2015 Antineoplastics

Objectives from Foundations, Derm and Neuro

Foundations

For cyclophosphamide, anthracycline antibiotics (doxorubicin, epirubicin), 5-fluorouracil and paclitaxel:

  1. Describe their mechanisms of action.  Specifically,
    1. Outline the process whereby cyclophosphamide damages DNA.
    2. Chart the specific pyrimidine synthesis enzymes and pathways that are blocked by 5-fluorouracil.
    3. Predict the components of DNA synthesis that are altered by anthracycline antibiotics.
    4. Diagram how paclitaxel prevents mitosis.
  2. Outline the basis of their cell cycle specificity, by differentiating between the time in the cell cycle when each drug works, and when it produces its greatest toxicity.
  3. Relate the side effects that are common among these cytotoxic drugs to the actions of the drugs on normal cells.  Understand why bone marrow suppression is the major dose-limiting toxicity of cytotoxic drugs, and relate this to the administration of cytotoxic antineoplastic drugs in “cycles”.

Dermatoskeletalmuscular System

For ifosfamide, etoposide, busulfan, fludarabine, Ara-C, cisplatin and methotrexate:

  1. Describe their mechanisms of action.  Specifically,
    1. Compare and contrast their mechanisms to the 4 drugs you studied in Foundations:  cyclophosphamide, doxorubicin, 5-fluorouracil and paclitaxel.
    2. Relate the use of MESNA and leucovorin to the mechanisms of action of cyclophosphamide/ifosfamide and methotrexate regimens, respectively.
  2. Outline the basis of their cell cycle specificity, by differentiating between the time in the cell cycle when each drug works, and when it produces its greatest toxicity.
  3. For the cytotoxic antineoplastic drugs that you have studied so far, distinguish between agents that can be delivered orally, and those that must be given IV.
  4. Outline a mechanism that explains why kidney function is monitored and supported during cyclophosphamide/ifosfamide, cisplatin and methotrexate administration.

Nervous System

  1. For carmustine, vincristine and temozolamide:
    1. Describe their mechanisms of action.  Specifically, compare and contrast their mechanisms to the 11 drugs you studied in Foundations and Dermatoskeletomuscular System:  Ara-C, busulfan, cisplatin, cyclophosphamide/ifosfamide, doxorubicin, etoposide, fludarabine, 5-fluorouracil, methotrexate and paclitaxel.
    2. Outline the basis of their cell cycle specificity, by differentiating between the time in the cell cycle when each drug works, and when it produces its greatest toxicity.
  2. Rank the crosslinking agents and antifungal drugs with respect to their ability to cross the blood-brain barrier.  For alkylating agents, relate ability to cross the blood brain barrier to what happens during drug activation.
  3. List of patient factors and tumor characteristics that can affect the outcome of chemotherapy treatment.  Discuss how the tumor could alter the blood brain barrier.
  4. Incorporate your knowledge of brain tumor symptoms and chemotherapy treatments (antifungal and antineoplastic) into a mechanism that can explain the common features of the cases that you presented, including the reason that dexamethasone is often included in the treatment of brain tumors.
Email: Dr. Janet Fitzakerley | ©2015 University of Minnesota Medical School Duluth | Last modified: 11-apr-15 9:39 AM