Cancer and Immunomodulating Agents Flashcards

1
Q

What are the three primary treatment modalities to address cancer?

A

surgery
radiation
chemotherapy

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2
Q

What is cytotoxic strategy?

A

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

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3
Q

Cancer drugs generally either ______________.

A

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

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4
Q

When are cell-cycle specific drugs effective?

A

only on cells going through a specific phase

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5
Q

What do cell-nonspecific drugs do?

A

inhibit replication of ALL cells they encounter

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6
Q

What is growth fraction?

A

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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7
Q

What is the cell kill hypothesis?

A

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

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8
Q

What are side effects of cancer treating drugs?

A

hair loss
anemia
anorexia

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9
Q

What do alkylating agents do?

A

generate a chemical alkyl group in the DNA chain

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10
Q

What is the largest group of anticancer drugs?

A

alkylating agents

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11
Q

What pathologies do alkylating agents treat?

A

leukemia
hodgkin and nonhodgkin lymphomas
brain tumors
melanoma

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12
Q

What are adverse effects of alkylating agents?

A

blood disorders
GI distress
CNS effects
metabolic disorders

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13
Q

What are antimetabolites?

A

interfere with normal metabolites

they are especially toxic to cells that have large growth fraction

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14
Q

What are indications for antimetabolites?

A

breast cancer
GI and liver cancer
leukemias

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15
Q

What are adverse effects of antimetabolites?

A

blood disorders
GI disorders
CNS toxicity
hepatotoxicity

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16
Q

_____________ are used for neoplastic disease due to high toxicity.

A

antibiotics

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17
Q

What are indications for antibiotics?

A

head and neck cancer
genital cancers
leukemia

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18
Q

What are adverse effects of antibiotics?

A

pulmonary toxicity
skin disorders
blood disorders
GI distress

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19
Q

What are hormones?

A

drugs that mimic or block the effects of certain hormones

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20
Q

What are indications for hormones?

A

leukemia
breast cancer
prostate cancer
renal cancer

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21
Q

What are adverse effects for hormones?
slightly different

A

GI distress
cardiovascular complications
CNS effects
general catabolic effect

22
Q

What are the other potential cancer drugs?

A

biologic response modifiers
platinum coordination complexes
aspirin and NSAIDS

23
Q

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

A

biologic response modifiers

24
Q

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

A

platinum coordination complexes

25
Q

What are the two types of immunomodulating agents?

A

immunosuppressants
immunostimulants

26
Q

What are the two primary components of immunity?

A

innate immunity
acquired immunity

27
Q

____________ immunity involves leukocytes.

A

innate

28
Q

___________ immunity involves T and B lymphocytes.

A

acquired

29
Q

What are the two reasons to suppress the immune system?

A

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

30
Q

What is cyclosporine?

A

primarily used to suppress tissue rejection

31
Q

What are the side effects of cyclosporine?

they are severe

A

nephrotoxicity
HTN

32
Q

What is the mechanism of action of cyclosporine?

A

selectivity of T-cells – inhibition of immune response

33
Q

What are glucocorticoids?

A

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

34
Q

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

A

glucocorticoids

35
Q

What are the adverse effects of glucocorticoids?

A

catabolic effect on collagenous tissues
HTN
increased risk of infection
glaucoma

36
Q

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

A

glucocorticoids

37
Q

What is the mechanism of action of methotrexate?

A

interferes with production of DNA, RNA and lymphocytes

originally an anticancer drug that has mild immunosuppressive effects

38
Q

What are the adverse effects of methotrexate?

A

hepatic toxicity
pulmonary toxicity
dose related

39
Q

When is mycophenolate mofetil used?

A

cardiac or renal transplants

typically used in combination

40
Q

What is the MOA of mycophenolate mofetil?

A

inhibits enzymes responsible for DNA synthesis

may also inhibit lymphocyte attraction

41
Q

What are adverse effects of mycophenolate mofetil?

A

blood disorders
GI problems
cardiovascular problems

42
Q

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

A

sirolimus

43
Q

What is the MOA of sirolimus?

A

inhibits T and B lymphocytes

44
Q

What are adverse effects of sirolimus?

A

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

45
Q

What is tacrolimus?

A

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

46
Q

What is the MOA of tacrolimus?

A

inhibits key immune mediators

47
Q

What are the adverse effects of tacrolimus?

A

GI
weakness
fever
renal toxicity
CNS toxicity

48
Q

What are the two types of immunostimulants?

A

bacille calmette-guerin
immune globulin

49
Q

What is bacille calmette-gluerin?

A

vaccine against TB
may also be effective against bladder cancer

50
Q

What are the adverse effects of bacille calmette-guerin?

A

local effects
skin irritation

51
Q

__________ is used to boost immune function.

A

immune globulin

52
Q

What are the adverse effects of immune globulin?

A

joint and muscle pain
GI
general malaise