Cancer: Pharmacology Flashcards
What are the 2 main categories of chemo meds?
Cell cycle specific
Non-cell cycle specific
Who can give chemo?
There is a risk of drug absorption with…
Only those w/ specialized training can prepare/administer
Handling chemo
Handling bodily fluids of those undergoing chemo for first 48 hours after doses
Chemo drugs have a _____ therapeutic index and ______ side effects
Narrow
Significant
What Pregnancy category are chemo drugs?
Category X
Some D
Why is high infection risk a contraindication of chemo?
What WBC condition is a contradindication?
Chemo causes myelosuppression
Neutropenia: <500 Neutrophils
Explain why the following are contraindications for chemo:
-severe nutrient/fluid deficits
-reduced kidney/liver function
-Chemo causes N/V
-metabolism/excretion vital
How is chemo dosing calculated?
What is the most common route?
Which route results in less toxicity?
By body surface area
IV: most common
PO, IM also
Regional: injected directly into tumor-less toxicity
How does chemo affect the following systems of rapidly dividing cells:
-Hair follicles
-GI tract
-Bone marrow
-alopecia
-N/V
-myelosuppression
Explain the following AEs from myelosuppression:
Anemia
Leukopenia
Thrombocytopenia
Anemia: pale skin/mucosa, fatigue, lethargy, SOB, inability to concentrate, tachycardia
Leukopenia: fever, chills, productive cough, urine changes
Thrombocytopenia: petechiae, ecchymosis, gingival bleeding, blood in urine/stool/vomit, IV stick bleeding
Explain NADIR
Lowest level of WBCs measured after chemo/radiation. Usually 10-28 days after chemo dose
-highest infection risk time
-Might use prophylactic antibiotics or blood cell stimulants
List the 5 drug classes that are cell-cycle specific
Explain what cell-cycle specific means
Drugs that are cytotoxic in a particular cell-cycle phase
Antimetabolites
Mitotic inhibitors
Alkaloid Topoisomerase II inhibitors
Topoisomerase I inhibitors
Antineoplastic enzymes
Antimetabolites
Mainly work in S phase, when DNA synthesis is most active
Antagonic actions of key cellular metabolites- cells can’t replicate
METHOTREXATE
METHOTREXATE
Antimetabolite: cycle specific (S-phase)
-Folate antagonist
-also used for autoimmune disorders like R. arthritis
-decreases lymphocyte and cytokine production
Mitotic Inhibitors
Cell-cycle specific class
-from plants
-Various phases of cycle
-retard cell division
VINCRISTINE
VINCRISTINE
Mitotic inhibitor: plant-based cycle-specific- retards cell division
AE: peripheral neuropathy
Topoisomerase Inhibitors
Cell-cycle specific class
Antineoplastic Enzymes
Cell-cycle specific class
-serious/systemic AEs
What are the 2 types of cycle-nonspecific drugs?
Alkylating Agents
Cytotoxic antibiotics
Alkylating Agents
Non-cycle specific
Prevent cells from reproducing
alter DNA structure
CISPLATIN
CISPLATIN
Alkylating Agent: non-cycle specific class
AEs: dose limiting
-N/V/Myelosuppression
-Alopecia
-Nephrotoxic, ototoxic, peripheral neuropathy
-Extrasvasation
Cytotoxic Antibodies
Non-cycle specific class
-interfere w/ DNA synthesis
-Serious AEs
-Hair loss, N/V, myelosuppression
BLEOMYCIN
Cytotoxic Antibody drug
-non-cycle specific
AE: pulmonary fibrosis and pneumonitis
DOXORUBICIN
Cytotoxic Antibody drug
-non-cycle specific
AE: left ventricular failure, myelosuppression
What is the normal absolute neutrophil count?
What is the range for severe neutropenia?
ANC: 1500-8000
ANC: <500
