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Oncology II

Specific Cell Cycle Cytotoxic Drugs: Pyrimidine Analog Antimetabolites

What is the MOA of pyrimidine analog antimetabolites? - inhibits the synthesis of pyrimidine
which phase of the cell cycle does pyrimidine analog antimetabolites acts on? - phase S
How dose the pyrimidine analog antimetabolites inhibits the pyrimidine synthesis during S-phase? - TWO active metabolites: 1- F-UMP: incorporate RNA --> replace U ( uracil) --> no cell growth ( fuckup the RNA) 2- 5-DUMP: inhibits thymidylate synthetase ( dump the thymidylate in the trash)
What are the common pyrimidine analog antimetabolites? 1- Fluorouracil ( adrucil) 2- CApecitabine ( prodrug 5-FU) 3- Cytarabine conventional 4- cytarabine liposomal 5- Gemcitabine
fluorouracil ( adrucil) vs. fluorouracil ( efudex) vs. Fluorouracil ( carac, tolak and fluoroplex)? - fluorouracil ( adrucil): conventional - fluorouracil ( efudex): basal cell carcinoma - CREAM - fluorouracil ( carac, tolak, and fluoroplex) -- for actinic keratosis - GEL
What is the role of leucovorin when given with fluorouracil? - enhance the efficacy of 5-FU via 5-FU binds tightly to the target enzyme ( thymidylate synthetase)
Which medication enhance the binding affinity of 5-FU to the targeted enzymes ( thmidylate synthetase) ? - Leucovorin
What is a RIKS factor that increases the potential of 5-FU and capecitabine toxicity? DPD deficiency ( Di-hydropyrimidine dehydrogenase)
When is the use of Capecitabine tablet is C/I ? - renal impairment CrCL < 30
what are some major clinical factors Capecitabine been associated with? (BBW) - increases the INR during the tx + 1 month after d/c treatment (BBW)
What are some common monitoring parameters for Capecitabine? whats the rational? SCr: C/I < 30 ml/min INR: increases the pt INR
What is the drug of choice to manage 5-FU or Capecitabine induced toxicity in patient with DPD deficiency? - give uridine triacetate 1- overdose 2- early toxicity
Which pyrimidine analog antimetabolites associated with FLU-LIKE sxs? - cytarabine and gemcitabine
which pyrimidine analog antimetabolites the infusion rate AFFECTS it's efficacy and toxicity? - Gemcitabine - PK affects PD
What is the route of Administration of Cytarabine liposomal? IT: intrathecal administration
which pyrimidine analog antimetabolites associated with chemical arachnoiditis? cytarabine liposomal IT administration
What are some consideration for managing cytarabine liposomal IT induced arachnoiditis? - Give dexamethasone FYI: arachnoiditis : pain disorders 2/2 to inflammation of the arachnoid that protects and surrounds the spinal cord>
describe cytarabine syndrome? Flu like sxs: 1- fever 2- bone pain 3- rash 4- myalgia
which pyrimidine analog antimetabolites associated with cardiotoxicity? - fluorouracil - capecitabine
which pyrimidine analog antimetabolites doesn't induce HAND AND FOOT SYNDROME? ALL EXCEPT Gemcitabine
which pyrimidine analog antimetabolites associated with photosensitivity? - fluorouracil - capecitabine
which pyrimidine analog antimetabolites associated with hepatotoxicity? - All except fluorouracil and capecitabine
which pyrimidine analog antimetabolites associated with pulmonary toxicity? - All except fluorouracil and capecitabine
which pyrimidine analog antimetabolites have BBW for Myelosuppression & hepatotoxicity? Cytarabine and gemciabine
which pyrimidine analog antimetabolites has BBW for pulmonary toxicity ? Gemciabine ( gym and inhaling toxic)
which pyrimidine analog antimetabolites induces conjunctivitis? Cytarabine tx with steroid eye drop
BBW that is specific for gemcitabine vs cytarabine vs. liposomal cytarabine? pulmonary toxicity vs. GI vs. arachnoiditis
which pyrimidine analog antimetabolites we use steroid in conjunction to tx side effects? cytarabine : - conjunctivitis - arachnoiditis
Created by: Smoham38



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