Chemotherapy

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Indications for 5-Fluorouracil: Solid tumors:
Colon + rectal, breast, head and neck, cervix
What are the toxicities of 5-FU?: Myelosuppresson; Diarrhea; palmar-plantar erythema (uncommon unless w/ continuous infusion); Mucositis; Hyperpigmentation, Increased sensitivity to the sun; Horrible toxicity in patients with enzyme def. like dihydrofluororeducatse def. (rare)
Indications for methotrexate: Osteosarcomas, lymphomas, breast cancer, leptomeningeal disease (can be tolerated in patient's spinal cord)
Rheum: RA and psoriatic arthritis
What are the toxicities of methotrexate?: Mucositis (can be fatal, administer w/ leucovorin to decrease severity); Diarrhea; Arachnoiditis. Accumulates in 3rd space - do not give in ascites or effusion
What is the mechanism of 5-FU?: Anti-metabolite. Inhibition of thymidylate synthetase; incorporation of FUTP into RNA and DNA
What is the mechanism of methotrexate?: Anti-metabolite; inhibits the folic acid pathway , specifically dihydrofluororeductase-mediated conversion of FH2 to FH4, necessary for generation of purines
What are the mechanism and indications for gemcitabine?: Anti-metabolite.
Pancreatic cancer.
What is the mechanism of doxorubicin (adriamycin)?: Topisomerase II inhibitor --> breaks in genomic DNA, intercalates DNA --> blocks DNA synthesis and transcription
What tumors is doxorubicin used for?: Breast (best drug), sarcomas, uterine, lymphomas, leukemias.
What are the toxicities of doxorubicin?: Hair loss (head only); Nausea & vomiting; Potential cardiotoxicity; Myelosuppression; Mucositis; Radiation recall; Hyperpigmentation; Pigmented secretions (rare). Admin in liposomal form (Doxil) helps decrease toxicity (cardiotoxicity, myelosuppression)
What is the mechanism of cisplatin?: Alkylating agent
What are the indications for cisplatin?: *Testicular, *lung, sarcoma, head & neck, cervix, bladder, *ovarian (key drug).
What are the toxicities of cisplatin?: Poorly-tolerated: Nephrotoxicity (give with mannitol); Neurotoxicity --> peripheral neuropathy; Ototoxicity (high frequency loss at high doses); ***Nausea & vomiting (affects everybody); Severe electrolyte imbalances (hypomagnesia, hypokalemia)
What is the mechanism of dacarabazine?: Alkylating agent
What are the indications of dacarbazine?: *Melanomas, sarcomas, Hodgkin's disease (rare)
What are the toxicities of dacarbazine?: Myelosuppression; Nausea & vomiting
What is the mechanism of cyclophosphamide?: Alkylating agent
What are the indications of cyclophosphamide?: Breast, lymphomas, lung (now 2nd line), ovary, bladder

Lupus
What are the toxicities of cyclophosphamide?: Hair loss; Myelosuppression; Nausea & vomiting; **Hemorrhagic cystitis (protected w/ admin of mesna)
What is the mechanism of taxanes?: Stabilizes microtubules. Inhibits depolymerization, which prevents disassembly and stabilizes the spindles into position
What are the indications for taxanes?: Breast, lung, head & neck, ovarian
What are the toxicities of taxanes?: *Peripheral neuropathy; *Complete alopecia, Myelosuppression, Peripheral edema; Hypersensitivity reactions. Different side effects depending on how long or short drug infused.
What is the mechanism of etoposide?: Topoisomerase II inhibitor --> arrests cell in late S-G2 phase
What are the indications for etoposide?: Small cell lung cancer, testicular, lymphoma, AML, Kaposi's, osteosarcoma, neuroblastoma
What is the mechanism of topotecan and irinotecan?: Inhibition of topoisomerase I --> DNA damage
What are the toxicities of Topotecan?: Myelosuppression
What are the toxicities of irinotecan?: Diarrhea
What is the mechanism of vinca alkaloids (vincristine, vinblastine)?: Binds tubulin, inhibiting polymerization --> disrupts mitosis --> cell death
What are the toxicities of vinca alkaloids?: Peripheral neuropathy
Myelosuppression (vinblastine only)
What are the indications of topotecan? Irinotecan?: Topo - ovarian
Irino - colon
What are the indications for vinca alkaloids?: Leukemia, lymphoma, Wilms, neuroblastoma, brain, rhabdomyosarcoma, breast, bladder cancer
What is the mechanism of hydroxyurea?: Inhibits ribonucleotide reductase --> impaired DNA synthesis
What are the indications for hydroxyurea?: CML, HIV
What is the mechanism of flutamide?: Competative antagonist of androgen receptor.

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Number of cards 34