Anticancer Flashcards
Define
Neoplasms
Benign and Malignant
Neoplasm = New and diseased form of tissue growth
Benign neoplasms = Non cancer form of tissue growth, which can be removed by surgery. No metastases.
Malignant neoplasms = Cancer form of tissue growt
\_\_\_\_\_\_\_\_\_\_= Leukemia (cancer of cells in blood) \_\_\_\_\_\_\_\_\_\_ = Sarcoma \_\_\_\_\_\_\_\_\_\_ = Carcinoma \_\_\_\_\_\_\_\_\_\_ = Lymphoma (also named as Hodkins disease) \_\_\_\_\_\_\_\_\_\_ = Myeloid leukemia \_\_\_\_\_\_\_\_\_\_ = Kaposis sarcoma \_\_\_\_\_\_\_\_\_\_ = Malignant melanoma
Bone marrow = Leukemia (cancer of cells in blood)
Connective tissue = Sarcoma
Epithelium = Carcinoma
Lymphoid tissue = Lymphoma (also named as Hodkins disease)
Myeloid stem cells = Myeloid leukemia
Endothelium = Kaposis sarcoma
Skin (melanocytes) = Malignant melanoma
cells must traverse the cell cycle phases before and during cell division.
Anticancer drugs may act on specific phase. Tumor cells are more responsive to specific drugs
Cell Cycle Phases
G0 phase – Resting phase
G1 phase – Synthesis of enzymes needed for DNA synthesis
S phase –DNA replication (DNA synthesis)
G2 phase –Synthesis of components needed for mitosis.
M phase – Mitotic tubule formationVincristine and vinblastine
Cell cycle phase
specific drugs
More active against cells that are specific phase of cycle: G1 phaseL-aspraginase and prednisone
S phaseMethotrexate, 6-thioguanine, cytarabine
G2 specificBleomycin and etoposide
M phaseVincristine and vinblastine, peclitaxol
Cell cycle specific drug (phase non-specific)
Alkylating agents, Antitumor antibiotic, Cisplatin
Cell cycle non specific agents
Effective whether cancer cells are in cycle or resting phase➡️radiation, nitrosoureas, mechlorethanime
Acute SEs of chemo • \_\_\_\_\_ effects the adjacent tissue • \_\_\_\_\_ damage to tissue/necrosis • \_\_\_\_\_\_Inflamm assoc w thrombus due to what? Dev aft chemo • Hypersensitive reactions • Rapid tumor lysis syndrome • Nausea and vomiting
Extravasation
Vessicant drugs
Thrombophlebitis due to activation of fibrinogen
Chronic Skin organ specific SEs
alopecia, dry skin, nail changes, pigmentation (melanoma), xerostomia
Loss of hair and drugs that causes this:
Alopecia. doxorubicin, daunorubicin, cyclophosphamide, vincristine, and paclitaxel.
*hair regrowth occurs aft 1-2 mos after stopping chemo
Vessicant agents drug examples
dactinomycin, doxorubicin, mechlorethamine, mitomycin, vincristine, and vinblastine
Also called bone marrow depression, examples and complications, onset, recovery time.
Myelosuppression: Neutropenia and Thrombocytopenia
- most dose limiting side effect of cancer
- onset is 7 – 10 ds and peak is 10 –14ds Recovery count occurs usually in 2 – 3 wks
Neutropenia drug tx.
treated by colony stimulating factors:
(G-CSF and GM – CSF) Filgrastim or
pegfilgrastim
Thrombocytopenia prevention tx:
for prevention use Oprelvekin (Inerleukin-11)
Deficiency in folic acid by methotrexate=Folinic acid (leucovorin, 5-formyltetrahydrofolic acid
Megaloblastic anemia
* Cancer patient with anemia= Erythropoeitins are useful
Least bone marrow depression anticancer drugs is?
Bleomycin
Cardiotoxicity:
Risk of CHF, commonly seen with?
Cause coronary spasms, mimicking a myocardial infarction?
- CHF: doxorubicin, daunorubicin, epirubicin, mitoxantrone.
- 5-FU, capecitabine
Cardiotoxicity can prevented or lessen by using what cardioprotective agent?
Dexrazoxane
Pulmonary toxicity:
Pneumonitis, pulmonary fibrosis commonly seen with what chemo drugs?
bleomycin, carmustine, cyclophosphamide, mitomycin, methotrexate, vinca alkaloids
Symptoms of pulmonary toxicity?
Symptoms of pulmonary toxicity include SOB, non-productive cough, and rarely low grade fever.
Another term for Dry mouth- one of the most common complications associated with radiation therapy. Reversible when?
Xerostomia. Reversible after 6 to 12 months of therapy.
How to manage dry mouth?
Can be managed by: sugar free hard candy, chewing sugar free gum stimulates salivation. Ice chips, sugarless candies, and commercially available saliva substitute or cholinergic agonist (Pilocarpine 5mg tab).
- Neurotoxicity common with what chemo agents?
* Peripheral neuropathies assoc w?
- vincristine, vinblastine, Cytarabines, Methotrexate (very little), 5FU, interferon alpha.
- Peclitaxel, Vincristine
- causes Perethesia
- High dose of this may produce cerebllar toxicity that manifest initially as loss of eye-hand coordination and progress to coma
- cause severe neurotoxicity
Vincristine
Cytarabin
Fludrabine
Genz burning, and pain on the ventral surface of tongue. Floor of tongue, mouth looks erythromatus.
-genz inflamm of oral mucosa.
Common with what chemo agents?
Mucositis
Stomatitis
-Doxorubicin, Methotrexate, 5-fluorouracil, Actinomycin,
Bleomycin capecitabine
Mucositis treatment and prevention:
• Top anes examples: _____
• _____ anti-inflammatory action.
• _____ Produces burning and pain and ultimately desensitizes pain.
• _____ provide benefit by coating.
This mwash may reduce severity and frequency of mucositis infections?
• Top. anes: Viscous lidocaine, or dyclonine HCL 0.5 or 1%
• Corticosteroid
• Capscisin
• Sucralfate suspension
-Chlorhexidine gluconate 0.12% (Peridex, Periogard)
N&V: Very high emetics anticancer drugs
- Cisplatin
- Streptozocin
- Cyclophosphamide
N&V: High emetics anticancer drugs
- Doxorubicin
- Methotrexate (250 mg to 1000 mg)
- Cytarabine
N&V: Lowest emetic anticancer drugs
- Bleomycin
- Methotrexate (under 50 mg)
- Vincristine
- Vinblastine
- Tamoxifen
The lowest emitogenic drugs n&v can be treated by?
• High and very high emitogenic drugs associated acute: n&v can be treated by?
• DOC for delayed nausea?
• Anticipatory n&v?
- Dexa PRN
- Dexa + Ondansetron
- Dexa DOC
- Benzodiazepine.
Hepatotoxicity monitor LFT, jaundice, or hepatitis chemo agents
asparaginase, cytarabine, mercaptopurine, and methotrexate.
Nephropathy: Elevate BUN and electrolyte abnormalities:
Amifostine may be used to protect the kidney from the nephrotoxicity associated with what chemo agents?
methotrexate may precipitate in kidney. Cisplatin and
streptozocin
Sexual dysfunction:
Chemo agents assoc with significant infertility in men and women?
Cyclophosphamide, melphalan, and procarbazine
• What bladder toxicity that is seen most commonly after administration of?
The other method is by administering uroprotecting agent called_____, which bind which metabolite and prevent from contacting the bladder mucosa.
Hemorrhagic cystitis: Cyclo. and Ifosfamide
-acrolein- these drugs produce this metabolite wc cause chemical irritation in bladder
mucosa, resulting in bleeding, prevented by excessive hydration and frequent urination.
-MESNA uroprotecting agent
Chemo agents admin intrathecally:
Warning: _____should be labelled as Intravenous only. _____ causes death.
administered intrathecally: Methotrexate, Cytarabine’ Thiotepa
Warning: Vincristine, intrathecally causes death.
Examples antimetabolites include?
methotrexate, 5 FU, mercaptopurine, citarabine and theoguanine
Examples of alkylating anticancer drugs?
Cisplatin, cyclophophamide, streptozocin
-Cancer patient on cancer chemotherapy, reports shortness of breath, non productive
cough?
-causes Pulmonary fibrosis?
-Least bone marrow depression, and emetic chemo drug
Bleomycin
