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Patho Exam 4 > Chemo > Flashcards

Chemo Flashcards

1
Q

Cell cycle NONspecific drugs: what do they do and what are they effective in treating

A

they exert effect in all phases including G0

Effective in treating tumors with slower dividing cells

Dosed intermittently to allow for recovery from side effects

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2
Q

Examples of drugs that are CCNS (cell cycle NONspecific

A

Alkylating Agents
Antitumor antibiotics
Hormonal therapies
Nitrosureas

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3
Q

Cell cycle SPECIFIC - what do these drugs do and what do they effect

A

Greatest tumor kill when given in divided but frequent doses or continuous infusion

Effects cells that are in stage of actively dividing

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4
Q

CCS drugs (cell cycle specific)

A

antimetabolities
plant alkaloids (vinca)
Miscellaneous agents

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5
Q

combination therapy

A

has less adverse effects

increased therapeutic response- combination of medicaations for a greater effect. Each medication acts by a different mechanism so you usually dont’ have the same toxicities

A/C CHOP FOLFOX CMF

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6
Q

Concurrent therapy includes

A

radiation and chemotherapy

targeted therapies added to chemotherapy

increases cell kill through a different mechanism

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7
Q

Alkylating Agents action:

A

break down the DNA helix strand, interfering with replication

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8
Q

Alkylating agents are effective against what cancers

A

blood related cancers, ovarian, lung, breast

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9
Q

AE of alkylating agents

A

bladder pain, hemorrhagic cystistis, hematuria, sepsis

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10
Q

Nitrogen Mustard medication class and example

A

Alkylating Agent

Cyclophophamide- DRINK LOTS OF WATER!!!!

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11
Q

Nitrosourea class and drug

A
  • Alkylating agent
  • Breaks DNA helix strand
  • Crosses the blood brain barrier

Carmustine (BCNU, BiCNU)

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12
Q

Antimetabolities, are they CCS or CCNS

A

CCS- occur during DNA sythesis and RNA growth

S phase

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13
Q

Antimetabolities are effective in treating what type of cancers

A

GI, breast, leukemia, ovarian

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14
Q

Examples of Antimetabolite drugs are

A

Flurouracil (5-FU)

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15
Q

antitumor antibiotic example

A

Anthracyclines

Doxorubicin

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16
Q

Antitumor Antibiotics action

A

they bind with the DNA interfering with enzymes and inhibit DNA/RNA synthesis)

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17
Q

Antitumor Antibiotics are they CCS or CCNS

A

CCNS

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18
Q

Anthracyclines

A

very effective antitumor antibiotics

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19
Q

antitumor antibiotics can cause adverse effects such as

A

cardiotoxicity, tissue necrosis and bone marrow/pulomary toxicity

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20
Q

Plant Alkaloid-VINCA: is it CCS or CCNS

A

CCS

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21
Q

Plant Alkaloids-VINCA action (in what phase and what it inhibits)

A

Mitotic Inhibitors- disrupts mitosis or blocks enzymes from producing proteins
needed for growth

Occurs in G2 phase blocking dna production and M phase preventing the division

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22
Q

Plant Alkaloid-VINCA medications

A

Vinblastine

Vinorelbine

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23
Q

Plant Alkaloid- VINCA AE:

A

neuropathies (paresthesias, numbness, tingling pain.)

OD can involve permanent paralysis

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24
Q

Plant Alkaloid- TAXANE action

A

stabilizes MICROTUBULES, inhibits cell division effective in G2 and M phase

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25
Plant Alkaloid-TAXANE medications:
PaclitTAXel
26
Plant Alkaloid TAXANE fights what cancers
ovarian and breast
27
Plank Alkaloids treat several
solid tumors, lymphomas and leukemias
28
What is most common AE when giving plant alkaloids
allergic reactions- ore-medicate and monitor closely
29
Hormone therapy is used in cancer to..
increase or reduce the level of sex hormones in the body
30
Example of hormone therapy cancer
Estrogen dependent cancers
31
Hormonal Therapy: Estrogen
interferes with hormone receptors and proteins in all phases of the cell cycle EXAMPLE: Diethylstilbestrol (DES)
32
Anti estrogen action
binds to and blocks estrogen receptors forming a complex that inhibits DNA synthesis
33
Tamoxifen is..and treats,,,
Anti-Estrogen treatment Treats: breast cancer, selectively blocking estrogen receptors. Can also be a treatment for osteoporosis (agonist at the bone)
34
how long is someone on anti-estrogen medications after they are diagnosed
2-5 years
35
Estogen receptor antagonists
selectively attach and block the activity of breast cancer cell hormones. inhibits tumor growth
36
hormonal therapy: aromatase inhibitors block...
aromatase enzymes which are responsible for forming small amounts of estrogen in postmenopausal women. inhibits estrogen by fat, muscle and other tissues
37
aromatase inhibitors cannot stop what
the ovaries from producing estrogen
38
Hormonal Thearpy:LHRH analog/ anti-androgen does what
- inhibits pituitarygonadotropin, -supressess FSH and LH - blocks androgens for prostate cancer and breast cancer - decrease ovarian hormones
39
Biotherapy is not based on the type of cancer but..,.
based on the proteins over expressed by the tumor
40
Biotherapy
augments the immune response to fight cancer cells, inhibiting biological processes that allow cancer cells to proliferate (increase in number)
41
Biologic Response Modifiers
uses the bodies immune system to stimulate the production of T cells, NK cells to cause regression of cancer
42
Biologic Response Modifiers are good when treating what cancers
kidney, melanoma, bladder
43
AE of Biologic Response Modifiers
flu like symptoms
44
Biologic Response Modifier: Hematopoetic Growth Factors stimulate the growth of
RBC and WBC and are used to counteract or inhibit bone marrow supression
45
Epoetin Alpha is what?? and it increases
It is a Biologic Repsponse Modifier increases RBC procrit/epogen
46
Filgrastim increases
WBC EX: neupogen
47
Epoetin alpha is used to prevent and treat
anemia in clients with hbg:
48
What is used adjunctively with epoetin to increase RBC
iron
49
AE of epoeitin
hypertension, edema, thromboembolism, increased tumor growth, diarrhea
50
BLACK BOX WARNING: Epoeitin
do not use in patients with >12 hbg and use at lowest dose possible
51
Filgrastim (neupogen) stimulates and treats
stimulates WBC Treats neutropenia and reduces incidence and severity of infections monitored by CBC and differential
52
Monoclonal Antibody
mass antibodies used to reach and destroy cancer cells and is made in the lab to enhance the immune system.
53
Monoclonal Antibody medication
herceptin for HER2 positive breast cancer
54
Immunotherapy active immunity:
vaccine acts as general immune stimulant, made from cancer cells BCG (TB vaccine) --bladder cancer
55
Immunotherapy passive immunity:
tumor specific T cells grown in lab and reinfused- direct cytotoxic effect on tumor cells
56
Chemoprotective Agents
protect from adverse events caused by vertain chemotherapy drugs. Given along with chemo.
57
Dexrazoxane is ...
cardioprotectant given with Doxorubcin Chemoprotective agent
58
Adverse effects of chemotherapy can occur
immediate or years later
59
Immunosuppression is a decrease in...
platelets, RBC and WBC WBC decrease can cause infction RBC decrease can cause anemia Platelet decrease can cause bleeding
60
If someone is immunosuppressed...teach them to..
avoid crows and infected people report signs of infection (fever might not always be present) maintain personal hygeine and handwashing Adequate sleeping
61
Neutropenic precautions:
Reverse isolation or protective isolation. Nurse is to wear: mask, gown, gloves, leave stethoscope in room, thermometer in room AVOID FRESH FRUIT OR VEGGIES OR FLOWERS
62
oral hygeine in patients receiving chemo
use a soft brush, brush tid, unwaxed floss, caution with toothpics, no lemon glycerine swabs, caution with OTC mouthwash, remove dentures, no tobacco or alcohol
63
Care for stomatitis (sores in the mouth)
small frequent servings of cold or room temp bland non irritateing foods with soft texture. NO ACID or SALT may need to decrease or stop doses if stomatitis occurs
64
"chemo brain"
confusion, short term memory loss, difficulty concentrating, reversibly Treatment- coping strategies, support groups
65
Fatigue can be caused by
does not improve with rest, can be caused by anemia, low thyroid function Improved with walking and ritalin
66
Neuropathy can be treated by
gabapentin or antidepressants
67
Tips for nutrition for chemo patients
nutritious foods first, add powdered milk or boost, finger foods, cold foods, decrease odors
68
Tumor lysis treatment can occur when..
large numbers of cancer cells are killed or damaged and release their contents into the blood stream
69
What can occur due to tumor lysis syndrome
hyperkalemia, hyperphosphatemia, hyperuricemia, hypomagnesemia, hypocalcemia, acidosis
70
Tumor lysis syndrome S/S:
Gi upset, fatigue, altered mental status, hypertension, muscle cramps, paresthesias, tetany, seizures, EKG changes, cradiac arrest, acute renal failure
71
Treat tumor lysis syndrome with..
IV, NS, NaHCO3, Allopurinol and treat electrolyte imbalances
72
Chemotherapy can be used for non-malignant disease such as
MS, Lupus and tumors
73
Primary treament for hematologic cancers..
leukemia, lymphoma and myeloma
74
Adjuvant therapy is treatment used
in addition to the main treatment such as surgery or radiation and is usually treatment after surgery. solid tumors, kill micrometastases after removal
75
Palliative therapy
symptom relief

Patho Exam 4 (2 decks)

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