Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PPP Winter Midterm > Cancer Chemotherapy > Flashcards

Cancer Chemotherapy Flashcards

1
Q

List 3 characteristics of a cancer cell

Define one characteristic that distinguishes a benign tumor from a malignant one

A

Uncontrolled growth + survival

Angiogenesis

Invasion + metastasis **

** What Malignant tumor has that benign one doesnt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name 3 major classes of non-targeted chemotherapies

Match them with the phase(s) in cell cycle

A

Inhibitors of mitotic spindle function = M phase

Inhibitors of DNA synthesis = S phase

Agents that cause severe DNA damage = S or any phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

For cancer-cell specific targeted chemotherapy, which targets

Inc. proliferation / survival
Inc. angiogenesis

A

Inc. proliferation/survival
EGFR
BCR-ABL

Inc. angiogenesis
VEGFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does EGFR do?

A

Activates cell proliferation through proteins that activate RAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does BCR-ABL do?

A

Unique constitutively active tyrosine kinase that promotes proliferation and prevents apoptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does VEGFR do?

A

Initiates signal cascades that stimulate angiogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where is the mostly likely location in the cell cycle for the action of targeted chemotherapies?

A

Between G0 and G1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the affected cell type responsible for fatigue?

A

RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the affected cell type responsible for bleeding from the GI and genitourinary tract?

A

Platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the affected cell responsible for the increased risk of infections?

A

Neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the affected cell type responsible for hair loss?

A

Hair follicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the affected cell type responsible for diarrhea?

A

GI epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are general AEs of non-targeted chemotherapies?

A

GI cells =
+diarrhea
+mucositis
+N/V

Bone marrow cells =
+dec. WBC = leukopenia
+dec. platelets = thrombocytopenia
+dec. RBCs = anemia

Hair follicles = alopecia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does pacytopenia refer to?

A

Leukopenia + thrombocytopenia + anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What drug classes are inhibitors of mitotic spindle function?

A

Vinca-alkaloids

Taxans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are examples of Vinca-alkaloids?

What is their MOA?

A

Vincristin

Vinblastin

Inhibit MT polymerization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are examples of Taxans?

What is their MOA?

A

Paclitaxel

Docetaxel

Inhibit MT DEpolymerization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are AEs of MT inhibitors ?

A

Neurotoxic = peripheral neuropathy

Hypersensitivity reactions
**mainly PACLITAXEL

Constipation
****mainly VINCRISTINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What drug classes inhibit DNA synthesis?

Are they non-targeted or targeted?

A

Non-targeted

Inhibitors of purine/pyrimidine synthesis

Inhibitors of deoxyribonucleotide synthesis

DNA intercalated

Topoisomerase inhibitors/DNA cleaving agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are drugs that inhibit purine/pyrimidine synthesis?

A

6-Mercaptopurine (6-MP)

Methotrexate (MTX)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the MOA of 6-MP?

A

Inhibits de-novo purine synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is an AE of 6-MP?

A

Hepatotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a DDI associated with 6-MP?

Why?

A

Allopurinol

This will inhibit the XO enzyme which usually metabolizes 6-MP into inactive moieties.. allopurinol onboard means more 6-MP gets diverted to the enzyme that will break it down into the active moiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the MOA of MTX?

A

Inhibits de novo purine synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What drugs inhibit deoxyribonucleotide synthesis?

A

5-fluorouracil

MTX

Hydroxyurea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the MOA of 5-FU?

A

Inhibits thymidylate synthase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What AE is associated with 5-FU?

A

Hand-foot syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the MOA of MTX?

Inhibition of deoxyribonucleotide synthesis

A

Inhibits thymidylate synthase

Inhibits de-novo purine synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What AE is associated with MTX?

A

Hepatotoxicity (BB warning)

Bone marrow suppression (BB warning)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When is MTX contraindicated?

A

Pregnancy (BB warning)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is leucovorin rescue therapy?

When it is given?

A

Activated folic acid

Given to limit toxicity since MTX inhibits the activation of DHF to the active folic acid (THF) form

32
Q

What is the MOA of hydroxyurea?

A

Inhibits ribonucleotide reductase

33
Q

What drugs are DNA intercalators?

A

Doxorubicin

Daunorubicin

Dactinomycin

34
Q

What is the MOA of DNA intercalators?

A

Intercalate with DNA, disrupt progress of replication fork in order to distort helix

35
Q

What AE is associated with DNA intercalators ?

A

Cardiotoxicity: cardiomyopathy

36
Q

What is a prevention for the cardiotoxicity AE associated with DNA intercalators?

A

Dexrazoxane (iron chelation)

37
Q

What drugs are topoisomerase inhibitors/ DNA clearing agents?

A

Topotecan
Etoposide

Bleomycin

38
Q

What is the MOA of topoisomerase inhibitors?

A

Inhibit topoisomerase = DNA strand breaks = apoptosis

39
Q

What AE is associated with topoisomerase inhibitors ?

A

Severe diarrhea

40
Q

What is the MOA of bleomycin?

A

Produces single strand/double strand breaks by complex mechanisms involving bleomycin, oxygen, and ferrous iron

41
Q

What AE is associated with bleomycin?

A

Pulmonary fibrosis

Major limitation

42
Q

What drug class agents induce structural DNA damage?

Are they cell-cycle specific?

A

Non-cell cycle specific

Alkylation agents

Platinum agents

43
Q

What drug is an example of an alkylation agent?

A

Cyclophosphamide

44
Q

What is the MOA of cyclophosphamide?

A

Alkylate DNA = cross-linking = strand break = apoptosis

45
Q

What AE is associated with cyclophosphamide?

A

Hemorrhagic cystitis (bleeding, inflammation in bladder) - due to formation of acrolein toxic metabolite

Secondary malignancies

Gonadotoxic

46
Q

What is a prevention treatment against hemorrhagic cystitis?

A

Extensive hydration

MESNA (binds to acrolein)

47
Q

What is a platinum agent?

A

Cisplatin

48
Q

What is the MOA of cisplatin?

A

Forms platinum adduct to cross-link guanines = apoptosis

49
Q

What AE is associated with cisplatin?

A

Nephrotoxicity

Ototoxicity = tinnitus, hearing loss

50
Q

What is prevention for nephrotoxicity from cisplatin?

A

Hydration

Amifastin (generates thiol metabolite that scavengers free radical)

51
Q

What drug classes are examples of TARGETED chemotherapies?

A

Tyrosine kinase inhibitors (TKIs)

Monoclonal antibodies (mabs)

52
Q

What are examples TKIs and their targets?

A

Erlotinib, Gefitinib =
EGFR tyrosine kinase

Imatinib, dasatinib, nilotinib =
BCR-Abl tyrosine kinase

Sunitinib =
VEGFR tyrosine kinase

53
Q

What AEs are associated with EGFR TKIs?

A

Rash

Steven Johnsons syndrome

Diarrhea

54
Q

What AEs are associated with BCR-Abl TKIs?

A

GI

Hepatotoxicity

QT prolongation (BB warning)
****NILOTINIB
55
Q

What AEs are associated with VEGFR TKIs?

A

Hepatotoxicity (BB warning)

HTN*

Thromboembolism*

*“class effect” of VEGFR targeting drugs

56
Q

What does VEGF do?

A

Stimulates NO production by endothelial cells

57
Q

What are types of MABs and their targets?

A

Cetuximab = EGFR

Trastuzumab = HER-2 (also growth factor)

Bevacizumab = VEGFR

58
Q

What AE is associated with Cetuximab?

A

Rash

GI effects

59
Q

What AE is associated with Trastuzumab?

A

Cardiotoxic

Dec. LV ejection fraction

60
Q

What AEs are associated with Bevacizumab?

A

HTN

Thromboembolism

61
Q

If a patient presented with the following, what would you diagnose as:

Tachycardia
SOB
Neck vein distension
Pulmonary rales
Enlarged heart on echo
A

Cardiomyopathy

62
Q

If a patient presented with the following, what would you diagnose as:

Painful urination, frequency and he matures

A

Hemorrhagic cystitis

63
Q

If a patient presented with the following, what would you diagnose as:

Cough
Dyspnea
Rales

A

Pulmonary fibrosis

64
Q

If a patient presented with the following, what would you diagnose as:

Numbness of hands and feet

A

Peripheral neuropathy

65
Q

If a patient presented with the following, what would you diagnose as:

Creatinine clearance 75 ml/min serum (declines from 110 ml/min @ baseline) magnesium (1.2 mEq/l)

A

Nephrotoxicity

66
Q

What drug could cause cardiomyopathy?

A

Doxorubicin

67
Q

What prevention is possible for cardiomyopathy?

A

Limit cumulative dose

Dexrozaxane

Liposomal preparations

68
Q

What is treatment available for toxicity from doxorubin leading to cardiomyopathy?

A

BBs

ACEIs

ARBs

Diuretics

69
Q

What drug can cause hemorrhagic cystitis?

A

Cyclophosphamide

70
Q

Is prevention for hemorrhagic cystitis AE possible?

What tx is available?

A

Prevention:
Forced hydration OR MESNA

Tx:
D/c and start hydration

71
Q

What drug can cause pulmonary fibrosis?

A

Bleomycin

72
Q

Is prevention of pulmonary fibrosis from bleomycin preventable?

What tx is available?

A

No.

Tx:
D/c med
Oxygen + steroids

73
Q

What drugs can cause peripheral neuropathy?

A

Vinca-alkaloids

Taxans

74
Q

Is prevention possible for the peripheral neuropathy AE from vinca-alkaloids and taxans?

What tx is available ?

A

No

Tx:
Pain meds for neuropathy = gabapentin, amitryptiline, fluoxetine

75
Q

What drug could cause nephrotoxicity?

A

Cisplatin

76
Q

Is Cisplatin - caused nephrotoxicity possible to prevent?

What tx is available?

A

Possible prevention:
Aggressive hydration
Amifastin

Tx:
IV saline
Lower dose
Switch to other platinum drugs
Oral Mg supplement
77
Q

What is an advantage of a TKI vs. MAB?

A

TKIs are available oral, while MABs are only IV or IM!

PPP Winter Midterm (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions