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What drugs are derived from the Madagascar periwinkle (Vinca rose)?
How do the vinca derivatives work?
Induce depolymerization by binding to tubuline and blocking polymerization at the plus end.
True or False. Vinca alkaloids work on the S phase of the cell cycle
False. They are M-phase specific
Which is more neurotoxic vincristine or vinblastine? more myelosuppressive?
Vincristine is more neurotoxic but vinblastine is more myelosuppressive.
How must vinca alkaloids be administered?
IV. also vincristine is caustic so make sure no leakage
What are some mechanisms of resistance for vinca alkaloids?
- 1) Increased efflux via membrane drug transporters
- 2) Mutations in tubulin
How do paclitaxel and docetaxel work?
They both interfere with mitotic spindle and prevent its disassembly back into tubulin.
True or False. Similar to vinca alkaloids Paclitaxel and Docetaxel are M phase specific
How must paclitaxel and docetaxil be administered?
What can happen after IV infusion of paclitaxel in up to 5% of patients? How do you prevent this?
- Hypersensitivity reactions
- Prevented by premedicating with dexamethasone, diphenhydramine and H2 antagonist.
What is abraxane?
- Its reformulated paclitaxel basically. Contains that and albumin.
- It decreases risk of hypersensitivity reactions and no predmedication.
- Also has less myelosuppression