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Systemic Pharmacology_Dr. McNaughton > 12. Cancer and Antiemetics > Flashcards

12. Cancer and Antiemetics Flashcards

1
Q

What is Antiemetics drugs for?

A

drugs that are used to against vomiting and nausea

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2
Q

Which cancers are the most lethal cancers in men and women?

A

Lung cancer and breast cancer. They are most likely of all cancers to spread to the eye.

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3
Q

What are the different anti-metabolites drugs for treating cancers?

A
  1. Methotrexate [Trexall] “MOST COMMON”
  2. Trimethorprim [Primsol]
  3. Pyrimethamine [Daraprim]
  4. Pemetrexed [Alimta]
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4
Q

The indication for taking Methotrexate (anti-metabolites) are for ______, ______ and ______.

A

Rheumatoid Arthritis, Psoriasis (dry, itchy patch on skin) and Choriocarcinoma (cancer developed from placenta).

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5
Q

Do we use Methotrexate to suppress the immune system?

A

Yes, it’s an Immunosupressant.

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6
Q

The mechanism of action of Methotrexate is to act as a _____ analogue, inhibits dihydrofolate reductase (DHFR), thus preventing formation of _____.
It also inhibits ______ proliferation.

A

folic acid, tetrahydrofolate (FH4), lymphocyte

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7
Q

What are some common adverse effects of taking Methotrexate?

A

Photosensitivity, pruritis (itchy), anemia, dizziness

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8
Q

What is the severe adverse effect of taking Methotrexate?

A

Neurotoxicity - damage to the nervous system

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9
Q

T/F Methotrexate has a “BLACK BOX” warning.

A

True.

  • Death reported: monitor bone marrow, liver, lung & kidneys; opportunistic infections
  • Potentially fatal myelosupression with NSAIDs
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10
Q

T/F Taking Methotrexate with NSAIDs, Sulfonamides, Ciprofloxacin and Penicillins will increase elimination of the drug, thus, reducing drug effects in the body.

A

False. It reduces the drug elimination in the body, which it produces additive effects to the drug.

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11
Q

T/F Taking Cyclosporine with Methotrexate reduce hepatic metabolism, therefore, increases the concentration in the body. *May increase the side effects

A

True

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12
Q

T/F Taking Ganciclovir (anti-viral) with Methotrexate will increase bone marrow suppression (myelosuppression).

A

True, It adds to the myelosupression effect of the drug.

Myelosuppression causes decrease in the production of red blood cells, white blood cells and platelets

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13
Q

T/F Taking Systemic Corticosteroids with Methotrexate will not suppress the immune system even more.

A

False. It has additive immunosuppression effect.

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14
Q

Taking Tetracyclines in the presence of Methotrexate will _____ Methotrexate levels.

A

elevate

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15
Q

Nearly _____% of all patients who undergo chemotherapy experience nausea or vomiting; incidence and severity depend on drug type, dose, route and schedule of administration

A

70-80

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16
Q

Key receptors involved in the emetic response are D2 and 5HT-3

A

D2, 5HT-3

17
Q

T/F Chemotherapeutic drugs only affects the CNS.

A

False.
Chemotherapeutic drugs can also act peripherally by causing cell damage in the GI tract and releasing serotonin from the enterochromaffin cells of the small intestinal mucosa. The released serotonin activates 5-HT3 receptors on vagal (CN X, heart and digestion) and splanchnic afferent fibers, which then carry sensory signals to the medulla, leading to the emetic response (vomiting and nausea).

18
Q

Methotrexate has high, moderate or mild emetic potency?

A

mild

19
Q

What is an Antiemetics drug?

A

Promethazine [Phenergan]

20
Q

What is Promethazine (antiemetic) use for?

A

nausea and vomiting, sedation, [Allergy], [Motion sickness]

21
Q

What is the dosage Promethazine use for nausea and vomiting vs. sedation.

A

twice as much med for sedation than for nausea and vomiting.
25-50mg qd for sedation
12.5 - 25 mg q4-6h

22
Q

T/F Promethazine is a non-selective central and peripheral H1 antagonist.

A

True

23
Q

Common Adverse effects of Promethazine includes drowsiness, blurred vision, confusion, dermatitis and ______.

A

photosensitivity

24
Q

serious adverse effects of Promethazine are

A

Thrombocytopenia (low platelet count) and agranuloctosis (decrease granulocytes)

25
Q

Is Promethazine have “Black Box” Warnings?

A

Yes,

Respiratory depression, Severe Tissue Injury (Gangrene) may occur.

26
Q

Taking Promethazine with Macrolides, Azoles and CAIs will cause what?

A

Prolonged OT segment. bad for heart.

27
Q

Taking Pilocarpine in the presence of Promethazine will cause what?

A

Pilocarpine antagonizes Promethazine

28
Q

Promethazine can impaired the metabolism of ______.

A

Beta-blockers

29
Q

Taking Anticholinergics, Sedating Antihistaminics, Olopatadine Nasal in the presence of Promethazine will produce a what effect?

A

Additive effect

30
Q

What can happen if you taking Omega-6 fatty acid with Promethazine?

A

Can cause seizures.

31
Q

Can you give your patient Proethazine if he/she has angle closure glaucoma?

A

No. “CAUTION”

Systemic Pharmacology_Dr. McNaughton (12 decks)

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