Antineoplastic drugs + immune modulators

Question 1

if a patient has myelosuppression, low WBC and low platelets, what kind of precautions are they going to be on?

Answer 1

Neutropenic precautions

Question 2

what are the 5 most common side effects of antineoplastic agents and immune modulators?

Answer 2

-N/V
-hair loss + skin issues
-higher Rx. of developing more cancer
-low immune system
-myelosuppression

Question 3

alkylating agents are non cell cycle specific, that means cancer cells are killed at any phase of the cell cycle, this is useful in what kind of cancers?

Answer 3

slow growing cancers like lymphoma, leukemia or myeloma

Question 4

this drug is an alkylating agent that damages the DNA so that cancer cells aren’t able to replicate.

“the chlorine in the pool is alkaline”

Answer 4

chlorambucil

Question 5

the biggest consideration with the drug chlorambucil is safety because of what 3 adverse effects?

Answer 5

-tremors
-muscle twitching
-confusion

Question 6

Metabolites are naturally occurring in our body and they are what’s essential for DNA production + growth, so when the synthetic metabolites are given for cancer treatment, like Methotrexate, what is happening to the cancer cells?

Answer 6

Methotrexate inhibits folic acid reductase, which then inhibits DNA synthesis + growth

Question 7

what is a big NO with methotrexate? (4)

Answer 7

NO:
-folic acid
-pregnancy
-crowds, live vaccines, fresh fruit
-razors or hard tooth brushes

Question 8

what is the antidote for methOtrexate if it becomes nephrOtoxic?

Answer 8

LeucOvorin

Question 9

A patient being treated for their cancer is taking Doxorubicin, an antineoplastic antibiotic, they tell you that their urine is red, is this concerning or a expected finding?

Answer 9

this is an expected, harmless finding

Question 10

how does Doxorubicin work in the treatment of cancer?

Answer 10

this drug binds to the DNA and breaks the link which inhibits synthesis

Question 11

Dexrazoxane is a cardio protectant drug that is administered with ________ because it can cause cardiac toxicity

Answer 11

Doxorubicin

Question 12

Which class of drug kills the cancer cells in the M phase when they are about to divide?

Answer 12

Mitotic Inhibitors

Question 13

Vincristine is a mitotic inhibitor. It can cause a serious reaction/ toxicity if it comes into contact with what parts of the body?

Answer 13

the skin
eyes
mucous membranes

Question 14

If vincristine extravasates into the skin + tissue, what is the antidote that will be administered?

Answer 14

hyaluronidase + sodium thiosulfate

Question 15

true or false? hormone modulators treat cancer by binding to specific hormone receptor sites to block the actual hormone from binding

Answer 15

true.

Question 16

Tamoxifen is antiestrogenic, this means that……..

Answer 16

it is competing with estrogen binding sites to block the estrogen from feeding the tumor

Question 17

what are the 2 main adverse effects of tamoxifen?
“tamoxiFEn - FEmale”

Answer 17

-menopausal symptoms
-thromboembolic events

Question 18

cancer cell specific agents target only cancer cells and act only on specific enzymes, what enzyme does Imatinib inhibit?

Answer 18

tyrosine kinase - it is produced by the Philadelphia chromosome in CML, that continues to stimulate proliferation

Question 19

why is it important to notify the provider if a patient had rapid weight gain, edema, and crackles in the lungs after Imatinib has been administered?

Answer 19

these are signs of pulmonary edema and pleural effusion

Question 20

What are the 2 types of immune modulator drugs?

Answer 20

suppressants and stimulants

Question 21

what are 3 uses for immune depressants?

Answer 21

1.post organ transplant
2.autoimmune disorders
3.some cancers

Question 22

interferons and interleukins are 2 immune stimulants present in the body during inflammation, they increase capillary permeability, how does that give the patient respiratory difficulty?

Answer 22

increased permeability means that WBC’s are getting to where they need to be, fluid is going to follow them, but this leads to fluid overload and that is what causes respiratory difficulty

Question 23

what do colony stimulating factors tell the bone marrow to do? and what are adverse effects of this (2)?

Answer 23

to make more WBC’s; but this can cause GI inflammation and bone pain

Question 24

what kind of symptoms will immune stimulants produce?

Answer 24

flu like symptoms

Question 25

Immune suppressants block the release of cytokines, what kind of molecules are those?

Answer 25

signaling molecules

Question 26

Cyclosporine is a T+ B cell suppressor to block B production and inhibit T - this drug is used to prevent ________ in transplant patients.

Answer 26

rejection

Question 27

Anakinra is a interleukin receptor antagonist, what is it doing?

Answer 27

this drug is slowing down the immune system

Question 28

monoclonal antibodies (MABs) are used to treat autoimmune diseases + cancer. How do they work?

MONO - 1

Answer 28

they are lab made proteins, made to bind to ONE specific receptor site

Question 29

what are the 2 huge serious side effects of MABs?

Answer 29

heart failure and hemorrhage

Question 30

what should you premedicate your patient with before giving MABs to decrease infusion reactions?

Answer 30

acetominophen

Question 31

what is angiogenesis?

Answer 31

this is when cancer cells release enzymes that grow/ generate new blood vessels that feed the cancer cells

Question 32

what kind of cells does carcinoma originate in?

Answer 32

epithelial cells - this is the skin and lining of organs and cavities

Question 33

where do sarcoma originate in?

Answer 33

the mesenchyme - this is connective tissue, like bone and muscle

Question 34

cyclosporine is a T+B cell suppressor, what is the biggest adverse effect?

Answer 34

they have a depressed immune system so the patient is a huge infection risk