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AFN Pharm 1 > Chemo > Flashcards

Chemo Flashcards

1
Q

Uncontrolled cell growth followed by a loss of function.

A

Cancer

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2
Q

What are the Basic Principles of Chemo Administration?

A

-Dosage is based on BSA
-Administration usually follows a schedule of Therapy/Recovery/Therapy
-Most agents are metabolized via biotransformation in the Liver
-Most agents are eliminated primarily in the urine. Some agents require Enterohepatic Circulation

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3
Q

-Bile acids are stored in the gallbladder
-During digestion, bile acids are absorbed through the gut mostly unconjugated (some conjugated)
-In the terminal ileum, the bile salts are reabsorbed and carried through the portal blood circulation to be reconjugated and secreted back into bile

A

Enterohepatic Circulation

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4
Q

What are the 4 Cancer causing Factors?

A

1) Environmental Exposure (smoking, radiation, asbestos)
2) Viruses (Hepatitis B&C, HIV, HPV, Epstein-Barr)
3) Oncogenes (cause cells designated for apoptosis to survive and proliferate instead)
4) Tumor Suppressor Genes (Usually found in combination with other genetic changes)

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5
Q

A gene that has the potential to cause cancer.
-Often mutated or expressed at high levels in tumor cells

A

Oncogene

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6
Q

A gene that protects a cell from one step on the path to cancer.
-If this gene mutates or loses function, the cell can progress to cancer.

A

Tumor Suppressor Genes

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7
Q

The primary treatment for patients who present with advanced Cancer for which no other treatment exists.
-Goals: relieve tumor related symptoms, improve quality of life, and prolong time to tumor progression

A

Primary Induction Chemotherapy

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8
Q

Treatment for patients who present with localized disease, but surgery and/or radiation are inadequate by themselves.
-Administered before the main treatment (surgery or radiation)

A

Neoadjuvant Chemotherapy

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9
Q

Applied after initial treatment for cancer, especially to suppress secondary tumor formation.
-Potentially curative following resection of the primary tumor
-Goals: reduce the incidence of both local & systemic recurrence and to improve the overall survival of patients

A

Adjuvant Chemotherapy

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10
Q

-Single drugs at clinically tolerable doses have been unable to cure cancer
-Benefits: provides maximum cell kill within the range of toxicity tolerated by the patient. Effective only if dosing is not compromised due to side effects.
-Provides a broader range of interaction between drugs and tumor cells
-May prevent/slow the subsequent development of drug resistance
-Ex: CHOP (Cyclophosphamide, Doxorubicin (Hydroxydaunorubicin, Adreiamycin), Vincristine (Oncovin), Prednisone)

A

Multi-Drug Therapy (Combination Therapy)

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11
Q

Only use drugs with a favorable history for the specific tumor
-Complete remission vs. Partial remission

A

Efficacy

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12
Q

Toxic effects of selected agents should not overlap.
-Minimizes the lethal effects of multiple insults to the same organ or organ system

A

Toxicity

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13
Q

Combinations should be given at consistent intervals
-Recovery should be the shortest time necessary
-Gauged by the recovery of the most sensitive normal target tissue (typically bone marrow)

A

Optimum Scheduling

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14
Q

Balance of factors to allow for maximal effects
-Biochemical, Molecular, Pharmacokinetics

A

Mechanism of Interaction

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15
Q

Random changes in drugs may reduce the impact of the most effective agent.
-Decreases the potential for a cure

A

Avoidance of Arbitrary Dose Changes

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16
Q

Increase the doses of the respective agent

A

Dose Escalation

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17
Q

Evaluate the patient’s response and then schedule the next round of Chemo

A

Reducing the Interval

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18
Q

Applied to both single agents and combo agents, drugs are given in a specific order

A

Sequential Scheduling

19
Q

Resistance in the absence of prior exposure to available standard agents

A

Primary resistance

20
Q

Develops in response to exposure to a particular cancer agent or an entire drug class.
-Usually based on a specific change in the genetic machinery of a given tumor cell
-Amplification of one or more genes on the tumor

A

Acquired Resistance

21
Q

Chemo cells go through Mitosis or Meiosis?

A

Mitosis

22
Q

Cells start in mitosis, then go through differentiation.
1) G1: Synthesis of cellular components needed for DNA synthesis
2) S phase: DNA Synthesis
3) G2 phase: synthesis of cellular components for Mitosis

A cell is weakest when it’s reproducing

A

Cell Cycle

23
Q

Anticancer agents that exert their effects on malignant cells in a particular phase

A

Cell Cycle Specific Drugs (CCS)

24
Q

Anticancer agents that can sterilize a tumor whether it is cycling or resting (G0 phase)
-Cycling cells are more sensitive

A

Cell Cycle Nonspecific Drugs (CCNS)

25
Q

Which Anti-cancer agents impact Nucleotide Biosynthesis?

A

Methotrexate

26
Q

Which Anti-cancer agents impact pyrimidines?

A

5-FU

27
Q

Which Anti-cancer agents impact DNA Replication?

A

1) Cyclophosphamide
2) Cisplatin
3) Bleomycin
4) Doxorubicin
5) Cytarabine
6) Carboplatin

28
Q

Which Anti-cancer agents impact Microtubule Polymerization?

A

1) Vincristine
2) Vinblastine
3) Taxel

29
Q

What are the two drugs that are Alkylating Agents?

A

Cisplatin and Carboplatin

30
Q

-Kills tumor cells in all stages (Non-specific)
-Binds DNA through the formation of intrastrand and interstrand DNA cross-links
-Requires dose modification for renal dysfunction

A

Cisplatin & Carboplatin

31
Q

What are the adverse effects associated with Cisplatin?

A

Nephrotoxicity, peripheral sensory neuropathy, and ototoxicity

32
Q

What are the adverse effects associated with Carboplatin?

A

Myelosuppression
Significantly less renal & GI toxicity than Cisplatin
-Has largely replaced Cisplatin

33
Q

What are the 3 drugs that are Antimetabolites?

A

Methotrexate, 5-FU, and Cytarabine

34
Q

-Interferes with DNA, RNA, and protein formation
-Adverse effects: Mucositis, Diarrhea, and Myelosuppression
-Leucorvorin Rescue is used in the presence of high dose MTX to rescue normal cells from toxicity

A

Methotrexate (MTX)

35
Q

-Inhibits DNA synthesis
-Extremely short 1/2 life (10-15 min)
-Adverse effects: Myelosuppression, mucositis, diarrhea, and hand-foot syndrome

A

5-Fluorouracil

36
Q

-Inhibits DNA elongation, synthesis, and repair
-S phase Specific (!!!!!)
-Adverse Effects: cerebellar ataxia (inflamed/damaged cerebellar tissue causing dizziness) and myelosuppression
-Give continuously over 5-7 days due to rapid degradation**

A

Cytarabine

37
Q

What are the 3 drugs that are the Natural Product Cancer Chemotherapy Agents?

A

1) Vinblastine
2) Vincristine
3) Paclitaxel

All inhibit mitosis, are metabolized by the Liver P450 system, and are excreted in feces.

38
Q

-Inhibits mitosis; Metabolized by the Liver P450 system, excreted in feces (same with whole drug class)
-Adverse effects: Myelosuppression, SIADH, Alopecia

A

Vinblastine

39
Q

-Inhibits mitosis; Metabolized by the Liver P450 system, excreted in feces (same with whole drug class)
-Adverse effects: Myelosuppression, SIADH, Alopecia

(Less Myelosuppression effects than Vinblastine)

A

Vincristine

40
Q

-Inhibits mitosis; Metabolized by the Liver P450 system, excreted in feces (same with whole drug class)
-Adverse effects: arrhythmias, skin rash
-5% of patients have a hypersensitivity rxn. Premedicate with Benadryl, Decadron, and Zantac

A

Paclitaxel

41
Q

What are the two drugs that are Anti-Tumor Antibiotics?

A

1) Bleomycin
2) Doxorubicin

42
Q

-Inhibits DNA Biosynthesis
-Cell Cycle Specific for G2 (!!!)
-Adverse effects: Pulmonary Fibrosis

A

Bleomycin

43
Q

-Oxygen free radicals bind to DNA, causing single and double strand DNA breaks
-Adverse effects: Cardiomyopathy
-Can also have radiation recall rxn (erythema and desquamation at the sites of prior radiation therapy)

A

Doxorubicin

44
Q

What are some side effects of chemotherapy?

A

1) Mucositis (sloughing of tissues in oral cavity)
2) Hand & Foot Syndrome (painful, reversible. During administration of agent, skin sloughs off. High risk for infection. Prevent with ice packs during administration)
3) Alopecia

AFN Pharm 1 (5 decks)

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