MED 6510 Histopathology January 27 and 30, 2006 Dr. Janet Fitzakerley Antineoplastics I [email protected] www.d.umn.edu/~jfitzake Page 1 of 4

ANTINEOPLASTIC DRUG CARD ASSEMBLY INSTRUCTIONS (approximate assembly time: 1 hour)

These drug cards are designed to help you organize antineoplastic drugs according to their various characteristics, and you will have to use the cards in Monday’s lecture. Preparing these cards ahead of time is therefore highly recommended --- it will make you more familiar with the 22 drugs presented during that 2 hour block.

Each of you should have lots of labels (you will need scissors to cut some of them apart) and 22 cards: 8 BLUE cards for ALKYLATING AGENTS, 4 WHITE cards for MISCELLANEOUS agents and 10 GREEN cards for NATURAL PRODUCTS.

Overall, when you’re done, the cards should look like this.

CCS or Regimens Therapeutic Uses: CCNS

PK: DRUG NAME Toxicities: Acute: Delayed: Subclass Mechanism of action

To assemble the cards:

1. Apply the labels with the drug names to the blank (unlined) face of the cards:

Drugs that disrupt DNA, prevent DNA repair and/or interfere with DNA/RNA synthesis (blue labels) on blue cards: BUSULFAN, CARMUSTINE (BCNU), CYCLOPHOSPHAMIDE, DACARBAZINE, LOMUSTINE (CCNU), MECHLORETHAMINE, MELPHALAN, THIOTEPA

Drugs that disrupt DNA, prevent DNA repair and/or interfere with DNA/RNA synthesis (blue labels) on white cards: AMSACRINE, CARBOPLATIN, CISPLATIN, PROCARBAZINE MED 6510 Histopathology January 27 and 30, 2006 Dr. Janet Fitzakerley Antineoplastics I [email protected] www.d.umn.edu/~jfitzake Page 2 of 4

Drugs that disrupt DNA, prevent DNA repair and/or interfere with DNA/RNA synthesis (blue labels) on green cards: BLEOMYCIN, DACTINOMYCIN, DAUNORUBICIN, DOXORUBICIN, ETOPOSIDE, IRINOTECAN, MITOMYCIN C

Drugs that prevent mitosis (green labels) on green cards: VINBLASTINE, VINCRISTINE, PACLITAXEL

2. Apply the nitrogen mustard stickers: CYCLOPHOSPHAMIDE, MECHLORETHAMINE, MELPHALAN

3. Apply the nitrosourea stickers: CARMUSTINE (BCNU), LOMUSTINE (CCNU).

4. Apply the antibiotic stickers: ANTHRACYCLINE ANTIBIOTICS: DAUNORUBICIN, DOXORUBICIN (not anthracycline) ANTIBIOTICS: AMSACRINE, BLEOMYCIN, DACTINOMYCIN

5. Apply the plant alkaloid stickers: ETOPOSIDE, IRINOTECAN, PACLITAXEL, VINBLASTINE, VINCRISTINE

6. Apply the crosslinks DNA stickers: BUSULFAN, CARMUSTINE (BCNU), CARBOPLATIN, CISPLATIN, CYCLOPHOSPHAMIDE, DACARBAZINE, LOMUSTINE (CCNU), MELPHALAN, MECHLORETHAMINE, MITOMYCIN C, THIOTEPA

7. Apply the intercalates DNA stickers: DACTINOMYCIN, DAUNORUBICIN, DOXORUBICIN

8. Apply the causes strand breaks stickers: AMSACRINE, BLEOMYCIN, ETOPOSIDE, IRINOTECAN, PROCARBAZINE

9. Apply the interrupts mitosis stickers: PACLITAXEL, VINBLASTINE, VINCRISTINE

10. Write the regimen designations onto the appropriate cards: ABVD: DOXORUBICIN (Adriamycin), BLEOMYCIN, VINBLASTINE, DACARBAZINE CHOP: CYCLOPHOSPHAMIDE, DOXORUBICIN (Adriamycin), and VINCRISTINE (Oncovin) CMF: CYCLOPHOSPHAMIDE MED 6510 Histopathology January 27 and 30, 2006 Dr. Janet Fitzakerley Antineoplastics I [email protected] www.d.umn.edu/~jfitzake Page 3 of 4

FAC: DOXORUBICIN (Adriamycin), CYCLOPHOSPHAMIDE MOPP: VINCRISTINE (Oncovin). PROCARBAZINE PVB: CISPLATIN (CARBOPLATIN), BLEOMYCIN, VINBLASTINE

11. Write CCNS/CCS designations onto the appropriate cards:

CCNS CCS Busulfan Amsacrine Carboplatin Bleomycin Carmustine (BCNU) Etoposide Cisplatin Irinotecan Cyclophosphamide Paclitaxel Dacarbazine Procarbazine Dactinomycin Vinblastine Daunorubicin Vincristine Doxorubicin Lomustine (CCNU) Mechlorethamine Melphalan Mitomycin C Thiotepa

12. Put the cards into the order that they will be used in the lecture: CYCLOPHOSPHAMIDE, MECHLORETHAMINE, CARMUSTINE (BCNU), LOMUSTINE (CCNU), CARBOPLATIN, CISPLATIN, BUSULFAN, DACARBAZINE, MELPHALAN, THIOTEPA, MITOMYCIN C, DACTINOMYCIN, DAUNORUBICIN, DOXORUBICIN, BLEOMYCIN, ETOPOSIDE, IRINOTECAN, AMSACRINE, PROCARBAZINE, VINBLASTINE, VINCRISTINE, PACLITAXEL

13. Write Therapeutic Uses, PK (pharmacokinetics: Administration, Distribution, Metabolism, Elimination) and Toxicities: Acute and Delayed headings onto the back (lined) side of the cards. MED 6510 Histopathology January 27 and 30, 2006 Dr. Janet Fitzakerley Antineoplastics I [email protected] www.d.umn.edu/~jfitzake Page 4 of 4

14. Write in the following therapeutic uses: CYCLOPHOSPHAMIDE: Broad spectrum; esp. non-Hodgkin’s lymphoma and breast cancer regimens MECHLORETHAMINE: Hodgkin’s disease regimen NITROSOUREAS (BCNU, CCNU): brain tumours, GI and lung cancer, melanoma, myeloma, lymphoma CARBOPLATIN: broad range of solid tumours: testicular, ovarian, cervical, bladder, head and neck cancer; sarcomas CISPLATIN: broad range of solid tumours: testicular, ovarian, cervical, bladder, head and neck cancer; sarcomas BUSULFAN: chronic myeloid leukemia (CML) DACARBAZINE: Hodgkin’s disease MELPHALAN: multiple myeloma THIOTEPA: ovarian cancer MITOMYCIN C bladder and rectal cancer DACTINOMYCIN: rhabdomyosarcoma, Wilm’s tumour; renal transplants DAUNORUBICIN: acute leukemias DOXORUBICIN: broadest spectrum; NOT brain tumors, colo-rectal, renal cancers, melanomas BLEOMYCIN: squamous carcinomas of head and neck and lungs; lymphomas, testicular tumours ETOPOSIDE: lymphomas, lung, testicular and ovarian cancer, acute leukemia; Karposi’s sarcoma IRINOTECAN: metastatic colorectal cancer AMSACRINE acute leukemia PROCARBAZINE: Hodgkin’s disease VINBLASTINE: testicular cancer; Hodgkin’s disease VINCRISTINE: Hodgkin’s disease, non-Hodgkin’s lymphoma PACLITAXEL: breast and ovarian cancer