Here are some amazing summaries for more advanced biology courses at Temple. They definitely helped me succeed and get into medical school. Great outlines, mnemonics, detailed study guides.
Dr. Yesudas Review Session: Anti-Neoplastic Drugs 2 or 3 questions over slides 9 & 10, anthracyclines, non-anthracyclines o Know the rescue agents Dexrazoxane for -rubicins Mesna/2-Mercapto Ethane Sulphonate sodium for cyclophosphamide/ifosfamide Leucovorin for methotrexate o Know irritants vs. vesicants Irritants: damage occurring inside blood vessels (ex: cisplatin, bleomycin) Vesicants: damage occurring outside blood vessels (ex: rubicins, nitrogen mustards) o Rubicins & nitrogen mustards are DNA-binding agents o Anthracyclines (-rubicins) MOA: intercalate b/w DNA bases Rubicins cause irreversible cardiotoxicity & irreversible necrosis due to extravasation o Non-anthracyclines (bleomycin) MOA: fragmentation of DNA by targeting phosphodiester bonds Bleomycin inhibits G2 phase Major AEs of dermal toxicity & pulmonary toxicity due to low bleomycin hydrolase in those tissues Camptothecins (-tecan): target Topoisomerase I o Know everything about Irinotecan b/c will have 1 exam question & 1 final question Prodrug that is converted to SN-38 diarrhea major AE Screen for UGT1A1 fxn before administration Podophyllotoxins (-side): target Topoisomerase II Vinca alkaloids (vincristine/vinblastine) MOA: inhibit microtubule formation Taxanes (-taxel) MOA: inhibit microtubule disassociation Anti-cancer antibodies: o Trastuzumab: HER2+ cancers, causes reversible cardiac toxicity o T-DM1: linked to cytotoxic emtansine for those who fail trastuzumab o Pertuzumab: binds & inhibits HER2 o Pembrolizumab: PD1 receptor inhibitor o Bevacizumab: VEGF inhibitor, inhibits angiogenesis in tumors, major AE: wound healing complications o Imatinib: tyrosine kinase inhibitor o Bortezomib: proteasome inhibitor o Palbociclib: cdk 4/6 inhibitor All alkylating agents have same MOA: covalently cross-linking DNA breaks DNA o Nitrogen mustards Mechlorethamine: causes vesicant extravasation Cyclophosphamide: not a vesicant because is a prodrug; causes hemorrhagic cystitis due to acrolein (mesna rescue agent) Ifosfamide: more severe hemorrhagic cystitis because longer half-life o Busulfan: causes pulmonary fibrosis, 100% myelosuppression so used for transplant prophylaxis o ThioTEPA: activated in low pH o Nitrosureas (carmustine, lomustine) are used for brain tumors because they can pass BBB o Cisplatin: know everything about this drug!! Platinum analog, highly emetogenic, marrow-saving drug Causes irreversible oto & nephrotoxicity Avoid amphotericin B coadministration Rescue agent: amifostine o Oxaliplatin: cold sensitivity AE o Procarbazine: disulfiram-like rxn No questions after slide 77 for Monday’s exam Do not need to know drugs that are not starred on drug list For the final: make sure to know slide 91, especially difference between tamoxifen, anastrozole, fulvestrant o Fulvestrant is for recurring breast cancer, degrades estrogen receptors
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