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Pharm Summer 2020 > Cancer > Flashcards

Cancer Flashcards

1
Q

Goal of chemo

A

Goal is to cause a lethal cytotoxic event or apoptosis in the cancer cell.

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2
Q

Dose response curve and TI for cancer drugs

A

Steep dose response curve and small TI

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3
Q

What cells are usually more susceptible to cancer drugs?

A

Rapidly dividing cells. Cells in G0 may survive.

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4
Q

When are cell cycle specific drugs effective?

A

For high growth fraction malignancies

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5
Q

When are cell cycle non specific drugs effective?

A

For low and high growth fraction malignancies

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6
Q

How does the growth rate of tumors change over time

A

Growth rate is initially rapid, but slows as it increases in size due to decrease in resources. Surgery/radiation can shift remaining cells to become active and then chemo can be more effective.

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7
Q

How can cancer drugs cause toxicity to normal cells undergoing rapid proliferation

A

Cheek and mouth ulcers
Bone marrow depression
GI mucosa
Hair follicles

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8
Q

Tx induced tumor

A

Most are mutagenic. Neoplasms can arise 10 or more years after original cancer was cured.

Especially probable with alkylating agents

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9
Q

What cancer drug class is most likely to cause a future tumor

A

Alkylating agents.

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10
Q

Antimetabolites MOA

A

Structurally related to normal compounds in the cell. Interferes with availability of normal purine or pyrimidine nucleotides. Causes inhibition of synthesis.

Maximal effects during S phase.

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11
Q

Cytarabine
MOA
Admin
Adverse effects

A

Enters cell and inhibits DNA pol.
Not effective oral. Give IV. Penetrates CNS.
GI, myelosuppression, hepatic disfunction, chemical conjunctivitis at high doses

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12
Q

5-FU
MOA
Given along with?

A

MOA: Enters cell through carrier medicated system.
Forms molecular complex that deprives cell of thymidine. DNA synthesis stops.

Given along with leucovorin. Booster. Helps 5-FU work longer

Given IV typically bc GI toxicity. Also given topically for skin cancer and prevention of scar tissue. Used in some ocular surgeries. Penetrates CNS

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13
Q

What drug can be given topically to prevent scar tissue formation and used in some ocular surgeries.

A

5-FU

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14
Q

Adverse effects of 5-FU (Systemic vs topical)

A

Systemic: Gi probs, alopecia, ulceration, BM depression, anorexia

Topical: not many

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15
Q

Mercaptopurine MOA

A

3 prong:
Nucleotide formation. Pretends to be purine base.
Incorporated into nucleic acid
Inhibit protein synthesis

**Thioguanine has similar

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16
Q

Which two antimetabolites have a 3 prong MOA

A

Mercaptopurine and thioguanine

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17
Q

Mercaptopurine
pharmacokinetics
adverse effects

A

Incomplete absorption on oral admin. Low bioavailability due to 1st pass. But still given orally lol weird

BM depression, jaundice, GI probs.

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18
Q

Thioguanine MOA

A

3 prong:
Nucleotide formation. Pretends to be purine base.
Incorporated into nucleic acid
Inhibit protein synthesis

Same as mercaptopurine

19
Q

Adverse effects of thioguanine

A

Dose related BM depression. Risk of liver toxicity with long term use. Not used for maintenance therapy.

20
Q

methotrexate MOA

A

Antagonist for an enzyme that creates folic acid. Required for cell response. Results can be reversed by thousand fold by dihydrofolate or leucovorin (similar structure to folic acid)

21
Q

What cells are resistant to Methotrexate

A

Non proliferating cells are resistant.

22
Q

Methotrexate results can be reversed thousand fold by

A

dihydrofolate or leucovorin (similar structure to folic acid)

23
Q

other than cancer, what could you take methotrexate for?

A

Low doses to treat some inflammation diseases. RA, chrons, psoriasis

24
Q

Methotrexate admin

A

Oral, IM, and IV.

Pt must remain hydrated to prevent renal toxicity: crystalluria.

25
Q

Methotrexate adverse effects

A

GI, toxicities in renewing tissues, renal damage if unhydrated, liver

Pulmonary toxicity in children
Avoid in pregnancy= abortion.

26
Q

What antimetabolite should you avoid in pregnancy

A

Methotrexate

27
Q

MOA of anti-tumor antibiotics

A

Binds DNA and prevents mRNA synthesis. Leads to free radicals that are cytotoxic.

28
Q 
Dactinomycin 
MOA 
Admin 
Excretion 
Adverse effects
A

MOA: interferes with RNA pol
Pharmacokinetics: IV admin. No CNS penetration.
Bile excretion.
adverse effects: BM suppression, immunosuppression, GI, sensitizes pt to radiation (inflammation may occur)

29
Q

Doxorubican pharmacokinestics

A

MUST be given by IV. Inactivated by GI tract.
Extravasation of drug may cause necrosis.
Extensive liver metabolism
Excreted by bile. Dose adjust in people with liver probs
Veins near IV may be dark red and red urine.

30
Q

Doxorubican adverse effects

A

Cardiotoxicity- irreversible. Dose dependent.
BM depression
GI
Severe alopecia.

31
Q

Bleomycin primarily used to tx __ cancer. Not used for ____ cancer

A

Testicular

Not used for liver or spleen tumors (enzymes there will inactivate drug)

32
Q

Bleomycin admin and adverse effects

A

Admin: Sub q, IM, IV
Adverse: pulmonary toxicity, alopecia, hypertrophic and hyperpigmentation of skin.

33
Q

Alkylating agents MOA

A

Adds carbon chains to DNA to alter structure and function.

*** ALL are mutagenic and carcinogenic. May cause secondary malignancies in the future.

34
Q

Alkylating agents for slow or fast growing tumors

A

Slow growing tumors. Not effective against fast.

35
Q

Admin of mAbs

A

Injection only.

36
Q

MOA of mAbs

A

Bind and induce apoptosis, inhibit growth, or interfere with cellular function.
Could also deliver toxin

37
Q

Rituxumab tx

A

Lymphomas and leukemias. Binds to sites on B lymphocytes and recruits immune effectors to kill.

38
Q

Trastuzumab tx

A

Breast cancer Tx. Arrests cells in GI. Reduces rate of relapse by 50% in the first year.

39
Q

Bevacizumab tx

A

Anti VEGF

Decreases O2 in tumor cells. Also used in retinal neovascular disease.

40
Q

MOA and admin of cisplatin, carboplatin, and oxiplatin

A

Similar to alkylating agents= cross linking DNA

IV admin

41
Q

Side effects of cisplatin

A

Cisplatin: Vomiting, nephrotoxicity, ototoxicity

42
Q

Side effects of carboplatin and oxiplatin

A

Mild nausea and myelosuppression (decreased blood cell formation)

43
Q

3 interferon types

A

Alpha: Leukocytic
Beta: produced by connective tissue fibroblasts
Gamma: produced by T cells

44
Q

Interferon alpha 2a and 2b used to tx

MOA and admin

A

Neoplastic disease.
MOA: binding of interferons produces intracellular reactions. Increases immune response of macrophage, T and B cells. Suppresses growth and tumor proliferation,

IM or subQ injection. Minimal liver met.

Pharm Summer 2020 (18 decks)

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