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Additional CSO Cards > Chapter 9: Med onc > Flashcards

Chapter 9: Med onc Flashcards

1
Q

Vitamin B ___ can be provided @ ____ - ____ mg, 2-3x/day to reduce hand/foot syndrom

A

B6
50-100 mg

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2
Q

The American College of Surgeons ________ ___ _________ accredit oncology locations & specifies . They ensure patients have access to a full scope of care including RDN, either onsite or by referral.

A

Commission on Cancer (CoC)

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3
Q

The American College of Surgeons Commission on Cancer recommends RDNs attend weekly __________ & represent at __________________ meetings

A

Tumor boards, cancer committee meetings

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4
Q

Antineoplastic therapies include (4):

A
  1. Chemotherapy
  2. Immunotherapy
  3. Targeted Therapy
  4. Hormone therapy
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5
Q

An oncologist prescribes cancer treatment according to _______________ OR _______ _____- guidelines

A

National Comprehensive Cancer Network (NCCN), Clinical trial

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6
Q

3 branches of oncology include

A
  1. Medical Oncology
  2. Radiation Oncology
  3. Surgical Oncology
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7
Q

Define tumor burden or tumor load

A

The size of tumor or amount of cancer in the body

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8
Q

T/F: Faster growing tumors respond better to therapy

A

True. As tumors increase in size the growth rate slows and reduces the effectiveness of cancer treatment

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9
Q

Define tumor growth rate

A

The proportion of cancer cells within the tumor that are growing/dividing to form new cancer cells. Rapidly growing respond better to treatment

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10
Q

Define Definitive Therapy

A

Use of radiation as the PRIMARY treatment, with or without chemo

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11
Q

Define Palliation

A

Use of cancer treatment modalities when disease cure/control is not possible to relieve symptoms/side effects or improve QOL

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12
Q

What is zolendronic acid (aka Reclast)

A

A type of Bisphosphonate drug used to slow bone breakdown usually d/t bone mets

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13
Q

Prevention versus Prophylactic therapy

A

Prevention uses medicine, other agents or surgery

Prophylactic uses radiation to relieve symptoms or prevent issues (i.e. prophylactic brain radiation w/ SCLC)

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14
Q

Chemotherapeutic agents interfere with _______________ to ultimately lead to cell death

A

Cell division, they work at different parts of the cell cycle

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15
Q

Describe the 5 parts of the cell cycle

A

G0 - rest
G1 - postmitotic phase, synthesis RNA & protein
S - synthesis, make DNA
G2 - premitotic phase, prepare to divide
M - mitotic phase, stop growing and divides into 2 daughter cells

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16
Q

Cell cycle non-specific agents damage drugs in all phases of the cell cycle. 4 classes are:

A
  1. Alkalyting agents
  2. Antitumor Antibiotics
  3. Hormone Therapies
  4. Nitrosureas
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17
Q

Cell cycle-specific agents damage cells within specific parts of the cell cycle

A
  1. Camptothecins (s)
  2. Antimetabolites (s)
  3. Misc (misc)
  4. Plant alkaloids & taxanes (mitosis)
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18
Q

3 factors used to determine a chemo prescription

A
  1. Frequency of cycles
  2. Length of cycles (minutes, hours, days)
  3. Number of cycles (per research)
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19
Q

Define personalized or precision medicine

A

Uses a patients genetic information to prevent, diagnose, or treat cancer. Performed on a sample of the tumor to detect DNA mutations

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20
Q

Define pharmacogenetics

A

The study of how a person’s genes affect the way the body responds to certain drugs

Looks at small variations within genes to determine of the drug activates or deactivates the gene

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21
Q

Retuximab

What does it treat and what are the side effects?

A

Monoclonal antibody
C20
B-cell disease
Tumor lysis syndrome

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22
Q

Tumor lysis syndrome is electrolyte and renal abnormalities, what are the defining characteristics?

A

High phosh
High K+
Low Ca
High uric acid

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23
Q

Which monoclonal antibody causes decreased appetite & hypomagnesium?

A

Cetuximab

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24
Q

Pertuzumab, Trastuzumab, and Ado-trastuzumab target which gene?

A

ERBB2
(HER2)

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25
Q

Monoclonal antibodies end in which 2 letters?

A

“ab”

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26
Q

What are common side effects of monoclonal antibodies?

A

Skin reaction, infusion reaction, GI, pulmonary, cardiotoxicities

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27
Q

What are common side effects of small molecule drugs?

A

Cardiotoxicities, skin reactions, GI

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28
Q

Angioneogensis inhibitors fall under which drug category?

A

Targeted molecules, specifically small molecule drugs

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29
Q

These are the 3 PD-1 targeted monoclonal antibodies

A

Pembrolizumab
Nivolumab
Impilimumab

29
Q

Denosumab (Xgeva)
What does it treat?
What class of drugs?
What are side effects?

A

Bone mets or osteoporosis
Monoclonal antibody
N/V/D
Hypocalcemia, Osteonecrosis of the jaw

30
Q

Pembrolizumab
What does it treat?
What class of drugs?
What are side effects?

A

PD-1 Monoclonal antibody
NSCLC, H&N, melanoma
Hyperglycemia, Hyponatremia, Hypoalbuminemia

31
Q

Nivolumab
What does it treat?
What class of drugs?
What are side effects?

A

PD-1 Monoclonal antibody
NSCLC, melanoma, renal cell
Colitis, constipation, N/V
Hyponatremia, Hypokalemia, Hymagnesimia

32
Q

Protein-targeted small molecule drugs end in which 2 letters?

A

“ib”

33
Q

What are the 3 small molecule angiogenesis inhibitors?

A

Bevacizumab
Lenailidomide
Thalidomide

34
Q

Which chemo drugs requires avoidance of tyramine-rich food/drink?

A

Procarbazine

35
Q

Which chemo drug requires avoidance of dairy?

A

Mercaptopurine

36
Q

Which small molecule drug must you take with a low fat meal?

A

Regorafenib

37
Q

Which supplements should you take with Zoledronic Acid?

A

calcium & vitamin DC

38
Q

Can you crush Temozolomide?

A

No

39
Q

What should you avoid within 2 hours of taking Tamoxifen?

A

Antacids

40
Q

What nutritional considerations should you take with Sipleucel-T? (2)

A

Drink extra water 2-3 days prior
Avoid caffeine

41
Q

Which 3 chemo drugs tend to cause hand/foot syndome?

A

Carboplatin
Fluorouracil
Oxaliplatin

42
Q

Mensa is given with these 2 chemo drugs d/t bladder toxicities

A

Cyclophosphamide
Ifosfamide

43
Q

You should avoid grapefruit juice and excess vitamin A with this chemo drug

A

Bexarotene

44
Q

Avoid alcohol with these 2 chemo drugs

A

Vincristine
Lomustine

45
Q

Cryotherapy during infusion can help prevent mucositis with boluses of these 2 chemo drugs

A

Fluorouracil & Melphelan

46
Q

What are potential side effects of angiogenesis inhibitors?

A

Hypertension, MI, stroke, nosebleeds, GI perforation

47
Q

2 specific side effects of Bevacizumab

A

Proteinuria (1/3 of pts)
Hypothyroidism

48
Q

Imatinib
What does it treat?
What class of drugs?
What are side effects?

A

CML
Small molecule tyrosine kinase inhibitor
Fluid retention/edema

49
Q

Temsirolimus & Everolimus are ___________ agents that treat _____________

A

Protein-targeted therapy
Renal cancer (and others)

50
Q

These 2 agents contain lactose, may require lactase enzyme

A

Deferasiox
Nilotinib

51
Q

These are the 5 categories of immunotherapy (not including monoclonal antibodies)

A
  1. Non-specific
  2. CAR-T cell
  3. Cancer vaccines
  4. Oncolytic viral therapies
  5. Cadiopharmaceuticals
52
Q

What are the 2 non-specific immunotherapies

A

Interferon & interlukin

Create a broad-based immune response rather than targeting certain genes

53
Q

T-VEC can be used to treat melanoma and is a ________ kind of therapy

A

Oncolytic viral therapy - genetically modified herpes simplex

54
Q

What kind of immunotherapy is sipuleucel-T?

A

Cancer vaccine used in hormone-refractory metastatic prostate cancer

55
Q

T-cell therapy has been used for treatment of (2)

A

B-cell lymphoma in adults & ALL in children

56
Q

How do SERMs work? What are the 3 agents?

A

Compete with estrogen for binding to receptors

Tamoxifen, Ruloxifen, Toremifene

57
Q

What are 5 side effects of SERMS?

A
  1. Blood clots
  2. Menstural symptoms
  3. Fluid retention
  4. Weight gain
  5. Increased risk for endometrial cancer
58
Q

How do aromatase inhibitors work? What are the 3 agents?

A

Block the conversion of androgen hormones to estogen. Anstrazole, Lestrozole, Exemestane

59
Q

Which aramotase inhibitor causes high cholesterol?

A

Lestrozole

60
Q

How do progresterones work and what is the primary one?

A

They reduce stability of estrogens, thus limiting their availability

Megestrol acetate -

61
Q

What are the 5 classes of hormone therapies?

A
  1. Serms
  2. Aromatase inhibitors
  3. Progesterones
  4. Anti-androgens
  5. Luteinizing hormone releasing hormone agonists
62
Q

How to anti-androgens work? What are the 2 main ones?

A

Bind to androgen receptors to prevent the effects of testosterone in androgen-sensitive prostate cancer cells

Bicalutamide
Flutamide

63
Q

Which 2 cancers are leutinizing hormone releasing hormone agaonists used to treat?

A

Prostate and ovarian

64
Q

How to lutenizing hormone releasing hormone agonists work?

A

Stops the pituitary gland to stop producing LH, which results in suppression of testosterone and estrogen

65
Q

What are the 2 LHRH agonist drugs?

A

Leuprolide
Goserelin

66
Q

These 2_______ supplements interfere with Tamoxifen while _________ supplement may improve its use

A

Sillymarin (Milk Thistle) & Black cohosh
Melatonin

67
Q

What’s the concern with Quercitin?

A

May bind with iron and increase risk for deficiency

68
Q

What makes ibritumomab unique?

A

Radiopharmaceutical used to treat lymphomas

(Combo of y90 + rituximab)

69
Q

Most oral chemo drugs should be taken on an empty stomach with the exception of these 3 that should be taken with food

A

Bexarotene
Imatinib
Capecitabine

Additional CSO Cards (26 decks)

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