Anticancer - Alkylating Agents

Question 1

What are the Alkylating agents

Answer 1

Nitrogen mustards
Alkyl sulfonate
Nitrosureas
Triazene
Methylhydrazine
Platinum compounds

Question 2

What activates Cyclophosphamide

Answer 2

Hepatic enzymes

Question 3

What is the function of Alkylating agents

Answer 3

Alkylate N7 of Guanine
Abnormal base pairing with T or excision
Strand breakage
Cell-cycle non-specific

Question 4

What is the more potent version of Cyclophosphamide

Answer 4

Ifosfamide

Question 5

What is the toxic metabolite of Cyclophosphamide

Answer 5

Acrolein

Question 6

How does Acrolein cause Hemorrhagic cystitis

Answer 6

Irritates bladder mucosa

Question 7

What is given to inactivate Acrolein

Answer 7

Mesna

Question 8

What are the Nitrogen mustards

Answer 8

Cyclophosphamides
Ifosfamide
Chlorambucil
Mechlorethamine
Melphalan

Question 9

What is the Alkyl sulfonate

Answer 9

Busulfan

Question 10

What are the Nitrosureas

Answer 10

Carmustine
Lomustine
Semustine

Question 11

What is the Methylhydrazine

Answer 11

Procarbazine

Question 12

What are the Platinum compounds

Answer 12

Cisplatin
Carboplatin
Oxaliplatin

Question 13

What are the other Cyclophosphamide AE

Answer 13

SIADH
BM/Immuno suppression
N/V, alopecia, gonadal failure

Question 14

What is the problem with Ifosfamide

Answer 14

Higher risk of hemorrhagic cystitis

Pretreat with Mesna every time

Question 15

What do you give for CLL

Answer 15

Chlorambucil

Question 16

What do you give Mechlorethamine for

Answer 16

Non-Hodgkin’s Lymphoma

Question 17

What do you give for Multiple Myeloma

Answer 17

Melphalan

Question 18

What do you give Busulfan for

Answer 18

CML

Question 19

What are the Busulfan AE

Answer 19

Pulm fibrosis
Adrenal insufficiency
Skin pigmentation

Question 20

Can Nitrosureas cross the BBB

Answer 20

Yes

Question 21

What part of the Nitrosureas do the alkylation

Answer 21

Chloroethyl moiety

Question 22

What are Nitrosureas given for

Answer 22

Adjuvant for brain tumors (Primary or mets)

Question 23

Nitrosurea AE

Answer 23

GI distress
Delayed myelosuppression
CNS dysfunction

Question 24

What activates Dacarbazine

Answer 24

Hepatic enzymes

Question 25

What is Dacarbazine given dor

Answer 25

Hodgkin's Lymphoma Soft tissue Sarcolemma Melanoma

Question 26

What are the Dacarbazine AE

Answer 26

Myelosuppression | N/V

Question 27

What are the problems with Procarbazine

Answer 27

Teratogenic Mutagenic Leukemogenic

Question 28

What do you give Procarbazine for

Answer 28

Hodgkin's Lymphoma

Question 29

What are the main Procarbazine AE

Answer 29

Hemolytic anemia Pulm effects Disulfiram-like rxns

Question 30

What are the other Procarbazine AE

Answer 30

Myelosuppression Peripheral neuropathy N/V

Question 31

Which Platinums are less toxic and emetic but more myelosuppressive

Answer 31

Carboplatin | Oxaliplatin

Question 32

What happens when you combine Cisplatin with Amifostine

Answer 32

Reduce nephro/oto/neuro toxicity and myelosuppression

Question 33

What do you give Platinums for

Answer 33

Solid tumors | NSCLC

Question 34

Platinum AE

Answer 34

N/V Neurotox (peripheral nerve damage and deafness) Nephrotox

Question 35

What do you give for Platinum Nephrotoxicity

Answer 35

Mannitol NaCl Amifostine

Question 36

What is the problem with all Alkylating agents

Answer 36

Mutagenic | Carcinogenic

Question 37

What do you give for Hodgkin's Lymphoma

Answer 37

Dacarbazine | Procarbazine

Question 38

Mechlorethamine AE

Answer 38

Blisters