Anticancer Drugs 1

Question 1

Primary chemotherapy

Answer 1

Chemo indicated when neoplasms are disseminated and NOT amenable to surgery

Question 2

Adjuvant chemotherapy

Answer 2

Chemo used to attack micrometastases following surgery and radiation

Question 3

Neoadjuvant chemotherapy

Answer 3

Chemo Given prior to surgery to shrink the cancer

Question 4

Destruction of cancer cells follows _________ order kinetics

Answer 4

1st; given does destroys a certain fraction of the tumor cells

Question 5

Proliferating/non proliferating usually survive the effect of anti cancer drugs

Answer 5

Non proliferating

Question 6

Cell cycle specific agents

Answer 6

Antimetabolites, bleomycin, microtubule inhibitors, epipodophyllotoxins, camptothecins

Question 7

Cell cycle non specific agents

Answer 7

Alkylating agents, platinum coordination complexes, antitumor antibiotics

Question 8

What situations are cell cycle specific drugs more effective in?

Answer 8

Hematological malignancies and where there is a large growth fraction

Question 9

When are cell cycle non specific drugs more useful?

Answer 9

Low growth fraction solid tumors (but also high growth fraction tumors)

Question 10

Acquired multi drug resistance to cytotoxic drugs

Answer 10

Resistance emerge to several different drugs after exposure to a single agent

Question 11

Parts of the body that are susceptible to chemotherapy toxicity

Answer 11

Buccaneers mucosa, bone marrow, GI mucosa and hair cells

Question 12

Common adverse effects of chemo

Answer 12

Severe vomiting, stomatitis, bone marrow suppression and alopecia

Question 13

Adverse effects of doxorubicin

Answer 13

Cardiotoxicity;

Question 14

Adverse effects of cyclophosphamide and how would you treat that effect

Answer 14

Hemorrhagic cystitis; give them mesna

Question 15

Adverse effects of bleomycin

Answer 15

Pulmonary fibrosis

Question 16

Vincristine and paclitaxel adverse effects

Answer 16

Peripheral neuropathy

Question 17

What is used to manage chemotherapy induced emesis

Answer 17

5HT3 receptor blockers and NK-1 inhibitors

Question 18

What are filgrastim and sargramostim used for during chemotherapy

Answer 18

They are used to prevent and treat chemotherapy induced neutropenia

Question 19

___________ rescues bone marrow from methotrexate

Answer 19

Leucovorin

Question 20

_____________ reduces anthracyline induced cardiotoxicity

Answer 20

Dexrazoxane

Question 21

What is the use of amifostine in chemotherapy

Answer 21

It reduces renal toxicity caused by cisplatin

Question 22

Treatment induced neoplasms are especially seen after therapy with _________

Answer 22

Alkylating agents

Question 23

Types of antimetabolites used in chemotherapy

Answer 23

Folate analogs (ex. Methotrexate), purine analogs and pyramidine analogs

Question 24

Maximal cytotoxic effects by antimetabolite drugs target the __________ phase

Answer 24

S

Question 25

Mechanism of methotrexate?

Answer 25

Blocks dihydrofolate reductase and causes ↓ synthesis of dTMP and purine nucleotides → ↓ synthesis of DNA, RNA

Question 26

\_\_\_\_\_\_\_\_ increases the potency of methotrexate to other sites

Answer 26

Polyglutamates

Question 27

What is the enzyme that converts methotrexate to a series of polyglutamtes

Answer 27

Folylpolyglutamate syntheses (FPGS)

Question 28

List the adverse effects of methotrexate

Answer 28

Specific: - renal damage (complication with high dose methotrexate or impaired removal of it) - hepatic fibrosis and cirrhosis - pneumonitis - neurological toxicities

Question 29

Mechanism of leucovorin

Answer 29

It is a N-formal THF that is used to rescue bone marrow from drugs that ↓ folic acid levels like methotrexate It provides normal tissues with reduced folate (circumvents DHFR)

Question 30

\_\_\_\_\_\_\_ growing tumors with a small growth fraction are often unresponsive to cytotoxic drugs

Answer 30

slow growing

Question 31

what is primary resistance to cytotoxic drugs

Answer 31

no response to the drug on the first exposure

Question 32

Drugs that have multi drug resistance due to P glycoprotein

Answer 32

doxorubicin, daunorubicin, vincristine, vinblastine, etoposide, tenoposide

Question 33

drugs with high myelosuppression

Answer 33

cytarabine, alkylating agents, doxorubicin, daunorubicin, vinblastine

Question 34

what cell cycle phase does bleomycin effect?

Answer 34

G2-M

Question 35

what cell cycle phase does epidodophyllotoxins affect?

Answer 35

G1-S phase

Question 36

what cell cycle phase does camptothecins affect?

Answer 36

G2-M phase