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50 Cards in this Set
- Front
- Back
Mechanism of Methotrexate
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S phase specific; folic acid analog inhibits DHF reductase (decr dTMP and DNA/protein synth)
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Clinical use of methotrexate
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Leukemias, lymphomas, choriocarcinoma, sarcomas
Abortion, ectopics pregnancy, RA, psoriasis |
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Toxicity of methotrexate
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Myelosuppression, reversible w/leucovirin
Macrovesicular fatty change in liver Mucositis |
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Mechanism of 5-fluorouracil
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S phase specific antimetabolite
Pyrimidine analo bioactivated by 5-F-dUMP which covalently complexes folic acid This complex inhibits thymidylate synthase |
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Clinical use of 5FU
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Colon cancer/other solid tumors
Basal cell carcinoma (topical) Synergy with MTX |
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6-mercaptopurine (6-MP) mechanism
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Blocks de novo purine synthesis; activated by HGPRTase
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Clinical use of 6 mercaptopurine
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Leukemias/lymphomas (not CLL or Hodgkins)
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Toxicity of 6 mercaptopurine
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Bone marrow, GI, liver
Metabolized by xanthine oxidase so incr toxicity with allopurinol |
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Mechanism of cytarabine
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Inhibits DNA polymerase
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Clinical use of cytarabine
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AML, ALL, high grade NHL
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Toxicity of cytarabine
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Leukopenia, thrombocytopenia, megaloblastic anemia
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Mechanism of cyclophosphamide, ifosfamide
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Alkylating agents; covalently x link (interstrand) DNA at guanine N-7. Requires bioactivation by liver.
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Clinical use of cyclophosphamide
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NHL
Breast and ovarian carcinomas Immunosupression |
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Mechanism of nitrosoureas (carmustine, lomustine, semustine, streptozocin
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Alkylate DNA
Require bioactivation Cross BBB |
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Clinical use of nitrosoureas
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Brain tumors (incl GBM)
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Toxicity of nitrosoureas
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CNS toxicity (dizziness, ataxia)
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Cisplatin, carboplatin mechanism
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Cross link DNA
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Clinical use of cisplatin, carboplatin
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Testicular, bladder, ovary, and lung carcinoma
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Toxicity of cisplatin
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Nephrotoxicity, acoustic nerve damage
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Busulfan mechanism
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Alkylates DNA
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Clinical use of busulfan
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CML
Also ablate bone marrow in BMSCT patients |
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Toxicity of busulfan
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Pulmonary fibrosis, hyperpigmentation
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Doxorubicin, daunorubicin mechanism of action
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Generate free radicals and noncovalently intercalate in DNA 9create breaks to decr replication)
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Clinical use of doxorubicin
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Part of ABVD combo for Hodgkin's
Myelomas Sarcomas Solid tumors |
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Toxicity of doxorubicin
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Cardiotoxicity
Myelosuppression Marked alopecia |
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Dactinomycin mechanism
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Intercalates in DNA
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Clinical use of dactinomycin
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Wilm's tumor
Ewing's sarcoma Rhabdomyosarcoma |
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Toxicity of dactinomycin
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Myelosuppression
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Mechanism of bleomycin
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Induces formation of free radicals which cause breaks in DNA
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Clinical use of bleomcin
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Testicular cancer
Hodgkin's lymphoma |
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Toxicity of bleomycin
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Pulmonary fibrosis
Skin changes MINIMAL myelosuppression |
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Etoposide mechanism of action
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G2 phase specific agent aht inhibits topoisomerase II and incr DNA degradation
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Clinical use of etoposide
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Small cell carcinoma of lung/prostate/testicular carcinoma
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Toxicity of etoposide
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Myelosuppression, GI irritation, alopecia
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Prednisone mechanism of action
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May trigger apoptosis
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Clinical use of prednisone
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Most commonly usedglucocorticoid used in cancer chemo
Used in CLL, hodgkin's (MOPP regimen) Also used in autoimmune diseases |
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Mechanism of tamosifen, raloxifene
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SERMs-receptor antagonists in breast, agonists in bone, block binding of estrogen to estrogen receptor positive cells
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Clinical use of tamosifen, raloxifene
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Breast cancer, also useful to prevent osteoperosis
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Toxicity of tamoxifen, raloxifene
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Tamoxifen may incr risk of endometrial carcinoma via partial agonist effects "hot flashes"
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Trastuzumab mechanism
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Monoclonal antibody against HER-2 helps kill breast cancer that overexpressed possibly due to antibody dependent cytotoxicyt
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Clinical use of trastuzumab
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Metastatic breast cancer
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Mechanism of imatinib
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Philadephila chromosome tyrosine kinase inhibitor
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Clinical use of imatinib
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CML
GI stromal tumors |
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Toxicity of imatinib
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Fluid retention
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Mechanism of vincristine, vinblastin
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M phase specific alkaloids that bind to tubulin and block polymerization of microtubules so that mitotic spindle cannot form
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Clinical use of vincristine
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MOPP regimen for Hodgkin's
Wilm's tumor Choriocarcinoma |
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Toxicity of vincristine/vinblastine
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Vincristine-neurotoxicity, paralytic ileus
Cinblastine does bone marrow suppression |
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Mechanism of palitaxel/other taxols
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M phase specific
Bind to tubulin and hyperstabilizie polyerized tubules so that the mitotic spindle cannot break down (anaphase cannot occur) |
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Clinical use of paclitaxel
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Ovarian and breast carcinoma
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Toxicity of paclitaxel
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Myelosuppression and hypersensitivity
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