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51 Cards in this Set
- Front
- Back
Cell cycle non-specific agents
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effects at all stages
ex: alkylating, anthracyclines, nitrosoureas, Platinum agents |
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Cell Cycle specific agents
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antimetabolites, vincas, taxanes
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Mechanism of alkylating agents
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direct crosslinking of base pairs
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Alkylating agent toxicities
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myelosuppression
N/V secondary malignancies infertility hemorrhagic cystitis |
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Med to avoid hemorrhagic cystitis
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mesna
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Which platinum compounds cause peripheral neuropathies?
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Oxaliplatin (and cold sensitivity)
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Which platinum compounds cause nephrotoxic and N/V toxicities?
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cisplatin
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Which platinum compounds can cause thrombocytopenia toxicity?
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carboplatin
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Toxicities of nitrosoureas
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pulmonary
myelosuppression N/V phlebitis CNS |
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What specificity do antimetabolites have in the cell cycle?
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S phase
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2 main folate antagonists?
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MTX (w/ leucovorin), pemetrexed (w/ folic acid/B12)
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Main toxicities of MTX?
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mucositis
myelosuppression can have renal precipitates |
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Mechanism of MTX
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inhibition of DHFR
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2 main pyrimidine analogues
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fluorouracil & capecitabine (oral prodrug)
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Dose limiting toxicities for 5-FU
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GI, myelosuppression (bolus), used with leucovorin
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How does leucovorin supplement 5-FU?
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inc binding affinity to thymidylate synthetase
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Pyrimidine antagonist and toxicities?
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cytarabine (Ara-C)
tox.: cerebellar toxicity, conjunctivitis |
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purine antagonist (main 3)
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6-mercaptopurine
gemcitabine bendamustine (2 MOA: alkylating and antimetabolite) |
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Vinca alkaloids are what drug class? What phase of cell cycle?
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Microtubule targeting agent; M-phase cell cycle (MT destruction)
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Which vinca alkaloid has greater myelosuppressive toxicity?
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vinblastine
|
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Key warning for MT targeting agents?
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Do not administer intrathecally
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taxanes are what drug class? How do they differ from vinca alkaloids?
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MT targeting agents, MT stabilization v. destruction in vinca
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Toxicities of Taxanes
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myelosuppression
peripheral neuropathies hypersensitivity |
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What causes the hypersensitivity reaction with taxale tx?
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the delivery package
|
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What is ixabepilone similar to? How do they differ?
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Similar to taxanes, but greater potency
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MOA of Topo I inhibitors
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blocks relaxing of supercoiled DNA (blocks transcription)
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MOA of Topo II inhibitors
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blocks recoiling of DNA after transcription
|
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Topo I inhibitor ex? toxicity?
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Camptothecins
Toxicity includes myelosuppression, dirrhea |
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Topo II inhibitor ex? toxicity?
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etoposide (can cause hypotension)
Toxicity: myelosuppression, secondary malignancies (AML), dose dependent mucositis |
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MOA of anthracyclines
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intercalate DNA and inhibit Topo, can include free radical damage
|
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Anthracycline drugs
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doxorubicin, daunorubicin, epirubicin, mitoxantrone
|
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Toxicities of anthracyclines
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Main toxicity: heart failure (dose-dependent)
myelosuppression mucositis extravasation (blistering, necrosis, requires sx) |
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Differentiation agents for APL
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ATRA
Arsenic trioxide (only w/ shorter QT) |
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Bleomycin is what type of drug?
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antitumor antibiotics (w/ dactinomycin and mitomycin)
|
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MOA of L-asparaginase; toxicity?
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depletes asparaginase, which is needed for ALL growth
check pancreatitis, DIC |
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Toxicity of bleomycin
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pulmonary fibrosis, interstitial pneumonitis
(causes oxygen free radicals) |
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Bortezomib is what type of drug? MOA?
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proteasome inhibitor; disrupts regulatory proteins needed for tumor growth
|
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Toxicities of bortezomib
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fatigue
neuropathy thrombocytopenia |
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MOA of Immunomodulating agents?
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antiangiogenesis (VEGF), also inhibits CAMs
|
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Toxicities of Imids
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neuropathy
thromboembolism constipation |
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Immune based therapies can cause what toxicities?
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flu-like, depression
|
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2 classes of Breast cx therapy
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anti-estrogens
aromatase inhibitors |
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4 classes of prostate cx therapy
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antiandrogens
LHRH agonists (cause tumor flare) GnRH antagonist CYP17 inhibitors |
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4 types of monoclonal antibodies, from least reactive to most reactive
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human (mumab), humanized (umab), chimeric (imab), murine (onab)
|
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Rituximab target?
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CD20 (lymphoma)
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Trastuzumab target?
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Her-2 (breast cx)
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Cetuximab target?
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EGFR (solid tumors)
|
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Bevacizumab target?
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VEGF (solid tumors)
|
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Cetuximab toxicity?
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severe hypersensitivity reaction
acneiform rash (better survival) |
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Bevacizumab toxicity?
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proteinura
GI perforation |
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Acneiform rash present in what two therapies?
|
Tyrosine kinase inhibitors
EGFR directed therapies (like cetuximab) |