Ch 45

Question 1

cytotoxic agents

Answer 1

nonspecifically inhibit DNA replication or mitosis

Question 2

targeted anticancer drugs

Answer 2

inhibit specific proteins involved in tumor cell growth

Question 3

induction therapy

Answer 3

rapidly decrease tumor burden and symptoms

Question 4

consolidation therapy

Answer 4

complete or extend initial remission

Question 5

maintenance therapy

Answer 5

sustain remission as long as possible

Question 6

cancer Tx dosing schedule driven by

Answer 6

• drug/host kinetics
• tumor cell kinetics
• drug toxicity

Question 7

cell cycle specific

Answer 7

act during a specific phase of the cell cycle

Question 8

cell cycle nonspecific

Answer 8

act throughout the whole cell cycle

Question 9

drug resistance

Answer 9

• major cause of cancer treatment failure

- innate resistance or acquired resistance

Question 10

host toxicity

Answer 10

• nausea and vomiting
• alopecia
• target organ toxicities
• myelosuppression

Question 11

methotrexate

Answer 11

• ADE mitigated by leucovorin

- hepatotoxicity and renal injury

Question 12

pemetrexed

Answer 12

• myelosuppression is major toxicity

- folic acid and B12 minimize ADE

Question 13

purine analogues

Answer 13

• impair DNA synthesis
• used in leukemias
• myelosuppression is dose limiting
• allopurinol prescribed in conjunction

Question 14

pyrimidine analogues

Answer 14

• inhibit DNA synthesis
• fluorouracil used for solid tumors
• ADE: myelosuppression, N/V, oral/GI ulceration, alopecia

Question 15

ribonucleotide reductase inhibitor (hydroxyurea)

Answer 15

-also used to increase fetal hemoglobin levels in sickle cell anemia

Question 16

nitrogen mustards

Answer 16

• cyclophosphamide is most widely used
• DNA alkylating: cross link DNA strands
• ADE: hemorrhagic cystitis

Question 17

nitrosurea drugs

Answer 17

• DNA alkylating
• highly lipophilic with good CNS penetration
• used for brain tumors
• delayed, prolonged myelosuppression
• pulmonary damage with high doses

Question 18

platinum compounds

Answer 18

• DNA alkylating
• cisplatin first line for testicular, ovarian, cervical, and bladder cancer
• severe N/V and renal toxicity
• N/V severe enough to need pretreatment

Question 19

busulfan

Answer 19

• similar to nitrogen mustard
• used for chronic myeloid leukemia
• pulmonary fibrosis in small subset of long term use patients

Question 20

dacarbazine

Answer 20

used in hodgkin disease

Question 21

mitomycin

Answer 21

• used for stomach and pancreatic cancer

- can cause severe extravasation necrosis

Question 22

anthracycline MOA

Answer 22

intercalation of DNA to cause inhibition of topoisomerase which results in deformation and uncoiling of DNA

Question 23

anthracycline ADE

Answer 23

• extravasation
• cardiac toxicity
• dexrazoxane is cardioprotective

Question 24

DNA topoisomerase inhibitor MOA

Answer 24

cause permanent DNA strand breaks by preventing resealing after uncoiling for replication

Question 25

ironotectan

Answer 25

DNA topoisomerase inhibitor that causes diarrhea in significant number of cases

Question 26

mitotic inhibitor MOA

Answer 26

-interfere with microtubule function and block cell division

Question 27

vincristine

Answer 27

• vinca alkaloid mitotic inhibitor

- dose limiting neurotoxicity and cranial nerve damage

Question 28

protein kinase inhibitor MOA

Answer 28

inhibits enzymatic activation of growth factor receptors and other regulatory proteins thus impeding malignant cell transformation and proliferation

Question 29

antineoplastic monoclonal antibody MOA

Answer 29

bind to specific cancer cell antigen