cancer

Question 1

the two most lethal cancers in men and women are?

Answer 1

breast and lung cancer

Question 2

what two cancers are the most likely of all cancers to spread to the eye?

Answer 2

breast and lung cancer

Question 3

where do the majority of chemotherapeutic agents affect?

Answer 3

The majority of chemotherapeutic agents affect cell division or DNA synthesis and function

Question 4

what are the newer targeted therapeutic agents for chemotherapy?

Answer 4

tyrosine kinase inhibitors and monoclonal antbodies

Question 5

what are the most widely used cytostatics (masquerade as nucleic acid bases and disrupt DNA/RNA synthesis, halting cell division?

Answer 5

antimetabolites

Question 6

what are 4 anti metabolites?

Answer 6

Methotrexate [Trexall®]
Trimethoprim [Primsol®]
Pyrimethamine [Daraprim®]
Pemetrexed [Alimta®]

Question 7

indication for methotrexate?

Answer 7

INDICATION
 RA, Psoriasis, *Choriocarcinoma…
DOSING [5-15mg]
 7.5-25 mg PO qwk
 *15-30 mg PO qd x 5d

Question 8

methotrexate moa

Answer 8

CLINICAL PHARMACOLOGY
Immunosupressant, Anti-Metabolite
Mechanism of Action
Acts as a folic acid analogue, inhibits DHFR, thus preventing formation of FH4
Inhibits lymphocyte proliferation

Question 9

adverse effects of methotrexate

Answer 9

ADVERSE EFFECTS
Common: Photosensitivity, pruritus, anemia, dizziness
SEVERE ADVERSE EFFECTS
Neurotoxicity
BLACK BOX
Deaths reported; monitor bone marrow, liver, lung & kidneys; opportunistic infections
Potentially fatal myelosuppression w/ NSAIDs

Question 10

methotrexate drug interactions

Answer 10

NSAIDs, Sulfonamides, Ciprofloxacin, Penicillins (Reduced elimination; additive effects)
Cyclosporine (reduced hepatic metabolism)
Ganciclovir (additive myelosuppression)
Systemic Corticosteroids (additive immunosuppression)
Tetracyclines (elevated levels)

Question 11

what percent of pts who undergo chemotherapy will experience nausea or vomitting?

Answer 11

Nearly 70-80% of all patients who undergo chemotherapy experience nausea or vomiting; incidence and severity depend on drug type, dose, route and schedule of administration

Question 12

what are the 2 key receptors involved in the emetic response?

Answer 12

Key receptors involved in the emetic response are D2 and 5HT-3

Question 13

how do chemotherapeutic drugs act peripherally?

Answer 13

Chemotherapeutic drugs can also act peripherally by causing cell damage in the GI tract and releasing serotonin from the enterochromaffin cells of the small intestinal mucosa. The released serotonin activates 5-HT3 receptors on vagal and splanchnic afferent fibers, which then carry sensory signals to the medulla, leading to the emetic response