Cancer

Question 1

Cell-cycle specific

Answer 1

Drug effects specific phase of cell cycle

Drug will not be effective if cell is in G0 (resting) phase

Question 2

Cell-cycle nonspecific

Answer 2

Drug effective regardless of cell phase

Question 3

Alkylating Agents

Answer 3

Cyclophosphamide, ifosfamide

MOA: Bind DNA strands to prevent DNA function and replication
Cell cycle non-specific

Question 4

Alkylating Agents adverse effects

Answer 4

Blood disorders (-penias), N/V, CNS toxicity, Hemorrhagic cystitis (cyclophosphamide)

Question 5

Platinum Coordination Complexes

Answer 5

-platins,

Alkylating agents form cross links between and within DNA strands with platinum as opposed to alkyl side chains

Question 6

Platinum Coordination Complexes ADEs

Answer 6

-penias, N/V/D, Anaphylactoid reactions, peripheral neuropathy, neurotoxicity (cisplatin), and respiratory toxicity (oxaliplatin)

Question 7

Antimetabolites MOA

Answer 7

Interfere with normal metabolites (purines and pyrimidines nucleotides) during DNA/RNA synthesis

Question 8

Antimetabolites ADEs

Answer 8

Blood disorders (-penias), N/A, muscle pain, fatigue, rash, nephrotoxicity (methotrexate)

Question 9

Anticancer Antibiotics MOA

Answer 9

“-mycins” and “-rubicins”
Block synthesis of RNA, DNA, or both leading to disruption in cell synthesis

Question 10

Anticancer Antibiotics ADEs

Answer 10

Acute toxicity:
-N/V
-Fever
-Red urine with daunorubicin and doxorubicin (dyed)

Delayed Toxicity:
-Pulmonary fibrosis (Bleomycin)
-Skin and mucocutaneous

Cardiotoxicity
-rubicins
-Penias!!

Question 11

Antimicrotuble Agents MOA

Answer 11

“-taxel” and “-istine”
Cell-cycle specific (CCS) medications

Question 12

Antimicrotuble Agents ADEs

Answer 12

penias, N/V/D, Cardiopulmonary toxicity, peripheral neuropathies (very taxing on the periphery)

Question 13

Topisomerase Inhibitors ADEs

Answer 13

Severe diarrhea (I ran to the can), penias, N/V

Question 14

Monoclonal Antibodies

Answer 14

-mabs, mostly IV therapies

Question 15

Monoclonal Antibodies ADE

Answer 15

Infusion reactions + MAb specific reactions

Question 16

Tyrosine Kinase Inhibitors MOA

Answer 16

-nibs

Targeted therapy

Disrupt cell signal transduction of cancer-specific proteins

Less damage to normal cells than traditional chemotherapy

Question 17

Anemia precautions

Answer 17

Review Hemoglobin, Hematocrit, and platelets before treating

Expect reduced aerobic capacity, tachycardia

Question 18

Neutropenia Precautions

Answer 18

Review WBCs, Absolute Neutrophil Count (ANC)

Look for medications ending in –stim (filgrastim)

Implications for individual vs group therapy

Potential isolation precautions

Question 19

On-Cycle

Answer 19

When patient is receiving treatment
Expect clinical deterioration
Provide reduced intensity plan
May need to be treated individually due to immunocompromise

Question 20

Off-Cycle

Answer 20

Patient is not actively receiving treatment
Rebuild what was lost on-cycle
Increase muscle force and aerobic capacity