe the toxicity of aspirin

Back 1

gastric ulceration, bleeding, hyperventilation (OD), Reye's syndrome, tinnitus (CN VIII)

Front 2

Describe the toxicity of clopidogrel/ticlopidine

Back 2

Neutropenia (ticlopidine)

Front 3

What is the MOA of methotrexate?

Back 3

folic acid analog that inhibits dihydrofolate reductase (part of pyrimidine synthesis)

Front 4

Name 5 side effects of MTX

Back 4

myelosuppression, macrovesicular fatty change in liver, mucositis, teratogenic, neurotoxicity

Front 5

How can you reverse MTX myelosuppression?

Back 5

Give leucovorin which is N5 formyl THF which can be converted to THF to rescue DNA synthesis

Front 6

What is the mechanism of action of 5-FU?

Back 6

Pyrimidine analog that inhibits thymidylate synthase; blocks pyrimidine synthesis (synergy with MTX)

Front 7

How can you "rescue" 5-FU OD?

Back 7

with thymidine

Front 8

Name 2 side effects of 5-FU

Back 8

myelosuppression, photosensitivity

Front 9

What is the MOA of 6-MP?

Back 9

It's a purine analog that blocks de novo purine synthesis- trying to find out where exactly it works

Front 10

Side effects of 6MP?

Back 10

bone marrow, GI, liver

Front 11

What enzyme metabolizes 6MP?

Back 11

XO

Front 12

What enzyme activates 6MP?

Back 12

HGPRTase

Front 13

What is the MOA of dactinomycin?

Back 13

intercalates in DNA and inhibits RNA pol, DNA pol, and may cause strand breaks due to inhibition of DNA topoisomerase II

Front 14

What (general) tumors is dactinomycin used for?

Back 14

tumors of childhood like Wilms' tumor, Ewing's sarcoma, and rhabdomyosarcoma

Front 15

Toxicity of dactinomycin?

Back 15

myelosuppression

Front 16

What is the mechanism of action of doxorubicin/daunorubicin?

Back 16

Intercalates in DNA and inhibits rna pol, dna pol, and DNA topo II (possibly causing dbl stranded breaks) + generates free radicals --> single stranded breaks as well

Front 17

3 toxicities of doxo/daunorubicin?

Back 17

cardio, myelosuppression, and alopecia

Front 18

What is the MOA of bleomycin?

Back 18

Induces free radical formation which causes breaks in DNA strands (single stranded)

Front 19

Side effects of bleomycin (2)

Back 19

pulmonary fibrosis, skin changes (bc those tissues can't de-activate bleomycin)

*Note: minimal myelosuppression

Front 20

What is the MOA of etoposide (VP16) and teniposide?

Back 20

They inhibit DNA topoisomerase II, leading to double stranded dna breaks

Front 21

Toxicity of etoposide/teniposide?

Back 21

myelosuppression, GI irritation, alopecia

Front 22

Type of drug?
cyclophosphamide

Back 22

alkylating agent

Front 23

Type of drug?
ifosfamide

Back 23

alkylating agent

Front 24

nitrosoureas, type of drug?

Back 24

alkylating agent

Front 25

Type of drug?
carmustine

Back 25

alkylating agent

Front 26

Type of drug?
semustine

Back 26

alkylating agent

Front 27

Type of drug?
streptozocin

Back 27

alkylating agent

Front 28

Type of drug?
busulfan

Back 28

alkylating agent

Front 29

Name two main toxicities of cyclophosphamide/ifosfamide

Back 29

1) myelosuppression
2) hemorrhagic cystitis

Front 30

Name main toxicity of nitrosoureas

Back 30

CNS toxicity (dizziness/ataxia)

*Crosses BBB so used for brain tumors

Front 31

Name main toxicities (2) of busulfan

Back 31

pulmonary fibrosis, hyperpigmentation

Front 32

What is the mechanism of action of vincristine/vinblastine?

Back 32

Bind to tubulin during M phase and block polymerization of microtubules so mitotic spindle can't form

Front 33

What are the side effects of vincristine?

Back 33

neurotoxicity, paralytic ileus

Front 34

What are the side effects of vinblastine?

Back 34

vinblastine BLASTS the bone marrow (suppression)

Front 35

What is the MOA of paclitaxel and other taxols?

Back 35

hyperstabilizes polymerized microtubules in M phase so mitotic spindle can't break down

Front 36

What are the side effects of paclitaxel and other taxols?

Back 36

myelosuppression, hypersensitivity

Front 37

What's the MOA of cisplatin/carboplatin?

Back 37

cross-link DNA

Front 38

What are the side effects of cisplatin/carboplatin?

Back 38

nephrotoxicity and acoustic nerve damage

Front 39

How can you prevent nephrotoxicity from cisplatin/carboplatin?

Back 39

Give amifostine which is a free radical scavenger

Front 40

What is the mechanism of action of hydroxyurea?

Back 40

inhibits ribonucleotide reductase

Front 41

Toxicity of hydroxyurea?

Back 41

bone marrow suppression, GI upset

Front 42

Why is prednisone used to treat cancer?

Back 42

bc it can trigger apoptosis

Front 43

What is the MOA of tamoxifen and raloxifene?

Back 43

estrogen receptor antagonists in breast and agonist in bone

Front 44

What two things can you use tamoxifen/raloxifene for?

Back 44

To treat estrogen receptor positive breast cancer or to prevent osteoporosis

Front 45

Which SERM has a risk for endometrial carcinoma and why?

Back 45

tamoxifen - may increase risk of endometrial cancer via partial agonist effects

Front 46

What is the MOA of trastuzumab (aka herceptin)

Back 46

monoclonal Ab against HER-2 (aka erb-B2); helps kill cancer cells that over-express HER-2

Front 47

What is the toxicity of trastuzumab?

Back 47

cardiotoxicity

Front 48

What is the MOA of imatinib?

Back 48

Philadelphia chromosome bcr-abl tyrosine kinase inhibitor

Front 49

What is the main side effect of imatinib?

Back 49

fluid retention

Front 50

What is the MOA of rituximab?

Back 50

Anti-CD20 ab (used for B cell neoplasms)