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IHO Week 4 > Antineoplastics IV - Fitz > Flashcards

Antineoplastics IV - Fitz Flashcards

1
Q

What are the common motor symptoms seen in neurotoxicity with Vincristine?

A

Loss of Reflexes

  • Occurs within 2-3 weeks of treatment in 100% of patients
  • Used as indication of sufficient dose
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2
Q

What are the common autonomic symptoms seen in neurotoxicity with Vincristine?

A

Constipation
Paralytic ileus
Orthostatic Hypotension

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3
Q

What are the common sensory symptoms seen in neurotoxicity with Vincristine?

A

Paresthesias (pins and needles)

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4
Q

If loss of reflexes is followed by severe paresthesias and mild to moderate sensory loss, what does this indicate for Vincristine dosing?

A

Indication to DECREASE the dose (currently at a toxic level)

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5
Q

Why does treatment with natural product drugs (ie vinca alkaloids and taxanes) lead to multi-drug resistance?

A

Increased expression of P-glycoprotein

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6
Q

What drugs naturally occurs as cortisol?

A

Prednisone

Dexamethasone

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7
Q

What is the mechanism of action for Prednisone/Dexamethason?

A

Interferes with the concentration, distribution and function of leukocytes (increases neutrophils; decreases monocytes, T and B lymphocytes, eosinophils and basophils)
=> results in decreased TNF-a and IL-2 release

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8
Q

Compare the trigger for cell division in cancer cells vs. normal immune system:

A

Cancer Cells: Unstimulated

Normal Immune System: Specific Antigen

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9
Q

Compare the cell division in cancer cells vs. normal immune system:

A

Cancer Cells: Random

Normal Immune System: Syncrhonized

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10
Q

Compare the drug administration in chemotherapy vs. immunosuppression:

A

Chemo: High Dose - Pulse cycles

Immunosuppression: Low Dose - Continuous

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11
Q

When are antibodies and fusion proteins prescribed?

A

When traditional chemotherapy has failed or when patient factors (especially age) prevent cytotoxic drug use

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12
Q

What is the goal of using antibodies as therapeutic proteins?

A

Use the immune system to suppress itself by getting it to recognize and kill cells that express a particular antigen

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13
Q

How are cytokines cytotoxic?

A

They recruit the immune cells to do recognize the tumor cells as foreign and kill them

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14
Q

What drug is known for causing a cytokine storm and what is this?

A

IL-2

Activation and expansion of lytic lymphocytes causing inflammation, vascular leak syndrome, secondary release of cytokines (TNF and IFN-a)

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15
Q

What is palmar-plantar erythrodysesthesia?

A

Hand-foot syndrome

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16
Q

What is the number one complication of antineoplastic drugs?

A

Bone Marrow Suppression = Dose Limiting Complication

17
Q

What is the role of tyrosine kinases?

A

Phosphorylate Tyrosine Residues

18
Q

What are important regulators of intracellular signal transduction pathways responsible for development and multicellular communication?

A

Tyrosine Kinases

19
Q

How does Trastuzumab work?

A

Antibody binds to the HER2 receptor, interfering with signaling and identifying HER2 overexpressing cells as foreign

20
Q

How does Pertuzumab work?

A

First antineoplastic Dimerization Inhibitor

Prevents HER2 from dimerizing with other HER receptors

21
Q

How does Ado-Trastuzumab Emtansine work?

A

Internalized and undergoes lysosomal degradation to:

Trastuzumab and DM1 (disrupts microtubule network by binding tubulin)

22
Q

Describe the synergistic cytotoxicity in giving Methotrexate and then L-Asparaginase.

A

Methotrexate cell killing is dependent upon synthesis of enzymes necessary for DNA synthesis (DNFR and Thymidylate Synthase)

By giving L-Asparaginase (Asparagine -> Aspartate) after MTX, you shut down any remaining DNA synthesis by depriving the ALL cancer cell of Asparagine (cells already lack asparagine synthetase so they can’t convert Aspartate -> Asparagine)

23
Q

What first generation HDAC inhibitor that is used as a mood stabilizer and an antiepileptic is being explored for cancer treatment?

A

Valproic Acid

24
Q

What other diseases are HDAC inhibitors being used for?

A

Huntington’s Disease

ALS

25
Q

What is Differentiation Syndrome?

A

Formerly called Retinoic Acid Syndrome

Fever
Dyspnea
Weight Gain
Pulmonary Infiltrates
\+/- Leucocytosis
\+/- Pleural or Pericardial Effusions
26
Q

Define symptoms associated with CNS toxicity.

A 
Dizziness
Anxiety
Depression
Confusion
Agitation

IHO Week 4 (15 decks)

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