Cancer and Immunomodulating Agents Flashcards by Bailey Derr

What are the three primary treatment modalities to address cancer?

surgery
radiation
chemotherapy

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What is cytotoxic strategy?

basic strategy of anticancer drugs is to limit cell proliferation by killing the cells and attenuating the growth of cells

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Cancer drugs generally either ______________.

inhibit DNA/RNA synthesis
directly inhibit cell division (mitosis)

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When are cell-cycle specific drugs effective?

only on cells going through a specific phase

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What do cell-nonspecific drugs do?

inhibit replication of ALL cells they encounter

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What is growth fraction?

percentage of proliferating cells relative to total neoplastic population

cells in growth fraction are more susceptible to cell-cycle nonspecific drugs

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What is the cell kill hypothesis?

each round of chemotherapy will kill a percentage of cancerous cells but not all

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What are side effects of cancer treating drugs?

hair loss
anemia
anorexia

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What do alkylating agents do?

generate a chemical alkyl group in the DNA chain

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What is the largest group of anticancer drugs?

alkylating agents

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What pathologies do alkylating agents treat?

leukemia
hodgkin and nonhodgkin lymphomas
brain tumors
melanoma

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What are adverse effects of alkylating agents?

blood disorders
GI distress
CNS effects
metabolic disorders

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What are antimetabolites?

interfere with normal metabolites

they are especially toxic to cells that have large growth fraction

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What are indications for antimetabolites?

breast cancer
GI and liver cancer
leukemias

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What are adverse effects of antimetabolites?

blood disorders
GI disorders
CNS toxicity
hepatotoxicity

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_____________ are used for neoplastic disease due to high toxicity.

antibiotics

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What are indications for antibiotics?

head and neck cancer
genital cancers
leukemia

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What are adverse effects of antibiotics?

pulmonary toxicity
skin disorders
blood disorders
GI distress

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What are hormones?

drugs that mimic or block the effects of certain hormones

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What are indications for hormones?

leukemia
breast cancer
prostate cancer
renal cancer

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What are adverse effects for hormones?
slightly different

GI distress
cardiovascular complications
CNS effects
general catabolic effect

What are the other potential cancer drugs?

biologic response modifiers
platinum coordination complexes
aspirin and NSAIDS

_____________ are not necessarily toxic to cancer cells and effect mechanisms that regulate cell division.

biologic response modifiers

______________ are heavy metal compounds that treat certain epithelial, ovarian and bladder cancers.

platinum coordination complexes

What are the two types of immunomodulating agents?

immunosuppressants immunostimulants

What are the two primary components of immunity?

innate immunity acquired immunity

____________ immunity involves leukocytes.

innate

___________ immunity involves T and B lymphocytes.

acquired

What are the two reasons to suppress the immune system?

minimize risk of rejection after transplant surgery suppression of an autoimmune response

What is cyclosporine?

primarily used to suppress tissue rejection

What are the side effects of cyclosporine? **they are severe**

nephrotoxicity HTN

What is the mechanism of action of cyclosporine?

selectivity of T-cells -- inhibition of immune response

What are glucocorticoids?

exert a nonspecific inhibition of all aspects of cell-mediated and chemical-mediated immunity

____________ is the mainstay to prevent transplant rejection and used in the treatment of autoimmune disease.

glucocorticoids

What are the adverse effects of glucocorticoids?

catabolic effect on collagenous tissues HTN increased risk of infection glaucoma

What immunosuppressant is generally used with other meds to create a synergistic effect.

glucocorticoids

What is the mechanism of action of methotrexate?

interferes with production of DNA, RNA and lymphocytes **originally an anticancer drug that has mild immunosuppressive effects**

What are the adverse effects of methotrexate?

hepatic toxicity pulmonary toxicity dose related

When is mycophenolate mofetil used?

cardiac or renal transplants typically used in combination

What is the MOA of mycophenolate mofetil?

inhibits enzymes responsible for DNA synthesis may also inhibit lymphocyte attraction

What are adverse effects of mycophenolate mofetil?

blood disorders GI problems cardiovascular problems

___________ is a new drug primarily used to prevent organ rejection, specifically kidney.

sirolimus

What is the MOA of sirolimus?

inhibits T and B lymphocytes

What are adverse effects of sirolimus?

may cause blood lipid disorder other blood disorders diarrhea skin rashes HTN

What is tacrolimus?

similar to cyclosporine but more potent primarily used to prevent kidney and liver rejection

What is the MOA of tacrolimus?

inhibits key immune mediators

What are the adverse effects of tacrolimus?

GI weakness fever renal toxicity CNS toxicity

What are the two types of immunostimulants?

bacille calmette-guerin immune globulin

What is bacille calmette-gluerin?

vaccine against TB may also be effective against bladder cancer

What are the adverse effects of bacille calmette-guerin?

local effects skin irritation

__________ is used to boost immune function.

immune globulin

What are the adverse effects of immune globulin?

joint and muscle pain GI general malaise