Cancer and Immunomodulating Agents Flashcards
What are the three primary treatment modalities to address cancer?
surgery
radiation
chemotherapy
What is cytotoxic strategy?
basic strategy of anticancer drugs is to limit cell proliferation by killing the cells and attenuating the growth of cells
Cancer drugs generally either ______________.
inhibit DNA/RNA synthesis
directly inhibit cell division (mitosis)
When are cell-cycle specific drugs effective?
only on cells going through a specific phase
What do cell-nonspecific drugs do?
inhibit replication of ALL cells they encounter
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
What is the cell kill hypothesis?
each round of chemotherapy will kill a percentage of cancerous cells but not all
What are side effects of cancer treating drugs?
hair loss
anemia
anorexia
What do alkylating agents do?
generate a chemical alkyl group in the DNA chain
What is the largest group of anticancer drugs?
alkylating agents
What pathologies do alkylating agents treat?
leukemia
hodgkin and nonhodgkin lymphomas
brain tumors
melanoma
What are adverse effects of alkylating agents?
blood disorders
GI distress
CNS effects
metabolic disorders
What are antimetabolites?
interfere with normal metabolites
they are especially toxic to cells that have large growth fraction
What are indications for antimetabolites?
breast cancer
GI and liver cancer
leukemias
What are adverse effects of antimetabolites?
blood disorders
GI disorders
CNS toxicity
hepatotoxicity
_____________ are used for neoplastic disease due to high toxicity.
antibiotics
What are indications for antibiotics?
head and neck cancer
genital cancers
leukemia
What are adverse effects of antibiotics?
pulmonary toxicity
skin disorders
blood disorders
GI distress
What are hormones?
drugs that mimic or block the effects of certain hormones
What are indications for hormones?
leukemia
breast cancer
prostate cancer
renal cancer
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
