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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
Q

Plant Alkaloid-TAXANE medications:

A

PaclitTAXel

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26
Q

Plant Alkaloid TAXANE fights what cancers

A

ovarian and breast

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27
Q

Plank Alkaloids treat several

A

solid tumors, lymphomas and leukemias

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28
Q

What is most common AE when giving plant alkaloids

A

allergic reactions- ore-medicate and monitor closely

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29
Q

Hormone therapy is used in cancer to..

A

increase or reduce the level of sex hormones in the body

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30
Q

Example of hormone therapy cancer

A

Estrogen dependent cancers

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31
Q

Hormonal Therapy: Estrogen

A

interferes with hormone receptors and proteins in all phases of the cell cycle

EXAMPLE: Diethylstilbestrol (DES)

32
Q

Anti estrogen action

A

binds to and blocks estrogen receptors forming a complex that inhibits DNA synthesis

33
Q

Tamoxifen is..and treats,,,

A

Anti-Estrogen treatment
Treats: breast cancer, selectively blocking estrogen receptors.

Can also be a treatment for osteoporosis (agonist at the bone)

34
Q

how long is someone on anti-estrogen medications after they are diagnosed

A

2-5 years

35
Q

Estogen receptor antagonists

A

selectively attach and block the activity of breast cancer cell hormones. inhibits tumor growth

36
Q

hormonal therapy: aromatase inhibitors block…

A

aromatase enzymes which are responsible for forming small amounts of estrogen in postmenopausal women.

inhibits estrogen by fat, muscle and other tissues

37
Q

aromatase inhibitors cannot stop what

A

the ovaries from producing estrogen

38
Q

Hormonal Thearpy:LHRH analog/ anti-androgen does what

A
  • inhibits pituitarygonadotropin, -supressess FSH and LH
  • blocks androgens for prostate cancer and breast cancer
  • decrease ovarian hormones
39
Q

Biotherapy is not based on the type of cancer but..,.

A

based on the proteins over expressed by the tumor

40
Q

Biotherapy

A

augments the immune response to fight cancer cells, inhibiting biological processes that allow cancer cells to proliferate (increase in number)

41
Q

Biologic Response Modifiers

A

uses the bodies immune system to stimulate the production of T cells, NK cells to cause regression of cancer

42
Q

Biologic Response Modifiers are good when treating what cancers

A

kidney, melanoma, bladder

43
Q

AE of Biologic Response Modifiers

A

flu like symptoms

44
Q

Biologic Response Modifier: Hematopoetic Growth Factors stimulate the growth of

A

RBC and WBC and are used to counteract or inhibit bone marrow supression

45
Q

Epoetin Alpha is what?? and it increases

A

It is a Biologic Repsponse Modifier

increases RBC

procrit/epogen

46
Q

Filgrastim increases

A

WBC

EX: neupogen

47
Q

Epoetin alpha is used to prevent and treat

A

anemia in clients with hbg:

48
Q

What is used adjunctively with epoetin to increase RBC

A

iron

49
Q

AE of epoeitin

A

hypertension, edema, thromboembolism, increased tumor growth, diarrhea

50
Q

BLACK BOX WARNING: Epoeitin

A

do not use in patients with >12 hbg and use at lowest dose possible

51
Q

Filgrastim (neupogen) stimulates and treats

A

stimulates WBC

Treats neutropenia and reduces incidence and severity of infections

monitored by CBC and differential

52
Q

Monoclonal Antibody

A

mass antibodies used to reach and destroy cancer cells and is made in the lab to enhance the immune system.

53
Q

Monoclonal Antibody medication

A

herceptin for HER2 positive breast cancer

54
Q

Immunotherapy active immunity:

A

vaccine acts as general immune stimulant, made from cancer cells

BCG (TB vaccine) –bladder cancer

55
Q

Immunotherapy passive immunity:

A

tumor specific T cells grown in lab and reinfused- direct cytotoxic effect on tumor cells

56
Q

Chemoprotective Agents

A

protect from adverse events caused by vertain chemotherapy drugs. Given along with chemo.

57
Q

Dexrazoxane is …

A

cardioprotectant given with Doxorubcin

Chemoprotective agent

58
Q

Adverse effects of chemotherapy can occur

A

immediate or years later

59
Q

Immunosuppression is a decrease in…

A

platelets, RBC and WBC

WBC decrease can cause infction

RBC decrease can cause anemia

Platelet decrease can cause bleeding

60
Q

If someone is immunosuppressed…teach them to..

A

avoid crows and infected people

report signs of infection (fever might not always be present)

maintain personal hygeine and handwashing

Adequate sleeping

61
Q

Neutropenic precautions:

A

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
Q

oral hygeine in patients receiving chemo

A

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
Q

Care for stomatitis (sores in the mouth)

A

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
Q

“chemo brain”

A

confusion, short term memory loss, difficulty concentrating, reversibly

Treatment- coping strategies, support groups

65
Q

Fatigue can be caused by

A

does not improve with rest, can be caused by anemia, low thyroid function

Improved with walking and ritalin

66
Q

Neuropathy can be treated by

A

gabapentin or antidepressants

67
Q

Tips for nutrition for chemo patients

A

nutritious foods first, add powdered milk or boost, finger foods, cold foods, decrease odors

68
Q

Tumor lysis treatment can occur when..

A

large numbers of cancer cells are killed or damaged and release their contents into the blood stream

69
Q

What can occur due to tumor lysis syndrome

A

hyperkalemia, hyperphosphatemia, hyperuricemia, hypomagnesemia, hypocalcemia, acidosis

70
Q

Tumor lysis syndrome S/S:

A

Gi upset, fatigue, altered mental status, hypertension, muscle cramps, paresthesias, tetany, seizures, EKG changes, cradiac arrest, acute renal failure

71
Q

Treat tumor lysis syndrome with..

A

IV, NS, NaHCO3, Allopurinol and treat electrolyte imbalances

72
Q

Chemotherapy can be used for non-malignant disease such as

A

MS, Lupus and tumors

73
Q

Primary treament for hematologic cancers..

A

leukemia, lymphoma and myeloma

74
Q

Adjuvant therapy is treatment used

A

in addition to the main treatment such as surgery or radiation and is usually treatment after surgery.

solid tumors, kill micrometastases after removal

75
Q

Palliative therapy

A

symptom relief

Patho Exam 4 (2 decks)

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