med chem III test IV cancer

  1. epithelial origin
  2. connective or muscle origin
  3. lymphatic tissue
  4. hematopoetic origin
  5. muscle tissue
  6. solid tumor; adrenal gland
  7. skin pigment cells
  8. 2 STD risk factors linked to cancer
    • chlamydia trachomatis
    • human papillomaviruses
  9. most common disease related problem encountered with antineoplasics
    tumor lysis syndrome
  10. alkylating agent
    nitrogen mustard
    least toxic 
    use contraception
    chlorambucil - leukeran
  11. alkylating agent
    nitrogen mustard
    uses 17-beta-estradiol for delivery
    phosphate group solubilizes the agent for rapid hydrolyzation
    do not take with calcium containing drugs
    estramustin - emcyt
  12. alkylating agent
    nitrogen mustard
    prodrug - CYP 450 mediated
    SE due to acrolein (bladder inflamm)
    cyclophosphamide - cytoxan
  13. alkylating agent
    nitrogen mustard
    ifosfamide - ifex
  14. alkylatig agent
    nitrogen mustard
    extravasation a problem
    injection only
    mechlorethamine - mustargen
  15. alkylating agent
    nitrogen mustard
    analog of DNA
    adjust dose to BUN
    known to cause chromosome abnormalities
    melphalen - alkeran
  16. alkylating agent
    ind - hodgkins and non-hodgkins
    injection or wafer
    carmustine - BiCNU
  17. alkylating agent
    ind - brain tumors
    highly lipid soluble
    lomustine - CeeNu
  18. alkylating agent
    highly renal toxic
    no known antidote
    streptozocin - zanosar
  19. how do you treat extravasation of a ziradinium
    ice packs & infuse 0.16 sodium sulfate
  20. alkylating agent
    palliative treatment
    used for bone marrow ablation (infuse and it migrates)
    can cause hyperuricemia (allopurinol)
    busulfan - myleran
  21. alkylating agent
    oral based on body surface area
    altretamine - hexalen
  22. alkylating agent
    IV only (oral - eradicate absorption)
  23. compounds that prevent the biosynthesis or use of normal cellular metabolites
  24. 3 naturally occuring purines
    • guanine
    • adenine
    • hypoxanthine
  25. antimetabolite
    folic acid antagonist
    MOA - inhibit dihydrofolate reductase & thymidylate synthase 
    do not take with food
    yellow skin
    methotrexate - trexall
  26. methotrexate overdose therapy
    • leucovorin rescue
    • carboxypeptidase G2 - voraxaze
  27. antimetabolite
    folic acid anatagonist
    no back diffusion = decreased toxicity
    pemetrexed - alimta
  28. antimetabolite
    folic acid antagonist
    fast tracked - new for 2009
    pralatrexate - folotyn
  29. reduces anemia in ppl taking dapsone
    decreases bone marrow tox used in combo with trimetrexate
    combo in chemotherapy with methotrexate
    levoleucovorin - fusilev
  30. 3 naturally occuring pyrimidine
    • cytosine
    • thymine
    • uracil
  31. MOA of pyrimidine analogs
    • synthesis disruption
    • disrupt nucleic acid function
    • prodrugs
  32. antimetabolite
    pyrimidine analog
    MOA - inhibts thymidylate synthetase
    suicide substrate
    IV only
    metabed by DPD
    • fluorouracil
    • topical - efudex
  33. antimetabolite
    pyrimidine analog
    prodrug converted to 5-FU
    SE hand and foot painful swellig
    DI with warfarin
    capectiabine - xeloda
  34. antimetabolite
    analogue of 2' deoxycytidie
    ind - myelodysplasitc syndrome
    decitabine - dacogen
  35. antimetabolite
    purine analog
    MOA - competes with hypoxanthine and guanine
    many many drug interactions = increase tox
    long term use can increase risk of cancer
    mercaptopurine - purinethol
  36. how is 6-mercaptopurine inactivated
    methylated by thiopurine methyltransferase (TPMT)
  37. mitotic inhibitor
    MOA - inhibits tubulin causing random chromosome distribution
    SE - peripheral neuropathy
  38. antimitotic
    forms spiral aggregates
    most active of two
    metabolized by 3A4
  39. antimitotic
    forms spiral aggregates
    irreversible inhibition of mitosis
    metabolized by 3A4
  40. MOA  and metab of taxoids
    • spindle poison - promote assembly of microtubules and stabilize them such that depolymerization can not occur
    • CYP3A4
  41. antimitotic
    derived from pacific yew tree
    24 hour infusion
    SE hypersensitivity
    paclitaxel - taxol
  42. antimitotic
    derived from pacific yew tree
    24 hour infusion
    SE hypersensitivity
    second line in metastatic breast cancer
    combo with 5-FU and cisplatin
    metab by CYP3A4
    monitor bilirubin levels
    docetaxel - taxotere
  43. antimitotic
    semi-synthetic analog of Epothilone B
    special diluent, contains ethanol
    moa similar to taxoids
    IV dosing based on skin surface area
    ixabepilone - ixempra
  44. antimitotic
    semisynthetic marine sponge
    IV drug 
    moa - inhibition of growth phase w/o affecting the shortening phase
    eribulin - HALAVEN
  45. intracalating agent
    anti-malaral agent
  46. anti-tumor antibiotics MOA
    • cytotoxic intercalation
    • disrupts triplet codons
    • reacts with DNA bases
    • non-cycle specific
  47. 5 types of antitumor antibiotics
    • actinomycins
    • anthracycline
    • bleomycin
    • mitomycin
    • other
  48. antibiotic
    pee and sweat will turn dark red
    IV only
    not bioequivalent forms
    doxorubicin -
  49. liposomal form of doxorubicin with less toxicity
  50. what can be added to anthracyclines to plug the pumps
  51. antibiotic
    Cu chelating peptide
    minimal myelosupression - good one to add to decrease infection
    SE - pulmonary fibrosis
    off label - plantar warts
  52. antibiotic
    crosslinks guanine and cytosine
    IV only
    natural product
    mitomycin - mitosol
  53. antibiotic
    extremely corrosive to soft tissue
    natural product
    ind - wilm's tumor, ewing's sarcoma
    dactinomycin - cosmegen
  54. antibiotic
    also used in the Tx of MS
    urine will be a blue-green color
    IV only
  55. platinum complexes
    non cycle specific
    potentcy is a function of hydration
    don't use with Al
    sever vomitting
    • carboplatin - less vomitting
    • cisplatin
    • oxaliplatin
  56. substituted methylhydrazine
    ind - hodgkins
    moa - inhibits transmethylation by methionine
    initial Tx should be in hospital
    procarbazine - matulane
  57. imidazotetrazine
    prodrug producing MTIC
    ind - refractory anaplastic (brain) astrocytoma
    temozolomide - temodar
  58. ribonucleotide reductase inhibitor
    very underprescribed for sickle cell disease
    hydroxyurea - hydrea
  59. topoisomerase II inhibitor
    G2 specific
    isolated form podophyllum peltatum
    CYP3A4 to active form
    ind - refractory testicular & small cell lung
    etoposide - etopophos
  60. topoisomerase II inhibitor
    G2 & S specific
    isolated form podophyllum peltatum
    CYP3A4 to active form
    ind - refractory testicular & small cell lung
    teniposide - vumon
  61. topoisomerase I inhibitor
    isolated from bark of camptothecal acuminata
    pentacyclic quinoline alkaloid
      high cytotoxic
      poor solubility
      subject to hydrolysis
  62. topoisomerase I inhibitor
    combo with 5-FU and leucovorin for colon/rectal refractory cancer
    hepatic metab to a 2000X more active metabolite
    polymorphism UGT1A1*28 = increased risk of neutropenia
    irinotecan - camptosar
  63. anti-androgen 
    moa - non-steroidal competitive inhibitor
    must be taken in combo with LHRH
    racemic - R active
    SE - gynecomastia
    ind - advanced prostate cancer
    bicalutamide - casodex
  64. anit-androgen 
    moa - inhibits cellular uptake to testosterone and inhibits muclear binding to receptors
    ind - surgical castration of prostate
    nilutamide - nilandron
  65. progestin 
    moa - anti-leutinizing effect mediated by the pituitary gland
    off label - appetite stimulant in HIV
    ind - pallitive Tx, carcinoma of breast or endometrium
    megesterol - megace
  66. progestin
    moa - inhibits secretion of pituitary gonadotropin
    ind - adjunct and pallative of inoperable endometrial cancer
    long acting contraceptive via IM injection
    medroxyprogesterone - Dep-Provera
  67. GnRH analog
    moa - decrease androgen production in testes ind - advanced prostate cancer when estrogen dependent
    leuprolide - lupron
  68. polymeric matrix formulation of lupron for injection dosing
    every 3 months for sex offenders
  69. GnRH analog
    moa - receptor antagonist
    sub Q only
    prolongs QT interval
    new for 2009
    degarelix - firmagon
  70. anti-estrogen
    DOC for breast cancer
    moa - non-steroidal that competes with estradiol for receptors
    hepatic metab by CYP2D6
    resistance develops
    tamoxifen - soltamox
  71. anti-estrogen
    IM once monthly
    steroidal estrogen antagonist
    moa - down regulates estrogen receptor
    ind - use for tolerance to tamoxifen
    fulvestrant - faslodex
  72. aromatase inhibitor
    DOC for advanced breast cancer not responding to tamoxifen
    reversible competitive inhibitors
    postmenopausal women
    no endometrial cancer connection
    • letrozole - femara
    • anastrozole - arimidex
  73. aromatase inhibitor
    DOC for advanced breast cancer not responding to tamoxifen
    suicide substrate
    postmenopausal women
    no endometrial cancer connection
    exemestane - aromasin
  74. radiopharmaceutical
    ind - selected cases of thyroid cancer or Tx of hyperthyroidism
    moa - 90% beta and 10% gamma
    sodium iodide 131 - hicon
  75. radiopharmacetical
    ind - thyroid evaluation, short acting imaging
    moa - electron capture decay
    sodium iodide 123
  76. radiopharmaceutical
    ind - painful skeletal metastatic disease
    IV only
    moa - beta particle emission
    warning - use a normal toilet to prevent spread of radiation the first week following therapy
    strontium - 89 chloride - metastron
  77. brachytherapy
    contains either iodine 125 or palladium 103
    pharma seed
  78. cytoprotective
    ind - reduction of cumulative renal toxicity associated with 1) platinum based drugs 2) reduction of xerostomia due to irradiation 3) protects lung fibroblasts from taxol toxicity
    moa - scavenger prodrug
    amifostine - ethyol
  79. cytoprotective agent
    ind - reduction of cardiomyopathy associated with doxorubicin therapy, extravasation
    moa - prodrug of EDTA that prevents ferric iron free radicalization
    use only with anthracycline type anti-neoplastic agents
    • exrazoxane - zinecand
    • totect?
  80. cytoprotective agent
    ind - ifosfamide and cyclophosphamide induced hemorrhagic cystitis
    moa - thiol group scavenges the reactive urotoxic metabolit (acrolein)
    mesna - mesnex
  81. retinoid
    ind - induction of remission of acute leukemia containing the PML/RARa gene
    moa - induces maturation of promyelocytes
    tretinoin - absorica
  82. retinoid
    ind - cutaneous T-cell lymphoma
    moa - promotes cellular differentiation and proliferation
    bexarotene - targretin
  83. protein -tyrosine kinase inhibitor
    ind - most effective in chronic myeloid leukemia
    metab - CYP3A4
    SE - fluid retention and edema,
    CI - breast feeding
    imatinib - gleevec
  84. protein synthesis inhibitor
    ind - Tx of adults with chronic or accelerated phase chronic myeloid leukemia (CML)
    SE - myelosuppression, hyperglycemia, embryo-fetal toxicity
    omacetaxine mepesuccinate - synribo
  85. protein serine/threonine kinase inhibitor
    ind - advanced renal cell carcinoma
    moa - mTOR kinase inhibitor, arrests G1 phase and decreases expression of VEGF
    infusion only agent
    pretreat with anti-histamines
    temsirolimus - torisel
  86. protein serine/threonine kinase inhibitor
    ind - advanced renal cell carcinoma
    moa - mTOR kinase inhibitor, arrests G1 phase and decreases expression of VEGF
    DI - p glyco p pumps inhibitors
    no live virus immunizations
    monitor for oral ulcers, infections
    everolimus - afinitor (zortress)
  87. moa - PML-RARa inhibitor
    ind - refractory acute promyelocytic leukemia (APL)
    orphan drug
    monitor ECG
    trisenox - arsenic trioxide - As2O3
  88. ind - multiple myeloma pts who have failed at least 2 prior therapies
    moa - reversible inhibitor of the  26s proteosome
    bortezomib - velcade
  89. moa - tetrapeptide epoxyketone proteasome inhibitor
    ind - multiple myeloma
    kyprolis - carfilzomib
  90. moa - hedge hog pathway inhibitor
    ind - metastic basal cell carcinoma
    BBW - both sexes tetratogenic
    do not donate blood for at least 7 months after last dose
    vismodegib - erivedge
  91. histone deacytylase inhibitor
    contains hydroxamic acid
    ind - cutaneous manifestations of T-cell lymphoma (CTCL)
    metab - beta oxidation and glucoronidation
    DI - coumarin derivatives
    SE - GI, QT prolongaton
    vorinostat - zolina
  92. histone deacytylase inhibitor
    cyclic depsipeptide

    ind - cutaneous manifestations of T-cell lymphoma (CTCL)
    metab - beta oxidation and glucoronidation
    DI - coumarin derivatives
    SE - GI, QT prolongaton
    IV agent, cyclic depsipeptide
    romidepsin - istodax
  93. oxidative stress inducer
    orphan drug
    ind - metastatic melanoma
  94. moa - inhibitor of CYP17
    ind - prevention of testosterone who have failed docetaxel therapy
    abiraterone - zytiga
  95. ind - esophageal cancer
    photodynamic therapy
    moa - superoxide and hydroxide radical causing tissue and tumor death
    last resort drug for palliative Tx
    porfimer - photofrin
  96. ind - Tx inoperable adrenocortical carcinoma
    moa - suppresses adrenal function and production of adrenal steroids
    palliative Tx and last resort because of brain damage and depression
    mitotane - lysodren
  97. ind - ALL
    moa - hydrolysis of L-asparagine
    increases half life to increase metabolism
    PEG-L-asparaginase - oncaspar
  98. moa - increases the proliferation of fast growing cells
    SE - white fuzzy tongue growth
    keplvance - palifermin
Card Set
med chem III test IV cancer
med chem III test IV cancer