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Block 7 Week 1 Colt > Cancer Chemotherapy - Duan > Flashcards

Cancer Chemotherapy - Duan Flashcards

1
Q

Is cancer self or foreign?

A

self

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2
Q

what are the factors that promote cell proliferation in cancer?

A

shorter (accelerated) cell cycle
excessive proliferation
higher activity of nucleic acid and protein synthesis
altered cell-cell communication
invasive (disrupt normal healthy tissues)
migration to distant sites - metastasis

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3
Q

T/F: cancer cells use the same metabolic processes and nutrients as host cells

A

true

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4
Q

Growth Factor G-protein CR is involved in what part of the cell cycle?

A

G0 resting

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5
Q

What is the MOA of Mitomycin C?

A

cross-links DNA; bifunctional alkylate

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6
Q

When in the cell cycle does Mitomycin work?

A

G1

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7
Q

Cytosine arabinoside, hydroxyurea, 6-MP, MTX, 5-FU all have what MOA and are therefore used in what part of the cell cycle?

A

block DNA synth, S phase

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8
Q

Etoposide has what MOA and is effective in what part of the cell cycle?

A

inhibits topoisomerase II based DNA degradation and works in the G2 phase

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9
Q

Vincristine, vinblastine, and taxanes block mitotic (blank) formation and therefore are active during what part of the cell cycle?

A

block mitotic spindle formation and are active during Mitosis

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10
Q

Mechlorethamine, cyclophosphamide, and Ifosfamide are all (blank) mustards

A

nitrogen mustards

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11
Q

Carmustine, lomustine, and streptozotocin are all what type of agent?

A

Nitrosoureas

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12
Q

T/F: nitrosoureas interact with DNA specifically

A

false

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13
Q

T/f: alkylating agents are active even during G0

A

true

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14
Q

(blank) agents impair cell function by forming covalent bonds with the (blank) groups in biologically important molecules

A

amino, carboxyl, sulfhydryl, and phosphate

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15
Q

Which nitrogen in guanine in DNA is most susceptible to alkylation?

A

N7 of guanine

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16
Q

what was the first chemotherapy agent used in humans?

A

nitrogen mustards

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17
Q

What is the main source of toxicity from nitrogen mustards?

A

DNA cross linkage

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18
Q

The (blank) side chain in nitrogen mustards undergo an intramolecular cyclization to form carbonium ions intermediates

A

chloroethyl side chain

19
Q

The aziridine ring of nitrogen mustards attacks the (blank) of DNA base or protein, (blank) of DNA or phosphate, or the (blank) of protein

A

N of DNA base or protein, =O of DNA or phosphate, and -SH of protein

20
Q

Alkylation of the the 7 N in guanine in DNA makes it more (acidic/basic) causing it to mispair with what base?

A

acidic, thymine

21
Q

Nitrogen mustards cause a base pair substitution of?

A

A-T for GC

22
Q

Nitrogen mustards can open the imidazole ring or depurination by (blank) of the alkylated guanine residue

23
Q

The 2nd chloroethyl side chain in bifunctional alkylating agents can alkylate a second guanine and cause (blanking) of two nucleic acid side chains

A

cross-links

24
Q

T/F: Cross-linking can happen both between and within strands

25
Q

Chlorambucil and melphalan work to form crosslinking (between/within) strands

26
Q

Cis-platinum cross links (between/within) strands

27
Q

(Between/within) strand cross linking has a high correlation with cytotoxicity

28
Q

What are the three major classes of adverse reactions to nitrogen mustards?

A
  1. teratogenic
  2. immunosuppressive
  3. carcinogenic
29
Q

What are the two types of cancers that nitrogen mustards were used for?

A

lymphomas and leukemias

30
Q

what is the most reactive nitrogen mustard?

A

mechlorethamine

31
Q

What are the drugs used to MOPP up Hodgkin’s disease?

A

mechlorethamine + oncovin (Vincristine) +

procarbazine + prednisone

32
Q

Since mechlorethamine is toxic to proliferating cells, the three major side effects include:

A

bone marrow suppression
infertility
GI toxicity (via IV)

33
Q

(blank) is more commonly known as Cytoxan or Neosar

A

cyclophosphamide

34
Q

What are the two methods of admin of Cytoxan?

A

oral or IV

35
Q

What is the 2 step MOA of Cytoxan?

A
  1. bioactivation of prodrug via P450

2. DNA cross link of guanine N7

36
Q

What are the clinical uses for Cytoxan?

A 
Never Neglect ALL BaCoN
Nephrotic syndrome
Non-hodgkin's lymphoma
Acute lymphoid leukemia
Breast cancer
Carcinoid
Neuroblastoma
37
Q

What are the B.A.D. side effects of Cytoxan?

A

Bone marrow suppresion
Alopecia
Disturbed GI
hemorrhagic cystitis

38
Q

The CHOP regimen is used to treat what cancer?

A

Non-hodgkin’s lymphoma

39
Q

Which nitrogen mustard is activated in the liver by ring hydroxylation?

A

Ifosfamide (Ifex)

40
Q

Ifex is used to treat (carcinoma/sarcoma) along iwth germ cell testicular cancer, cervical, lung, bone, ovarian, and breast

41
Q

Why do we give ifosfamide in conjunction with Mesna?

A

to reduce the urinary toxicity

42
Q

what added serious side effect does ifosfamide carry compared to cylcophosphamide?

A

increased platelet suppresion and urothelial damage

43
Q

Nitrosoureas form 2-chloroethyl carboniums that have what three MOAs?

A
  1. crosslink DNA strands
  2. break DNA strands
  3. carbaboylate proteins
44
Q

What are the scary SE of nitrosoureas?

A 
HIGHLY CARCINOGENIC
profound and cumulative myelosuppresion
renal failure
alopecia
hepatotoxicity
pulmonary toxicity

Block 7 Week 1 Colt (9 decks)

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