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Immunology & Oncology | Medical (MD/DO) School Study Aid


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Immunosuppressants & Antineoplastic Agents
34 Picmonics to Learn | 60 mins

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Leflunomide
Use And Mechanism
Immunosuppressant Used In Rheumatoid Arthritis
DMARD
Inhibits Dihydroorotate Dehydrogenase
Blocks Pyrimidine Synthesis And T-Cell Proliferation
Adverse Effects
Hepatotoxicity
Bone Marrow Suppression
GI Upset
Alopecia
4 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
2 mins
Cyclosporine (Sandimmune) Overview
Mechanism
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Prevent Transplant Rejection
Psoriasis
Rheumatoid Arthritis
Considerations
Monitor Plasma Levels
Avoid Grapefruit Juice
Increased Risk of Lymphoma
2 mins
Cyclosporine (Sandimmune) Side Effects
Side Effects
Nephrotoxicity
Hepatotoxicity
Infection
Hypertension
Hirsutism
Tremor
Hyperkalemia
Hypomagnesemia
Gingival Hyperplasia
1 min
Tacrolimus (Prograf) Overview
Mechanisms
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Transplant Rejection
Atopic Dermatitis
Considerations
Increased Lymphoma Risk
Avoid Grapefruit Juice
1 min
Tacrolimus (Prograf) Side Effects
Nephrotoxicity
Neurotoxicity
GI Distress
Infection
Hypertension
Hyperkalemia
Hyperglycemia
1 min
Methotrexate
Indications
Rheumatoid Arthritis
Cancer
Medical Abortion
Mechanism
Folic Acid Analog
Inhibits Dihydrofolate Reductase
Side Effects
Pulmonary Fibrosis
Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
Macrocytic Anemia
Hepatitis
Teratogenic
Mucositis
1 min
Azathioprine (Imuran)
Mechanism
Antimetabolite
Prodrug of 6-mercaptopurine (6-MP)
Inhibits Synthesis of Nucleic Acids
Indications
Autoimmune Disorders
Kidney Transplantation
Side Effects
Myelosuppression
Increased Toxicity with Allopurinol Use
Pancreatitis
Malignancy
3 mins
Bevacizumab Mechanisms and Indications
Mechanisms
Monoclonal Antibody to VEGF
Inhibits Angiogenesis (and Vasculogenesis)
Indications
Capillaries Grow CORN (CG-CORN acronym)
Colorectal Cancer
Glioblastoma
Cervical Cancer
Ovarian Cancer
Renal Cell Carcinoma
Non-small Cell Lung Cancer (NSCLC)
Age-related Macular Degeneration
2 mins
Bevacizumab Side Effects
Impaired (Delayed) Wound Healing
Hemorrhage
Nosebleed (Epistaxis)
GI Perforation
Thromboembolic Event
Osteonecrosis of the Jaw
1 min
Cyclophosphamide
Mechanism
Requires Bioactivation by Liver
Cross-links DNA
Guanine N7 Position
Indications
Autoimmune Disorders
Leukemia
Lymphoma
Solid Tumors
Side Effects
Myelosuppression
Hemorrhagic Cystitis
Prevent with Mesna
3 mins
TNF-Alpha Inhibitors Overview
Mechanism
Downregulates pro-inflammatory cytokines
Decreased lymphocyte activation and migration
Granuloma breakdown
Treats
Crohn's Disease
Rheumatoid Arthritis
Juvenile Rheumatoid Arthritis
Psoriasis
Ankylosing spondylitis
1 min
TNF-Alpha Inhibitor Drugs and Complications
Etanercept
Decoy TNF- Alpha receptor
Anti-TNF- Alpha antibody
Adalimumab
Infliximab
Complications
Increased risk of infection
Predispose to Tuberculosis (TB) reactivation
Order Baseline PPD- skin test
Quantiferon Gold In-Tube
Order Chest X-Ray
2 mins
Rituximab
Indications
Chronic Lymphocytic Leukemia (CLL)
Non-Hodgkin Lymphoma
Rheumatoid Arthritis
Microscopic Polyangiitis (MPA)
Wegener's (Granulomatosis with Polyangiitis)
Mechanism
Monoclonal Antibody Against CD20
Found on B Cell Neoplasms
Side Effects
Infusion Reactions
Skin and Mouth Reactions
Reactivation of Hepatitis B Virus (HBV)
Progressive Multifocal Leukoencephalopathy (PML)
3 mins
Trastuzumab
Indications
HER-2+ Breast Cancer
Stomach cancer
Mechanism
Monoclonal antibody against HER-2
Inhibition of Cellular Signaling
Cytotoxicity
Side effects
Cardiotoxicity
1 min
Fluorouracil (5-FU)
Mechanism
Antimetabolite
"Thymine-less Death"
Indications
Slow-growing Solid Tumors
Co-administered with Leucovorin for Stomach Cancer
Basal Cell Carcinoma (Topical)
Side Effects
Myelosuppression
Mucositis
Severe Diarrhea
3 mins
Bleomycin
Indications
Testicular Cancer
Hodgkin's Lymphoma
Mechanism of Action
Induces Free Radical Formation
Breaks in DNA Strands
Side Effects
Pulmonary Fibrosis
Skin Changes
Mucositis
1 min
Dactinomycin (Actinomycin D)
Indications
Wilms' Tumor
Rhabdomyosarcoma
Ewing's Sarcoma
Gestational Trophoblastic Malignancy
Mechanism
Intercalates DNA
Side Effect
Myelosuppression
2 mins
Doxorubicin (Adriamycin)
Indications
Solid Tumors
Lymphomas and Leukemias
Mechanism
Free Radical Production
Intercalates DNA
Prevents Double Helix from Sealing
Side Effect
Cardiotoxicity
Dexrazoxane Decreases Toxicity
1 min
Busulfan
Indications
CML
Bone Marrow Ablation
Mechanism
Cross-links DNA
Side Effects
Myelosuppression
Pulmonary Fibrosis
Hyperpigmentation
1 min
Tamoxifen
Mechanism of Action
Selective Estrogen Receptor Modulator (SERM)
Antagonist on Breast Tissue
Indications
ER-positive Breast Cancer
Side Effects
Decreased Risk of Osteoporosis
Increased Risk of Endometrial Cancer
Increased Risk of Venous Thromboembolism (VTE)
1 min
Aromatase Inhibitors
Indications
Estrogen Receptor-positive (ER+) Breast Tumors
Systemic Metastases
Drugs
Reversible, non-steroid
Letrozole
Anastrozole
Irreversible, steroid
Exemestane
Side Effects
Osteoporosis
Arthritis
1 min
Imatinib (Gleevec)
Indications
Chronic Myelogenous Leukemia (CML)
Inhibitor of BCR-ABL Tyrosine Kinase
Caused by Philadelphia Chromosome
GI Stromal Tumors
Inhibitor of C-kit Tyrosine Kinase
Toxicity
Fluid Retention
1 min
Hydroxyurea
Mechanism
Inhibits Ribonucleotide Reductase
Decreased DNA Synthesis
S-phase Specific
Indications
Melanoma
Chronic Myelogenous Leukemia (CML)
Sickle Cell Disease
Through Increased HbF (Fetal Hemoglobin)
Side Effects
Myelosuppression
GI Distress
2 mins
Etoposide
Indications
Small Cell Lung Cancer
Testicular Cancer
Mechanism of Action
Inhibits Topoisomerase II
Errors in DNA Synthesis Cause Apoptosis
Side Effects
Myelosuppression
Alopecia
Hypotension
Nausea and Vomiting
2 mins
Cisplatin
Indications
Carcinomas
Ovarian
Bladder
Lung
Testicular
Mechanism
Cross-Links DNA
Side Effects
Ototoxicity
Nephrotoxicity
Treat with Amifostine and Chloride Diuresis
2 mins
Vincristine (Oncovin)
Mechanism
Vinca Alkaloid
Inhibits Microtubules
Indications
Leukemias
Lymphomas
Side Effects
Peripheral Neuropathy
Paralytic Ileus
Considerations
Vesicant
2 mins
Cetuximab and Panitumumab
Mechanism
Monoclonal Antibodies Against EGFR
Indications
Colorectal Cancer
Head and Neck Cancer
Ménétrier Disease
Side Effects
Elevated LFTs
Rash
Diarrhea
Hypokalemia
Hypomagnesemia
1 min
Nitrosoureas
Mechanism
Requires Bioactivation by Liver
Alkylating Agent
Cross-links DNA
Crosses Blood-Brain Barrier
Indications
Glioblastoma
Side Effects
Myelosuppression
Pulmonary Fibrosis
CNS Toxicity
Drugs
Carmustine
Lomustine
2 mins
Erlotinib
Mechanism of Action
Inhibits EGFR Tyrosine Kinase
Inhibits Progression of G1 to S Phase
Indications
Non-small Cell Lung Cancer (NSCLC)
Pancreatic Cancer
Side Effects
Rash
Diarrhea
Considerations
Avoid Grapefruit Juice
1 min
Paclitaxel (Taxanes)
Mechanism of Action
Taxane
Stabilizes Microtubules
Indications
Breast Cancer
Ovarian Cancer
Non-Small Cell Lung Cancer
Kaposi Sarcoma (HHV-8)
Side Effects
Mucositis
Myelosuppression
Peripheral Neuropathy
Hypersensitivity
Alopecia
Considerations
Diphenhydramine (Benadryl)
2 mins
Rasburicase
Characteristics
Recombinant Uricase
Converts Uric Acid to Allantoin
Inidication
Hyperuricemia
Tumor Lysis Syndrome
Side Effects
Hypersensitivity Reaction
Methemoglobinemia
Considerations
Contraindicated in G6PD Deficiency
1 min
BRAF Inhibitors
Characteristics
BRAF Proto-oncogene
Serine/Threonine Kinase
V600E Mutation
Indications
Melanoma
Non-Hodgkin Lymphoma
Papillary Thyroid Carcinoma
Hairy Cell Leukemia
Drugs
Dabrafenib
Vemurafenib
2 mins
Hydroxychloroquine
Mechanism of Action
Immunosuppressant
Indications
Malaria
Rheumatoid Arthritis
Systemic Lupus Erythematosus (SLE)
Porphyria Cutanea Tarda
Side Effects
Cardiotoxicity
Retinopathy
Considerations
Ophthalmological Exams
3 mins

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