Anti-cancer medications

Question 1

Neoadjuvant

Answer 1

Give chemotherapy before local therapy (radiation or resection), (i.e. Chemo with immunotherapy before breast cancer)

Question 2

Adjuvant therapy

Answer 2

Given after local therapy, eradicate tumor cells not previously detected (i,.e. aromatase inhibitors are taken for years after breast cancer surgery)

Question 3

Which phase of the cell cycle do antimetabolites target

Answer 3

DNA synthesis (S)

Question 4

Which phase of the cell cycle does Bleomycin target

Answer 4

G2

Question 5

Which phase does antimicrotubular phase target

Answer 5

M phase

Question 6

Which cell cycle phase do antitumor antibiotics target

Answer 6

G2-M phase

Question 7

What cell cycle phase do topoisomerase inhibitors target

Answer 7

G1-S or G2-M

Question 8

Which cell cycle phase do Hydroxyurea and methotrexate target

Answer 8

S phase

Question 9

Methotrexate chemotherapy toxicities

Answer 9

Myelosuppression

Question 10

If you administer an anthracycline/rubicin to a patient, what toxicity could they complain of?

Answer 10

Cardiomyopathy

Question 11

What is methotrexate and what is it used for

Answer 11

Folate antimetabolite- prevent activation of folate to turn into purine, prevents DNA synthesis
Psoriasis, rheumatoid arthritis, ALL, Breast cancer, crohn’s disease

Question 12

mab vs nib

Answer 12

mab= extracellular
nib= intracellular, target downstream pathway

Question 13

What is tamoxifen’s MOA

Answer 13

Binds to estrogen receptor, has antiestrogen effects, maintains cell in G0 and G1
Selective estrogen receptor modulator

Question 14

Aromatase inhibitors example and MOA

Answer 14

-Anastrozole
-Inhibit conversion

Question 15

bicalutamide MOA and class

Answer 15

Antiandrogen
(Androgen deprivation therapy)
Binds and causes inhibition at androgen receptors

Question 16

Examples of glucocorticoids in oncology

Answer 16

prednisone, methylprednisolone, dexamethasone

Question 17

Vesicant

Answer 17

Cause severe tissue injury. Most drug references have specific guidelines. Not just chemo, but many drugs are vesicants or irratants.

Question 18

Infiltration vs extraversion

Answer 18

infiltration- medication/fluid is not a vesicant
Extravasation- Fluid is not a vesicant

Question 19

Specific risk factors for CINV

Answer 19

Previous experiance with CINV
Women>men
Younger>older
Motion sickness
morning sickness
no alcohol use ( moderate is protective)

Question 20

Treatment goal of emesis for CINV

Answer 20

No N/V throughout the period, lasts 2 days after moderate chemo, 3 days after high treatment)

Question 21

Describe the grading scale for severity of chemotoxicities

Answer 21

0- no symptom
4-worst symptoms, cause severe pain and issues.
5- Death :(

Question 22

What is magic mouthwash

Answer 22

lidocane and diphenhydramine (antihistamine), maalox– causes decreased pain and numbs the mouth. Mouthwash the pt uses and then spits out.

Question 23

Concern for infection with patients who have neutropenia are dependent on which 2 factors

Answer 23

1. severity
2. Duration

Worse severe neutropenia (<100 ANC) or longer duration of having neutropenia

Question 24

What is febrile neutropenia

Answer 24

Neutropenia and an oral temp >101f, or 38.3c.
Increases mortality rate by 20-30%
Always warrents broad-spectrum antibiotics

Question 25

What labratory findings do you have for TLS

Answer 25

Hyperuricemia, hyperkalemia, hyperphosphatemia, increased LDH, HYPOcalcemia