Antineoplastic drugs + immune modulators Flashcards
rotation 1 - week 3
if a patient has myelosuppression, low WBC and low platelets, what kind of precautions are they going to be on?
Neutropenic precautions
what are the 5 most common side effects of antineoplastic agents and immune modulators?
-N/V
-hair loss + skin issues
-higher Rx. of developing more cancer
-low immune system
-myelosuppression
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?
slow growing cancers like lymphoma, leukemia or myeloma
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”
chlorambucil
the biggest consideration with the drug chlorambucil is safety because of what 3 adverse effects?
-tremors
-muscle twitching
-confusion
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?
Methotrexate inhibits folic acid reductase, which then inhibits DNA synthesis + growth
what is a big NO with methotrexate? (4)
NO:
-folic acid
-pregnancy
-crowds, live vaccines, fresh fruit
-razors or hard tooth brushes
what is the antidote for methOtrexate if it becomes nephrOtoxic?
LeucOvorin
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?
this is an expected, harmless finding
how does Doxorubicin work in the treatment of cancer?
this drug binds to the DNA and breaks the link which inhibits synthesis
Dexrazoxane is a cardio protectant drug that is administered with ________ because it can cause cardiac toxicity
Doxorubicin
Which class of drug kills the cancer cells in the M phase when they are about to divide?
Mitotic Inhibitors
Vincristine is a mitotic inhibitor. It can cause a serious reaction/ toxicity if it comes into contact with what parts of the body?
the skin
eyes
mucous membranes
If vincristine extravasates into the skin + tissue, what is the antidote that will be administered?
hyaluronidase + sodium thiosulfate
true or false? hormone modulators treat cancer by binding to specific hormone receptor sites to block the actual hormone from binding
true.
Tamoxifen is antiestrogenic, this means that……..
it is competing with estrogen binding sites to block the estrogen from feeding the tumor
what are the 2 main adverse effects of tamoxifen?
“tamoxiFEn - FEmale”
-menopausal symptoms
-thromboembolic events
cancer cell specific agents target only cancer cells and act only on specific enzymes, what enzyme does Imatinib inhibit?
tyrosine kinase - it is produced by the Philadelphia chromosome in CML, that continues to stimulate proliferation
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?
these are signs of pulmonary edema and pleural effusion
What are the 2 types of immune modulator drugs?
suppressants and stimulants
what are 3 uses for immune depressants?
1.post organ transplant
2.autoimmune disorders
3.some cancers
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?
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
what do colony stimulating factors tell the bone marrow to do? and what are adverse effects of this (2)?
to make more WBC’s; but this can cause GI inflammation and bone pain
what kind of symptoms will immune stimulants produce?
flu like symptoms
Immune suppressants block the release of cytokines, what kind of molecules are those?
signaling molecules
Cyclosporine is a T+ B cell suppressor to block B production and inhibit T - this drug is used to prevent ________ in transplant patients.
rejection
Anakinra is a interleukin receptor antagonist, what is it doing?
this drug is slowing down the immune system
monoclonal antibodies (MABs) are used to treat autoimmune diseases + cancer. How do they work?
MONO - 1
they are lab made proteins, made to bind to ONE specific receptor site
what are the 2 huge serious side effects of MABs?
heart failure and hemorrhage
what should you premedicate your patient with before giving MABs to decrease infusion reactions?
acetominophen
what is angiogenesis?
this is when cancer cells release enzymes that grow/ generate new blood vessels that feed the cancer cells
what kind of cells does carcinoma originate in?
epithelial cells - this is the skin and lining of organs and cavities
where do sarcoma originate in?
the mesenchyme - this is connective tissue, like bone and muscle
cyclosporine is a T+B cell suppressor, what is the biggest adverse effect?
they have a depressed immune system so the patient is a huge infection risk
