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OCN ONS Bundle > Cancer Treatment Modalities: Chemotherapy > Flashcards

Cancer Treatment Modalities: Chemotherapy Flashcards

1
Q

Neoadjuvant chemotherapy =

A

Preop chemo, sometimes used to shrink a cancer tumor before surgery so that it is easier to remove

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2
Q

Adjuvant chemotherapy =

A

Postop chemo, where surgery is the main treatment but chemo is given after with intent to cure or control disease

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3
Q

Multi-modal therapy =

A

chemo can be given in combo with other therapies such as radiation

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4
Q

The 5 phases of the cell cycle

A 
GO phase (resting phase) 
G1 phase 
S phase 
G2 phase 
M phase
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5
Q

G0 phase (resting stage) =

A

The cell has not yet started to divide

G0 can last from a few hours to a few years. When the cell gets a signal to reproduce , it moves to G1 phase

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6
Q

G1 phase =

A

Cell starts making more proteins and growing larger, so the new cells will be of normal size

~18-30 hours

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7
Q

S phase =

A

Chromosomes containing the genetic code (DNA) or copied, so both of the new cells formed will have matching strands of DNA

~18-20 hours

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8
Q

G2 phase =

A

The cell checks the DNA and gets ready to start splitting into two cells

~2-10 hours

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9
Q

M phase =

A

Mitosis phase, cell splits into two new cells

~30-60 minutes

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10
Q

Chemotherapy classifications (6)

A 
Alkylating Agents 
Antimetabolites 
Antitumor Antibiotics 
Plant Alkaloids 
Glucocorticoids 
Hormonal Agents
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11
Q

Alkylating agents treat which types of cancer?

A 
Leukemia 
Lymphoma 
Hodgkin disease 
Multiple myeloma 
sarcoma 
Cancers of lung, breast, ovary
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12
Q

How do Alkylating agents work?

What part of the cell cycle do they work in?

A

Interferes with DNA replication, RNA transcription, and nucleic acid function

Cell cycle nonspecific, works in all phases of the cycle

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13
Q

What is a potential downfall of receiving alkylating agents? (2)

A

Can eventually lead to acute leukemia bc it damages DNA causing long term damage to bone marrow (dose dependent)

Also a significant threat to future fertility in adolescents and young adults of child bearing age (discuss egg retrieval, sperm banking, etc)

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14
Q

Alkylating agents

2 types

A

Non-platins

Platinum analogs

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15
Q

Alkylating agents

Non-platins (5)

A

1) Nitrogen mustards (mechlorethamine, chlorambucil, cyclophosphamide, ifosfamide, melphalan)
2) Nitrosoureas (Streptozocin, carmustin BCNU, lomustine)
3) Alkyl sulfonates (Busulfan)
4) Triazines (Dacarbazine DTIC and temozolomide)
5) Ethylenimines (Thiotepa and altretamine (hexmethylmelamine) )

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16
Q

Alkylating agents

Platinum analogs (3)

A

Carboplatin
Cisplatin
Oxaliplatin

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17
Q

How do Antimetabolites work?

What part of the cell cycle do they work in?

A

Inhibits protein synthesis, substitute erroneous substances needed for DNA/RNA replication, and inhibit DNA synthesis

S phase

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18
Q

Examples of Antimetabolites

A

5FU
6-MP
Capecitabine, Cladribine, Clofarabine, Cytarabine
Floxuridine, Fludarabine, Gemcitabine
Hydroxurea
Methotrexate, Pemetrexed, Pentoastatin, Thioguanine

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19
Q

How do antitumor antibiotics work =

Interfered with enzymes required for ->

Are cell cycle _______

A

Used to treat hematologist and various types of solid tumors

DNA replication

Nonspecific (all phases)

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20
Q

Antitumor Antibiotics (2)

A

Anthracyclines

Liposomal formulations

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21
Q

Major consideration for Anthracyclines

A

Can permanently damage heart if given in high doses

-> Lifetime dose limits

Baseline cardiac function (ECG, MUGA scans)

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22
Q

Examples of Anthracyclines (5)

A 
Daunorubicin 
Doxorubicin 
Epirubicin 
Idaraubicin 
Valrubicin
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23
Q

Liposomal Formulations (2)

A

Doxorubicin hydrochloride liposome

Daunorubicin citrate liposomal

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24
Q

What are Plant Alkaloids?

Cell Cycle _____

A

Derived from certain types of plants and have varying mechanisms of action

Specific

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25
Q

Types of Plant Alkaloids (3)

A

Vinca Alkaloids
Epipodophyllotoxins
Taxanes

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26
Q

Vinca Alkaloids come from?

A

From Madagascar Periwinkle plant, naturally extracted from pink periwinkle plant

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27
Q

Vinca Alkaloids

Have hy____ and cy____ effects, therefore have been used to treat (2)

A

Hypoglycemic
Cytotoxic

Diabetes, HTN, as a disinectant

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28
Q

What part of the cell cycle do Vinca Alkaloids work on?

A

M Phase

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29
Q

Vinca Alkaloids significant SE (3)

A

Myelosuppression

Peripheral Neuropathy

N/V

30
Q

Examples of Vinca Alkaloids (3)

A

Vinblastine
Vincristine
Vinorelbine

31
Q

Types of Epipodophyllotoxins Categories (2)

A

Camptothecans

Podophyllotoxins

32
Q

Campothecans come from the?

A

Asian “happy tree” plant

33
Q

Podophyllotoxins come from the?

A

May apple plant

34
Q

How do Epipodophyllotoxins work on the cell cycle? What enzyme?

A

Forms a complex with topoisomerase and DNA resulting in inhibition and function of topoisomerase enzyme (required for DNA synthesis)

35
Q

What part of the cell cycle do Epipodos work on?

A

Late S, G2 phases

36
Q

Types of Cancer Epipodos are used to treat (2)

A

Leukemia’s

GI Cancers

37
Q

Common SE of Epipodos (2)

A

Diarrhea

Neutropenia

38
Q

Types of Epipodophyllotoxins (4)

A

Etoposide
Teniposide
Camptothecan
Topotecan hydrochloride

39
Q

What are Taxanes? Where are they derived from?

A

Mitotic inhibitors (stops mitosis)

Pacific Yew Tree

40
Q

What part of the cell cycle do taxanes work on?

A

M phase

Also active in G1 and S transition phase a last checkpoint where cell division can be stopped

41
Q

What types of cancers do taxanes treat?

A

Breast, Lung

Myelomas, Lymphomas, Leukemia’s

42
Q

What side effect are taxanes known for causing?

Therefore ->

A

Peripheral nerve damage

Dose limiting

43
Q

Types of Taxanes (4)

A

Paclitaxel
Docetaxel
Cabazitaxel
Paclitaxel protein bound

44
Q

What are Glucocorticoids?

A

Steroids, naturally occurring hormones, hormone like drugs

45
Q

How do glucocorticoids work on the cell cycle?

A

They modify transcription and protein synthesis within the cell -> reversal of increased capillary permeability, inhibits glucose transport and phosphorylation to induce cell death

46
Q

Glucocorticoids treat what types of cancers?

A

L/L

MM

47
Q

Glucorticoids can also be used for what?

A

Before, after, during tx

  • antiemetics
  • allergic reactions
  • SVC, SCC
48
Q

Types of Glucocorticoids (4)

A

Prednisone
Hydrocortisone
Methylprednisone
Dexamethasone

49
Q

Hormonal Agents =

A

Effects sex hormones, change the action of production of female or male hormones

50
Q

Hormonal agents treat what types of cancers?

A

Breast
Prostate
Endometrial

51
Q

How do hormonal agents work on cancer?

A

They prevent the cancer cell from using the hormone it needs to grow to prevent body from making hormones

52
Q

Categories of Homronal Agents (2)

A

Estrogen receptor (ER) modulators

Aromatase inhibitors

53
Q

Types of Estrogen Receptor (ER) modulators (3)

A

Tamoxifen
Toremifene
Raloxifine

54
Q

Types of Aromatase inhibitors

A 
Anastrozole, Letrozole
Exemestane
Fulvestrant 
Leuoprolide 
Glutamine 
Bicatulamide 
Nilutamide 
Fluoxymesterone 
Estradiol 
Octreotide 
Megestrol 
Medroxyprogesterone acetate
55
Q

Chemotherapy effects normal rapidly dividing cells as well such as?

A

Blood cells formin in bone marrow

Digestive tract

Reproductive system

Hair follicles

56
Q

Chemo side effects present as ->

A

Myleosuppression
Mucositis
N/V
Alopecia

57
Q

Most common SE of chemo

A

1) Myleosuppression (anemia, neutropenia, thrombo)
2) GI (anorexia, n/v, constipation, diarrhea, mucositis
3) Fatigue
4) Cognitive/ Neuro changes
5) Sexual and reproductive dysfunction (hot flashes, decreased libido, infertility)
6) Organ dysfunction (renal, hepatic, cardiac, pulmonary)

58
Q

Hazardous drugs are those that exhibit one or more of what types of toxicities?

A 
Carcinogenicity 
Teratogenicity/other developmental toxicity 
Reproductive toxicity 
Organ toxicity in low doses 
Genotoxicity
59
Q

Adverse health effects of occupational exposure to hazardous drugs include

1) Integumentary/mucosal (3)
2) Neuro (2)
3) Respiratory (1)
4) GI (2)
5) Hypersensitivity (2)
6) Reproductive 6)

A

1) Skin irritation or contact dermatitis, mouth and nasal sores, partial alopecia, hair thinning
2) HA, dizziness
3) Dyspnea
4) N/V, abdominal pain
5) Allergic asthma, eye irritation
6) Infertility, prolonged time to conception, premature delivery/low birth weight, ectopic pregnancy, spontaneous abortions/miscarriages, stillbirths, learning disabilities in offspring

60
Q

Risk levels for Hazardous drugs

1) Chronic low-level exposure to HD’s can lead to a______
2) Chronic low level absorption may cause significant long term ___ ___
3) Acute exposure may cause ___ symptoms
4) Use of _ _ _ reduces risk of absorption

A

1) absorption
2) side effects
3) acute
4) PPE

61
Q

Ways you can be exposed to Hazardous drugs (4)

A

1) Absorption (through skin, eyes, mucous membranes)
2) Injection (accidental needle sticks)
3) Ingestion
4) Inhalation (sprays, aerosolization, drug dust, spills)

62
Q

What do you wear for PPE when administering hazardous drugs?

A

1) Gloves (two pairs)
2) Gown
3) Face shield
4) Respirator mask (only if required by specific drug)

63
Q

Postadmin considerations for body fluids and linen handling

Body fluids

1) HDs are found in?
2) Consider all bodily fluids contaminated for at least __ hours after completion of drug admin
3) ____ toilets without a lid before flushing to avoid spray contamination. Encourage use of toilets instead of urinal/bed pan to decrease exposure
4) Protect the skin of ____ patients
5) Remember: D____ can be contaminated too
6) Wear _ _ _ when emptying foley catheters and urinals or bed pans

A

1) Urine, feces, sweat, vomit, breast milk, seminal fluid
2) 48
3) Cover
4) incontinent
5) Diapers
6) PPE

64
Q

Postadmin considerations for linen handling

1) Prevent exposure: use ___ backed disposable pads under incontinent patients
2) Use v___/p____ pillow covers
3) If linen becomes contaminated with any body fluid within 48 post admin, what do you do?

A

1) plastic
2) vinyl/plastic
3) don PPE, bas as contaminated, double wash, if home double wash separately from other linen

65
Q

CAM stands for

A

Complementary, Alternative, and Integrative medicine

A broad category of approaches to health care with origins outside of mainstream western medicine

66
Q

A non-mainstream therapy combined with conventional medicine =

A

Complementary

67
Q

A non-mainstream therapy used instead of conventional medicine =

A

Alternative

68
Q

Therapies that have had widespread use in western medicine =

A

Conventional

69
Q

Unproven therapy

A

Any therapy that has not been scientifically tested and approved, therapies under investigation

70
Q

Disproven therapy

A

One for which evidence exists but not in support a therapy

71
Q

The following are all examples of?

Vitamin or mineral supplements
Intercessory or self prayer
Chiropractic or osteopathic care
Herbal therapies

A

CAM therapies

72
Q

Acupuncture, Animal assisted activity, Aromatherapy, art therapy, ayurveda, chiropractic medicine, naturopathy, osteopathy, reflexology, reiki, yoga are all examples of CAM therapy that require?

A

Licensure, certification, training

OCN ONS Bundle (11 decks)

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