Cancer Drugs

Question 0

Cytotoxic agents (chemotherapy) adverse effects.

Answer 0

Bone Marrow suppression
Stomatitis
Nausea/Vomiting
Alopecia
Reproductive Toxicity
Hyperuricemia
Carcinogenesis

Question 1

Meds for cancer

Answer 1

1. Cytotoxic agents (chemotherapy); Kill cancer cells
2. Hormones, Hormone Antagonists: mimic/block actions of endogenous hormones.
3. Biological Response Modifiers: Enhance immune action against cancer cells.

Question 2

Alkylating agents

Answer 2

Disrupt DNA and RNA synthesis, Cell cycle phase non-specific

Types: 
Nitrogen Mustards
    - cyclophosphamide/ Cytoxan
Nitrosoureas
     - Carmustine (BCNU)/ BiCNU
     - Lomustine (CCNU)/ CeeNU

Question 3

Cyclophosphamide/ Cytoxan

Answer 3

MOA: Converted to active form on Liver. Transfers an alkyl group to DNA structure –> cross-linking and breakage of DNA strand –> destroys cancer cell

IND: Lymphomas
     - Multiple Myeloma
     - Head and Neck
     - Ovary, breast
AE: Bone marrow suppression
     N/V
     Alopecia
    Hemorrhagic Cystitis

NURS: Monitor urine output, Assess for blood in urine, Hydration

Question 4

Platinum Compounds

Answer 4

Similar to alkylating agents, cell cycle non-specific,

Cisplatin/ Platinol-AQ

Question 5

Cisplatin/ Platinol-AQ

Answer 5

MOA: Forms Cross links between, within strands of DNA –> srand breakage –> death of cancer cell

IND: Metastatic testicular and Ovarian cancer, Advance Bladder cancer

AE: Severe N/V
     - Bone Marrow suppression
     - OTOTOXICITY
     - Renal Damage
     - Neurotoxicity
NURS: Monitor for TINNITUS
     - Hydrate
     - Monitor for changes in sensation

Question 6

Antimetabolites

Answer 6

Either inhibit enzymes that synthesize cellular constituents or get incorporated in DNA and disrupt replication. Cell Cycle Phase Specific - S phase

Methotrexate/ Rheumatrex

Question 7

Methotrexate/ Rheumatrex

Answer 7

MOA: Inhibits enzyme that converts folic acid into active form. Need folic acid to synthesis of cellular constituents (precursors to DNA). Affects normal cells: Give leucovorin- bypasses metabolic block caused by methotrexate.

IND: Acute Leukimia
     - Lymphoma
     - Head and Neck Cancer
     - Osteogenic cancer
AE: Bone Marrow Suppression
     - Oral and GI Ulceration
     - Pulmonary infiltrates and fibrosis
     - Kidney Damage
NURS: Oral Care, Inc Fluids

Question 8

Anti-tumor Antibiotics

Answer 8

Injure cells through direct interaction with DNA, Cell-cycle phase nonspecific.

Doxorubicin/ Adriamycin

Question 9

Doxorubicin/ Adriamycin

Answer 9

MOA: Distorts DNA structure and inhibits DNA, RNA synthesis

IND: Lymphomas, Leukemias

 - Bone Cancer
 - Carcinomas: Lung, Stomach, Breast, Testes, Thyroid

AE: Bone Marrow Suppression

 - N/V
 - RED color URINE, SWEAT
 - Cardiotoxicity

NURS: Baseline Echo

Question 10

Mitotic Inhibitors

Answer 10

Prevent cell division, cell-cycle phase specific - M phase

Vincristine/ Oncovin

Question 11

Vincristine/ Oncovin

Answer 11

MOA; Blocks mitosis by disrupting assembly of microtubules that move chromosome during cell division.

IND: Leukemia, Lymphoma, Breast cancer, Bladder cancer

AE: Alopecia, Peripheral Neuropathy

NURS: Assess for injury to neurons

Question 12

Topoisomerase Inhibitors

Etoposide/ Vepesid

Answer 12

MOA: Inhibits Topoisomerase II, and enzyme that is needed to reseal breaks in DNA strand –> Cell death because of accumulated broken DNA. Cell-Cycle phase specific for S phase and partially G2.

IND: Lung cancer, Testicular cancer

AE: Bone marrow suppression, N/V, Stomatitis, Hypotension

NURS: Administer slowly due to risk of Hypotension

Question 13

Asparaginase/ Elspar

Answer 13

MOA: Converts asparagine to aspartic acid –> deprives cells of asparagine, needed to synthesize proteins. Cell-cycle phase specific: G1 phase.

IND: Acute Leukemia

AE: Injury to liver, Pancreas, Kidneys

 - CNS Depression
 - N/V

NURS: Monitor Organ Function, Monitor Mental Status

Question 14

Gonadotropin-releasing Hormone antagonists

Leuprolide/ Lupron

Answer 14

MOA: Suppress androgen production by testes. Given SQ daily, or IM Monthly or q3months. Or once per year as implant.

IND: Prostate Cancer

AE: Hot flashes, impotence, Loss of libido, Dec in Muscle mass, Inc in adipose tissue, Inc risk of osteoporosis and fractures.

Question 15

Androgen Receptor blockers

Flutamide/ Eulexin

Answer 15

MOA: Blocks androgen receptors in tumor cells, given with lupron to increase effectiveness.

IND: Prostate Cancer

AE: Gynecomastia, Liver toxicity

Question 16

Antiestrogens

Tamoxifen/ Nolvadex

Answer 16

MOA: Blocks Estrogen receptors on breast cancer cells, depriving them of estrogen. Selective estrogen receptor modulator (SERM) - Blocks receptors but also can activate

IND: Breast Cancer, Prevent breast cancer in high risk women

AE: Hot flashes, Fluid Retention, Vaginal Discharge, Menstrual irregularities, N/V, Inc risk of blood clots and endometrial cancer.

Question 17

Aromatase Ihibitors

Anastrozole/ Arimidex

Answer 17

MOA: Blocks production of estrogen from androgenic precursors - inhibits aromatase

IND: Breast cancer in Post-Menopausal women

AE: Joint and muscle pain, Inc risk of osteoporosis

Question 18

Biological Response Modifiers (BRM)

Answer 18

Interferon alpha 2a and 2b: Effective against leukemias

Aldesleukin (Interleukin 2)/ Proleukin; For metastatic renal cancer, metastatic melonoma.