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Combo Chemo
USMLE Step 1
Disease | Drug |
---|---|
Acute Lymphocytic Leukemia (ALL) | 1. Actinomycin & 6-MP, 2. prednisone & vincristine, 3. *Note POMP*: Prednisone, Oncovin, Methotrexate, Purimethol |
Wilms' tumor: congenital kidney tumor that becomes manifest b/t ages 2-5. | dactinomycin & vincristine |
Hodgkin's disease | *Note think MOPP*: Mechlorethamine, Oncovin, Prednisone, Procarbazine |
Prednisone | MOA: steroid that induces lymphocytopenia, also used in lymphomas |
Vincristine | MOA: derived from periwinkles & binds to tubulin prevent MTs from forming, thus - mitosis; ADRs: peripheral neuropathy, phlebitis, alopecia, multiple GI probs; *Note that Oncovin is vincristine* |
Methotrexate | MOA: inhibits dihydrofolate reductase, inhibiting the use of folate and therefore the synthesis of DNA |
Purimethol | ADRs: stomatitis, bone marrow suppression, alopecia, n/v, renal & hepatic damage; *Note another term for 6-MP* |
Dactinomycin | MOA: low concs, - DNA-primed RNA syn by intercalating w/ guanine residues of DNA.higher concs, - DNA syn. Interstrand & DNA-protein cross-links occur.; ADR: tissue necrosis, enhance radiation injury 2 tissues, dont use in pregnancy, chickenpox or h.zoster |
Mechlorethamine | MOA: alkylating agent, guanines in DNA for cross-linking that are removed; ADRs: very severe n/v, extreme bone marrow suppression, herpes zoster and extensive blisters |
Procarbazine | MOA: - both DNA & RNA synthesis; ADRs: bone marrow suppression, disulfiram rxns (blocking of EtOH dehydrogenase leading to acetaldehyde accumulation & sxs of flushing, n/v, etc) & neurotoxicity |
Doxorubicin | ADR: cardiotoxic |
Bleomycin | ADR: pulmonary fibrosis |
Cisplatin | ADR: renal toxicity |
Cyclophophamide | ADR: hemorrhagic cystitis |
L-asparaginase | ADR: allergic rxns |
Cycle-specific drugs | 1. antimetabolites, 2. bleomycin, 3. vinca alkaloids |