Chemotherapy 3 (Proven Q&A for Achieving Top Academic Scores)

methotrexate - Answer antimetabolite; antagonist of folic ac inhi DHFR (can be reversed by leucovorin or 1000 excess of FH2) cycle specific f S-phase acute lymphocitic leukemia, choriocarcinoma, breast bladder cancer, H&N carcinomas, lymphomas (Burkitt) also low dose for Crohn d, sev psoriaris, rheumatid arthritis abso at low doses fr GI, also IM/IV, not readily csf so admin intrathecally. Conct in intesti epi, liv, kidney, ascites, pleural effusions, skin. high doses undergo 7-hydroxylation= less active and less water-solublecrystalluria, m urine excr, sm feces nonprolif c are resistant adv: nvd, myelosupresion, renal damage (ADj f impair), neuro in IT, pulm fibrosis, mucositis interacts: omeprazole, folic ac, warfarin, nsaid, penicilin, cephalosporinstt Hydroxyurea - Answer pemetrexed - Answer antimetabolite; antagonist of folic ac inhi DHFR & thymidilate synthase and other enzymes of DNA syn cycle specific f S-phase mostly non-small cell lung cancer give w folic ac & vitB12 to redu hematologic & gi toxic 2 | P a g e pralatrexate - Answer antimetabolite; antagonist of folic ac inhi DHFR cycle specific f S-phase mostly relapsed or refractory T-c lymphoma give w folic ac & vitB12 to redu hematologic & gi toxic, adv: mucositis (adjust dose) 6-mercaptopurine - Answer remission in ALL, also Crohns d nucleotide formation (cata by HGPRT) inhi purine synthesis (as TMI), incorp into nucleic ac= nonfunct rna/dna erratic incomplete oral, NO Csf, redu by first pass meta, excr by kidney adv: anorexia, BM supression, rash hepatotoxic. if using also Allopurinol (xanthise oxidase inhi), redu dose to prev toxic interact: warfarin allopurinol SMZ/TMP azathioprine - Answer 6-mercaptopurine anolog- blocks purine syn, crohn d fludabarine - Answer purine nucleotide analog, prodrug (must be phosphorylated to a nucleotide), dec syn in S-phase IV (to avoid toxic metabolite), urine excr accounts f partial elim, csf chornic lymphocytic leukemia, hairy c leukemia, indolent non-hodkin lymphoma adv: rash fever edema neurotox immunosupr interacts: cytarabine, cyclophosphamide, pentostatin cladribine - Answer purine nucleotide analog, prodrug (must be phosphorylated to a nucleotide), hinders elongation & dna repair & inhi ribonucleotide reductase- s phase, aff also our cells 3 | P a g e chornic lymphocytic leukemia, hairy c leukemia, non-hodkin lymphoma single continuous infusion, inlu csf adv: fever Teratogenic periphneur immunosupr 5-fluorouracil - Answer pyrimidine analog, contains stable fluorine atom, deprives c of thymidine, in S phase admin w leucovorin (reduced folate coenzyme) IV for slowly growing solid tumors t pancreatic colorectoral, and topicaly f superficial basal c carcinomas rapid meta in kidney-lung-liv, urine excr, inc DPD (varies in popu) can dec its bioava & defi can c sev toxic (pancytopenia mucositosis life-threat diarhea) adv: diarhea sevmucositosis hand-foot syndr(in cont infusion) coronary vasospasm int: methotrexate & other folic ac antag capecitabine - Answer..................