Term
| MOA for cyclophosphamide? |
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Definition
-bifunctional alkylating agent that preferentially alkylate N-7 of guanine base which interferes with DNA replication by forming intrastrand and interstrand DNA cross links
-first activated by P450 microsomal enzymes |
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Term
| Is cyclophosphamide CCNS or CCS? |
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Definition
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Term
| Which alkylating agents are CCNS? |
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Definition
| Cyclophosphamide, Ifosphamide, Temozolomide, Cisplatin, Carboplatin, Oxaliplatin |
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Term
| Which alkylating agents are M-phase specific? |
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Definition
| Vincristine, Vinblastine, Vinorelbine, Paclitaxel, albumin-bound Paclitaxel, Cabazitaxel, Docetaxel |
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Term
| Which alkylating agents are G1-S phase specific? |
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Definition
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Term
| What are the SE of cyclophosphamide? |
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Definition
| Nausea, vomiting, hair loss, myelosuppression, hematuria (mitigate by administering drug in the morning, frequent urination and maintain hydration) |
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Term
| Define the utility of mesna when administered with an alkylating agent. |
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Definition
| Cyclophosphamide and ifosphamide are coadministered with mesna to prevent hemorrahagic cystits. Mesna is an inactive dimer in the blood and cells. In the urine, mesna is an active monomer that binds to alkylating agent species in the urine preventing their toxic effect on urothelium. |
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Term
| Which platin drug is dose-limited by renal toxicity? How can this be avoided? |
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Definition
cisplatin
-give a saline/mannitol diuresis (chloruresis) before administering |
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Term
| Which platin drugs are not renal toxic? |
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Definition
| carboplatin and oxaliplatin |
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Term
| Which platin drug causes hypomagnesemia? |
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Definition
|
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Term
| Which platin drug causes CN VIII damage leading to high freq hearing loss? |
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Definition
|
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Term
| Which platin drug has a unique dose calculation? |
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Definition
carboplatin
Dose(mg) = AUC x (GFR+25) |
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Term
| What platin drugs are dose limited by myelosuppression? |
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Definition
| carboplatin and oxaliplatin |
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Term
| What platin drug causes sensory neurotoxicity - both acute cold induced neuropathy and chronic sensory neuropathy? |
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Definition
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Term
| What is the MOA of vincristine? |
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Definition
inhibits mitotic spindle formation in the M-phase
"microtubules are the VINes of your cells" |
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Term
| What is the MOA of paclitaxel? |
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Definition
prevents breakdown of the mitotic spindle in the M-phase
"it is TAXing to stay polymerized" |
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Term
| What is the MOA of etoposide? |
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Definition
| Inhibits topoisomerase II causing DNA strand breakage in G1-S phase |
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Term
| What is the most common side effect of vincristine? |
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Definition
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Term
| What alkylating agent can cause hyponatremia due to stimulation of ADH release? |
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Definition
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Term
| What chemo drug is associated with increased incidence of leukemia at doses >2gm/M2? |
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Definition
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Term
| What is the dose limiting SE of paclitaxel? |
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Definition
|
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Term
| What is the dose limiting SE of etoposide? |
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Definition
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Term
| What chemo agent can cause severe hypersensitivity rxns & pts receiving this drug must be premedicated with steroids, diphenhydramine and an H2 blocker? |
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Definition
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Term
| What alkylating agents require dose modification dur to renal insufficiency or jaundice? |
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Definition
vincristine -- do NOT give with hepatic damage/signs of jaundice
Paclitaxel -- dec dose with hepatic dysfunction
Etoposide -- dec dose with hepatic or renal dysfunction |
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