Cancer

Question 1

cytotoxic agents

Answer 1

most frequently used
directly attack both CA and healthy cells

cycophosphamide
cisplatin
methotrexate
doxorubicin
vincristine

Question 2

hormonal agents

Answer 2

deprive CA cells of hormones needed to grow

tamoxifen
leuprolide

Question 3

high growth fraction

Answer 3

cells which constantly undergo cell cycle
ex. bone marrow, hair follicles, sperm-forming cells

these cells best respond to chemotherapy

Question 4

low growth fraction

Answer 4

cells which go through G0 resting phase during cell cycle

these cells typically require surgery + radiation + chemotherapy

Question 5

diffficulties w/CA tx

Answer 5

1. all CA cells must be killed & many tx are immunosupressants
2. pts must tolerate full tx
3. once CA has been reduced to 1 billion cells, no longer detectable

Question 6

cytotoxic agent toxicities

Answer 6

bone marrow supression
GI tract damage
N/V
alopecia
local tissue injury "extravasation"
secondary cancer

Question 7

cycophosphamide

Answer 7

cytotoxic agent
tx wide variety of CA
bone marrow suppression, N/V, alopecia
damage to bladder mucosa-->hemorrhagic cystitis
antidote: 3L fluid daily, mesna

Question 8

cisplatin

Answer 8

cytotoxic agent
derived from platinum
bone marrow suppression, N/V, alopecia
nephrotoxic, ototoxic
monitor pt for hearing loss, vertigo

Question 9

methotrexate for CA

Answer 9

cytotoxic agent
MASSIVE dose
bone marrow suppression, N/V, alopecia
nephrotoxic
antidote for healthy cells: leucovorin

Question 10

doxorubicin

Answer 10

cytotoxic agent
bone marrow suppression, N/V, alopecia
bright red-->turns urine and sweat red
cardiotoxic-->dysrhythmias
max dose: 550mg/m2
may receive dexrazoxane, but further supresses bone marrow

Question 11

vincristine

Answer 11

cytotoxic agent
from periwinkle flower
NO bone marrow supression
nerve damage–>neuropathy, decreased DTR, constipation, urinary hesitancy

Question 12

tamoxifen

Answer 12

hormonal agent - blocks estrogen receptors for breast cancer
hot flashes, endometrial CA, blood clots
increases bone density, improves cholesterol
may be prophylactic

Question 13

leuprolide

Answer 13

hormonal agent - decreased production of testosterone for prostate CA
decreased libido, erectile dysfunction, gynecomastia, reduced muscle mass, hot flashes
alternative to castration