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Questions and Answers
Which of the following is a folate analog commonly used in cancer chemotherapy?
Which of the following is a folate analog commonly used in cancer chemotherapy?
What is the primary mechanism of action for fluorouracil (5-FU)?
What is the primary mechanism of action for fluorouracil (5-FU)?
Inhibits DNA synthesis by inhibiting thymidylate synthase.
Capecitabine is a prodrug that is activated to FdUMP in target cells.
Capecitabine is a prodrug that is activated to FdUMP in target cells.
True
What is the name of the prodrug for 5-FU?
What is the name of the prodrug for 5-FU?
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What is the name of the prodrug for Cytarabine (ara-C)?
What is the name of the prodrug for Cytarabine (ara-C)?
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What drug is a competitive inhibitor of thymidylate synthase, leading to inhibition of DNA synthesis?
What drug is a competitive inhibitor of thymidylate synthase, leading to inhibition of DNA synthesis?
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Gemcitabine is a prodrug that is activated to dFdCTP, which inhibits DNA polymerase.
Gemcitabine is a prodrug that is activated to dFdCTP, which inhibits DNA polymerase.
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What are the two main topoisomerase inhibitors mentioned in the provided content?
What are the two main topoisomerase inhibitors mentioned in the provided content?
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Which of the following drugs is a microtubule inhibitor and is highly specific to M-phase?
Which of the following drugs is a microtubule inhibitor and is highly specific to M-phase?
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What is the name of the drug that is a prodrug activated by carboxylesterase, and is commonly used to treat cancer?
What is the name of the drug that is a prodrug activated by carboxylesterase, and is commonly used to treat cancer?
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Match the following drugs with their main mechanism of action:
Match the following drugs with their main mechanism of action:
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Study Notes
Cell Cycle Specific Agents
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Mechanism of Action: Drugs function by inhibiting dihydrofolate reductase, interfering with purine and thymine synthesis, or competing with enzymes within specific phases (S-phase mostly). Some drugs compete with thymidylate synthase for thymidine.
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Pharmacokinetics: Many drugs are well absorbed orally or administered intravenously (IV). Plasma protein binding, renal excretion, and other pathways vary depending on the individual drug.
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Toxicity: Common side effects include gastrointestinal disturbances, myelosuppression, and nephrotoxicity. Some drugs cause organ-specific effects like pulmonary toxicity.
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Resistance: Impaired cellular uptake, drug export by multidrug resistance protein, or enzyme mutations can lead to drug resistance.
Anti-metabolites: Pyrimidine Analogs
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Mechanism of Action: Inhibiting specific enzymes in thymidine synthesis or by mimicking natural molecules (e.g. acting as nucleosides).
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Pharmacokinetics: Variable oral or IV absorption; significant metabolism by liver or other enzymes.
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Toxicity: Common GI side effects, myelosuppression, and potential for cardiovascular issues. Other toxicities include rare cases of cerebellar or ocular toxicity.
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Resistance: Decreased enzyme activity, altered drug uptake mechanisms, and drug activation changes can lead to resistance.
Anti-metabolites: Purine Analogs
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Mechanism of Action: Acting as analogs to purine compounds, these agents block or interfere with purine synthesis at different levels.
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Pharmacokinetics: Varied oral and IV absorption and metabolism.
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Toxicity: Myelosuppression (bone marrow suppression), other organ-related toxicities.
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Resistance: Mutational changes in enzymes or alterations in drug export mechanisms can lead to resistance.
Topoisomerase Inhibitors
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Mechanism of Action: Inhibition of DNA topoisomerase enzyme, influencing DNA replication and repair.
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Pharmacokinetics: Primarily intravenous administration. Rapid and extensive metabolism by various enzymes.
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Toxicity: Myelosuppression, gastrointestinal discomfort, and potential for severe diarrhea or cholinergic syndrome.
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Resistance: Altered enzyme activity, impaired accumulation of active metabolites or altered drug export mechanisms can influence resistance.
Microtubule Inhibitors
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Mechanism of Action: Interference with microtubule assembly, crucial for cell division.
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Pharmacokinetics: Varied routes, with primary administration being intravenous.
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Toxicity: Peripheral neuropathy, myelosuppression, and/or emetogenicity are commonly seen side effects.
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Resistance: Mutations in specific cellular processes, or changes in the cellular machinery involved in the process can lead to resistance.
Other Antineoplastic Agents
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Mechanism of Action: Varies significantly; may involve alkylation, inhibition of specific enzymes (e.g. topoisomerases), or immunesystem-modulating properties.
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Pharmacokinetics: Drug administration by various routes and notable metabolic pathways.
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Toxicity: A wide range of possible toxicities including myelosuppression, gastrointestinal issues, and various organ-specific effects are possible.
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Resistance: Several mechanisms including increased drug efflux, altered drug metabolism, overexpression of drug resistance proteins and/or cellular mutations.
Genotoxic Agents
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Mechanism of Action: Alkylating agents that directly damage DNA.
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Pharmacokinetics: Can be absorbed orally or intravenously.
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Toxicity: Bone marrow suppression, nausea, vomiting, and other effects.
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Resistance: Decreased DNA damage through increased DNA repair systems.
Anthracyclines
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Mechanism of Action: Intercalate into DNA, and interfere with DNA replication and repair. Also can cause oxidative stress.
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Pharmacokinetics: Intravenous administration and metabolism.
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Toxicity: Potential cardiovascular issues, myelosuppression, and secondary cancer.
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Resistance: Altered cellular defenses against reactive oxygen species.
Molecular Targeted Agents
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Mechanism of Action: Inhibit specific enzymes or proteins involved in cell signaling and proliferation.
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Pharmacokinetics: Varies by agent, frequently requiring oral or intravenous administration.
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Toxicity: Myelosuppression, other possible organ related toxicities, cardiovascular issues, and others.
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Resistance: Genetic mutations that change the specific target of the drug, resulting in its decreased effectiveness.
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