Drugs Used in the Treatment of Leukemias/Lymphomas Flashcards

1
Q

Doxorubicin (adriamycin) MOA and toxicity

A

Inhibits Topo 2

Cardio

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2
Q

Bleomycin MOA

A

Causes DNA strand breaks by intercalating…can chelate metals and generate ROS..may target RNA

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3
Q

Bleomycin side effects

A

Allergic runs, skin toxicity, pulmonary firbsosi…due to inflammation and can treat with TNF inhibitor…skin changes due to melanocyte/keratinocyte interaction changes

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4
Q

Paclitaxel MOA and toxicity

A

Arrests MT depolarization

Immunosuppression

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5
Q

Vinblastine MOA, metab

A

Inhibits MT formation
Neuropathy
P450 metab

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6
Q

Dacarbazine side effects and metab

A

Toxic to bone marrow
Modified in by CYP1A1, CYP1A2, and CYP2E1 into active diazomethane form…these have low levels so limit activity in vivo

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7
Q

Targets of ABVD

A

A - topo 2 in G2
B - G2
V - S prevent MT
D - G1 damage directly

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8
Q

Bretuximab use and MOA

A
Second line refractory Hodgkin 
Targets CD30 (which is TNFR and receptor for CD153)
Conjugate of antibody to a mitotic inhibitor called auristatin via a peptide bond...goes into cell and releases auristatin
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9
Q

NHL regiment

A

Cyclophosphamide, doxorubicin, vincristine, prednisone…may also add retixumab and ondansetron

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10
Q

Rituximab

A

Another option for patient with TNF inhibitor restart RA…used with methotrexate

Binds to CD20(cell surface Ca channel needed on B cells) and triggers cell death

Used for Bcell lymphomas

Chimeric

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11
Q

Rituximab side effect, preconditions

A

Immunosuppression

Worried about prior infections

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12
Q

Antibody clearance

A

By RES, lived for 3-12 days

Can be affected by immune system status

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13
Q

CLL tx

A

Nucleoside analog with Cyclophosphamide, vincristine, prednisone, or doxo

Almost identical to NHL

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14
Q

Cytarabine MOA

A

Converted to mono, di, and triphosphate forms…latter is competitive inhibitor of DNA polymerase alpha (primate) and beta (base excision repair)

Also incorporated into RNA and DNA blocking chain elongation

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15
Q

Cytarabine PK/PD ad main use

A

Cleared rapidly and must be continually infused

Only used for hematological cancers because of qukc clearance

Side effects typical for chemo

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16
Q

Asparaginase

A

Used for ALL
Can cause tumor lysis syndrome
Deprive leukemic cells of asparagine that they cannot synthesize

17
Q

ALL tx

A

Methotrexate, cytarabine, vincristine, dexamethasone

18
Q

Blimatumomab

A

Used for ALL

Binding sites for CD3 (T) and CD19 (B)…activates T cell to kill B cell

19
Q

AML tx

A

Cytarabine plus anthracycline

Often get filgastrim as well

20
Q

G-CSF

A

Filgastrim

Enhance neutrophil recovery after chemotherapy

21
Q

CML tx

A

Imatinib

22
Q

MM tx

A

Bortezomib, lenalidomide, dexamethasone

23
Q

Bortezomib MOA

A

Inhibits IkB degradation…IkB inhibits NFkB that is often mutated in MM

Boron on one end and binds to 26s subunit of proteasome
Cleared quick
Neuropathy and myelosuppression…shingles

24
Q

Lenalidomide

A

Used for MM…don’t know mechanism

25
Q

Cyclophosphamide MOA

A

Alkylating agent targets DNA

26
Q

Prednisone MOA

A

Binds glucocorticoid receptors

27
Q

Crizotinib

A

Inhibits ALK