Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pharmacology II > Anti-neoplastic Therapy > Flashcards

Anti-neoplastic Therapy Flashcards

1
Q

What are the four cancer cell characteristics?

A
  1. Uncontrolled cell growth
  2. Ability to invade adjacent structures and/or travel to distant areas
  3. Incapable of physiologic functions of the mature tissue or origin
  4. Altered proteins, Enzyme systems, membrane characteristics, and cytogenics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the different anti-cancer therapies?

A 
Cytotoxic therapies
Anti-hormonal therapies
Targeted therapies
Immunotherapy
Blood and bone marrow transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is adjuvant chemotherapy?

A

Given after surgery to reduce the risk of local and systemic recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is neoadjuvant chemotherapy?

A

Given prior to surgical intervention to reduce the tumor size or to remove micrometastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is cytotoxic chemotherapy?

A

Traditional treatment

Toxic to all cells but more specific for rapidly dividing cells like those found in the GI tract, Hair, and bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the agents classified as cytotoxic chemotherapy?

A

Alkylating agents
Antimetabolites
Natural Products
Misc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the three tumor growth kinetics?

A

Doubling time
Gompertzian Growth
Log-kill hypothesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is doubling time of the tumor growth?

A

Time needed for a tumor cell population to double in size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Gompertzian tumor growth?

A

Early growth is exponential, but as tumor gets bigger, growth slows due to decreased nutrients/blood supply

Small tumors grow faster, larger tumors grow slower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is log-kill hypothesis?

A

A given dose of chemotherapy kills the same fraction of tumor cells regardless of the size of the tumor at the time of treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the principles of cytotoxic chemotherapy?

A 
Combination chemotherapy or regimen
Good single agent activity against tumor
Different MOAs
Different toxicities or different onset of toxiticites
Maximum cell kill within toxic limits
Different mechanisms of action to target a cancer cell in different ways
Decrease drug resistance
Dosing
Administration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the dosing principle for cytotoxic chemotherapies?

A

Dose based on body surface area (BSA)

Use actual weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the administration principles of cytotoxic chemotherapies?

A

Cycles every 14, 21, or 28 days most common
Cycling or rotating differetn combinations may be done to decrease resistance
Dose intensity and dose density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is NATER?

A

point at which neutrophils are lowest in the body usually 7-10 days after patient receives chemo and normal levels are reached again by day 21

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the MOA of alkylating agents?

A

Prevents cell division by cross-linking DNA strands and decreasing DNA synthesis

Cell-cycle non specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the toxicities of alkylating agents?

A 
Myelosuppression
N/V = acute; moderate to high severity
Alopecia
Sterility/infertility
Secondary malignancies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which three alkylating agents are lipophilic and typically used to treat brain tumors?

A

Carmustine
Lomustine
Procarbazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the toxicities of Cyclophosphamide/Ifosfamide?

A

hemorrhagic cystitis due to acrotein metabolite

Treat with mesna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the toxicity of Cisplatin?

A

Nephrotoxicity
N/V
Ototoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the toxicity of Oxaliplatin?

A

Neuropathies that are exacerbated by the cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are antimetabolites?

A

Structural analogs of naturally occurring substances necessary for specific biochemical reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the MOA of antimetabolites?

A
  1. Compete with normal metabolites
  2. falsely insert themselves for a metabolite normally incorporated into DNA and RNA

Active in S phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the toxicities of antimetabolites?

A 
Myelosuppression
Mucositis
Mild N/V
Diarrhea
Renal toxicity
CNS toxicity
Hand foot syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the toxicity of methotrexate?

A

Renal toxicity

Use leucovorin to treat/replenish folate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the toxicity of cytarabine?

A

High dose therapy causes nervous system toxicity

Occular irritation = treat with eye drops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What enhances efficacy of Fluorouracil?

A

Leucovorin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the toxicity of capecitabine?

A

hand-foot syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the natural products?

A

Antitumor antibiotics
Plant alkaloids = vinca alkaloids, taxanes, topoisomerase I and II
Marine based products
Enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the antitumor antibiotics?

A

Anthracyclines
Mitomycin
Dactinomycin
Bleomycin

30
Q

What is the MOA of anthracyclines?

A

block RNA and DNA transcription

31
Q

What is the MOA of mitomycin?

A

Cross-links DNA

32
Q

What is the MOA of Dactomycin?

A

Blocks RNA synthesis

33
Q

What is the MOA of Bleomycin?

A

inhibits DNA synthesis

34
Q

What are the toxicities of Antitumor antibiotics?

A

N/V
Alopecia
Stomatitis
Myelosuppression
Bleomycin = Lung toxicity/pulmonary fibrosis/interstitial pneumonitis
CARDIOTOXIC/congestive heart failure = anthracyclines
Dose dependent myocardiotoxicity

35
Q

What is the lifetime limit for dose of antitumor antibiotics?

A

450

In kids its 300

36
Q

What is the dose dependent myocardiotoxicity of antitumor antibiotics?

A

Produces toxic free radicals, membrane lipid peroxidation leading to irreversible damage and replacement by fibrous tissue

Risk factors include cumulative dose, patient age, concomitant chemotherapy with known cardiotoxicity, and radiation therapy

Can have early toxicity within 3 months of completion or late toxicity decades later

Treat with Dexrazoxane

37
Q

What is the MOA of Dexrazoxane?

A

EDTA-like chelating agent, binds intracellular iron released following lipid peroxidation

38
Q

What are Mictrotuble agents?

A

Synthetic and semi-synthetic

Different MOAs

Taxanes and Vinca alkaloids

39
Q

What are the toxicites of taxanes?

A

Neuropathies
Peripheral edema
Hypersensitivity reactions = especially Paclitaxel; premedicate with H1, H2 blocker and steroids

40
Q

What are the toxicites of vinca alkaloids?

A

Neuropathies
Constipation
DO NOT GIVE INTRATHECALLY = Vincristine

41
Q

What are the toxicities of Topoisomerase I?

A

DIARRHEA = immediate and delayed reaction ( I ran to the can)

42
Q

What are the toxicities of Topoisomerase II?

A

Secondary cancers

43
Q

What are the toxicities of Enzymes?

A

Hypersensitivity reaction
Hyperglycemia
Pancreatitis
Coagulopathies

44
Q

What are the two marine based natural products?

A 
Eribulin = sea sponge
Trabectedin = sea squirt
45
Q

What is the MOA and toxicities of Eribulin?

A

Microtubule like agent

Fatigue
Peripheral Neutropathy
Chemotherapy induced N/V
Myelosuppression

46
Q

What is the MOA and toxicities of Trabectedin?

A

like an alkylating agent

Fatigue
Hand-foot syndrome
CINV
Hepatic damage
Myelosuppression
47
Q

What is hormonal therapy?

A

Blocks production of hormones or hormone receptors in the body

48
Q

What are the types of hormone therapy?

A

Anti-estrogens
Anti-androgens
Luteinizing hormone releasing hormone analogs

49
Q

What are SERMs used in?

A

Premenopausal diseases

50
Q

What are aromatase inhibitors used in?

A

Postmenopausal diseases

51
Q

What is the benefit of using SERMs in hormonal therapy?

A

increased 15 year survival rate

52
Q

What are the ADRs of SERMs?

A

Cataracts
Endometrial cancer
VTE
DDI with antidepressants

53
Q

What are the ADRs of aromatase inhibitors?

A

Osetoporosis
Fractures
Arthralgias

54
Q

What are LHRH agonists for hormonal therapy?

A

inhibit the pituitary from releasing LH and FSH which stops stimulation of the testes to produce testosterone

First line treatment for prostate cancer

55
Q

What is the ADR of LHRH agonists?

A

Tumor flare

56
Q

What are LHRH antagonist?

A

Directly inhibit pituitary from releasing LH and FSH

57
Q

What are antiandrogens?

A

Blocks antigen receptor

58
Q

What is the MOA of targeted therapies?

A

identifies certain features of a cancer cell taht make it different from the normal cell

Prevent tumor cells from entering cell cycle ro target signals that trigger cancer growth, metastasis, and immortality

59
Q

What are the targeted agents?

A

Monoclonal antibodies

Molecularly targeted therapies

60
Q

What is the MOA of monoclonal antibodies?

A

Antibodies that match an antigen on the cancer cell surface

61
Q

What is the MOA of molecularly targeted therapies?

A

block signaling inside the cell

62
Q

What are the toxicities of VEGF signaling pathway inhibitors?

A

Hypertension
Proteinuria
Bleeding
Imparied wound healing

63
Q

What is the toxicity of EGFR inhibitors?

A

Acneiform rash

64
Q

What are the toxicities of mTOR inhibitors?

A 
Hyperglycemia
Dyslipidemia
Mucosal sensitivity
Ulcers = usually only one; treat with deamethasone swish and spit
CYP 3A4 DDIs
65
Q

What are the toxicities of BCR-ABL mutation inhibitors/

A 
Edema
N/V
Neutropenia
Fatigue
Cardiac
Diarrhea
CYP3A4 DDIs
66
Q

What do CD20 specific target therapies attack and what are their toxicities?

A

B cells

Infusion reactions
Myelosuppression

67
Q

What are the toxicites of HER2 inhibition?

A 
CARDIOTOXICITY
N/V
Fatigue
Diarrhea
Hand-foot syndrome
DDIs with strong 3A4 inducers/inhibitors
68
Q

What are the targeted agents toxicities?

A

Monoclonal Antibodies have potential hypersensitivity reactions based on mAb origin

QT prolongation
Neuropathy
Colitis
Fatigue
Hair thinning
Low grade N/V and myelosupression
HAIR DEPIGMENTATION
DYSPHONIA
HYPOTHYROIDISM (does not reverse)
69
Q

What are the immunological therapies?

A 
Interferon
Interleukin
Lenalidomide
Thalidomide
CTLA-4 inhibitors
PD-1/PDL-1 inhibitors
Cancer vaccine
70
Q

What are the immunological therapies toxicities?

A 
Fatigue
Itching
Rash
Malaise
Pneumonitis
71
Q

What are the types of Bone marrow transplants?

A

Autologous - high dose with stem cell rescue
Allogeneic
Nonmmyeloablative

72
Q

What are the sources of stem cells?

A

Bone marrow
Peripheral blood
Cord blood

Clinical Pharmacology II (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions