Chemotherapy for Leukemia and Lymphoma Pharmacology

  1. S Phase specific drugs:
    • Hydroxyurea
    • Methotrexate (self-limiting)
  2. M phase specific drug:
  3. Cell cycle non-specific drugs:
    Alkylating drugs
  4. G2 phase drug:
  5. Tyrosine Kinase inhibitors:
    Imatinib and Dasatinib
  6. Alkylating agent:
  7. Mechanism of action for Cyclophosphamide
    Alkylation of N7 guanine
  8. Therapeutic indication for cyclophosphamide:
    Solid tumors leukemia, lymphomas
  9. Which drug has High oral bioavailability and Bioactivation by the liver?
  10. Which drug produces cytotoxic metabolite that leads to hemorrhagic cystitis?
  11. ADR of cyclophosphamide?
    • N/V
    • Hemorrhagic cystitis
  12. What is Mesna?
    A chemoprotectant given with cyclophosphamide to protect bladder by binding toxic metabolites
  13. What are the two drugs that need to be used together to prevent hemorrhagic cystitis due to formation of cytotoxic metabolite Acrolein?
    Cyclophosphamide and IV Mesna
  14. _______ produces a cytotoxic metabolite called ______ and so the use of _______ in combination with said drug is recommended
    • Cyclophosphamide
    • Acrolein
    • IV Mesna
  15. ADR of Mesna?
    • GI complaints
    • Abd pain, diarrhea
    • Lack of strength
  16. Bleomycin targets _____ phase, and its MOA is:
    • G2
    • MOA: induce free radicals via iron interacting with O2 causing DNA damage
  17. Therapeutic indications for bleomycin:
    Hodgkin/ Non-Hodgkin lymphoma
  18. Bleomycin can be given in _____ form(s)
    IM, IV
  19. ADR of bleomycin:
    • Allergic reaction
    • PULMONARY FIBROSIS (dose-limiting ADR)
  20. Which drug can cause pulmonary fibrosis and thus need to be dose limited?
    Bleomycin (G2 phase specific)
  21. T/F: Methotrexate is an antimetabolite/ anti-folate, that is S phase specific
    True; interfere with DNA synthesis
  22. MOA of methotrexate:
    Competitively inhibits dihydrofolate reductase
  23. Therapeutic indications for methotrexate?
    • acute lymphoblastic leukemia (ALL)
    • Lymphoma
  24. ROA for methotrexate:
    Oral, IV, intrathecal
  25. ADR for methotrexate:
    • Myelosuppression
    • Mucositis
  26. Which drug can cause myelosuppression:
    • Methotrexate
    • Hydroxyurea
    • Vincristine
    • etoposide
  27. Hydroxyurea is an _____
  28. MOA of hydroxyurea
    Inhibit ribonucleotide reductase (convert nucleotides to deoxynucleotide)
  29. Which drug’s MOA is to inhibit ribonucleotide reductase?
  30. Therapeutic indications for hydroxyurea:
    • Polycythemia vera
    • Leukemia
    • Sickle cell anemia
  31. Which drug can also be used to treat sickle cell anemia in addition to leukemia?
  32. Which drug can also be used to treat polycythemia vera in addition to leukemia?
  33. Hydroxyurea is given _______
  34. ADR for hydroxyurea:
    • Myelosuppression
    • Malignancy
  35. Which drug can have a side effect of malignancy?
  36. What is the therapeutic indications for leucovorin?
    “rescue” methotrexate toxicity
  37. What is a reduced form of folic acid:
    Leucovorin (calcium folinate)
  38. In case of methotrexate toxicity, what is the rescue drug used?
  39. Leucovorin ROA:
    Oral, IV, IM
  40. ADR for leucovorin (Rescue methotrexate):
    • Allergic reaction
    • Urticaria
    • Anaphylactoid reactions
  41. MOA of vincristine:
    Inhibit tubulin polymerization
  42. Which type of drug prohibits the formation of microtubules and mitotic spindles formation?
    Vinca alkaloids (agent: vincristine)
  43. Therapeutic indication for vincristine?
    • solid tumor
    • Leukemia
    • HL and NHL
  44. T/: Vincristine is given IV only
  45. ADR of vincristine:
    • Peripheral neuropathy
    • Myelosuppression
  46. Which drug can cause peripheral neuropathy:
  47. MOA of tyrosine kinase inhibitors:
    Inhibit tyrosine kinase activity of BCR-ABL oncoprotein
  48. Therapeutic indications for tyrosine kinase inhibitor (imatinib) :
    • CML
    • Philadelphia chromosome positive ALL
  49. ADR for imatinib:
    • GI
    • Fluid retention
    • CHF
    • Myalgia
  50. Which drug is indicated for CML and Ph+ ALL
  51. Which leukemia drug can cause CHF and Fluid retention as a side effect:
  52. MOA of etoposide:
    Inhibit topoisomerase which inhibits DNA synthesis and function
  53. Which type of drug inhibits topoisomerase?
  54. Therapeutic uses for etoposide:
    • HL and NHL
    • Gastric cancer
    • Lung cancer
  55. T/F: etoposide oral form is twice as potent as its IV form, which only has 50% bioavailbility
    False; oral only 50% bioavailable while IV is twice as strong
  56. ADR of etoposide?
    • N/V
    • Myelosuppression and alopecia
  57. Which drug can lead to alopecia?
  58. For HL or NHL, use:
    • Bleomycin
    • Vincristine
    • Etoposide
Card Set
Chemotherapy for Leukemia and Lymphoma Pharmacology
HemeOnc Midterm 2