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pharm/tox final > Chemotherapeutic Agents > Flashcards

Chemotherapeutic Agents Flashcards

1
Q

Use of medications to kill or inhibit the growth and spread of disease.

A

Chemotherapy

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2
Q

Drugs that harm or destroy malignant cells.

A

Antineoplastic

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3
Q

Agents that can harm or kill living cells.

A

Cytotoxic

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4
Q

Doses are based on ______.

A

BSA

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5
Q

Set percentage of cells are killed with each dose of chemotherapy.

A

Cell Kill Theory

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6
Q

Exert activity in particular phase of cell division cycle.

A

Cell cycle specific

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7
Q

Cytotoxic activity unrelated to cell cycle.

A

Cell cycle nonspecific

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8
Q

Apoptosis signals a cell to enter G1 phase of cell division.

A

Feedback system

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9
Q

What happens in cancer patients in regard to the feedback system?

A

Cells enter division cycle independently of body’s feedback system.

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10
Q

postmitotic phase

A

G1

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11
Q

premitotic phase

A

G2

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12
Q

synthesis phase

A

S

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13
Q

Resting phase

A

G0

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14
Q

Phase that cell-cycle specific agents do not work in

A

G0

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15
Q

Plant derivatives and antimetabolites are classes of what type of agents?

A

Cell Cycle Specific Agents

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16
Q

Vinca alkaloids and etoposide are examples of what class?

A

Plant derivatives (cell cycle specific)

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17
Q

Folate antagonists and pyrimidine analogues are examples of what class?

A

Antimetabolites (cell cycle specific)

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18
Q

Interfere with DNA and RNA formation; specific to cells undergoing DNA synthesis (S phase)

A

Antimetabolites

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19
Q

Structural analog of folic acid. Inhibits dihydrofolate reductase. High dose leads to low bioavailability. Accumulates in fluid collections (risk of ascites or pulmonary effusions).

A

Methotrexate (antimetabolite)

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20
Q

Hepatotoxicity is an adverse effect of what?

A

Methotrexate

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21
Q

What drug rescues toxicity of methotrexate and minimizes adverse effects?

A

Leucovorin

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22
Q

True or false: Close patient monitoring is required in patients taking methotrexate.

A

True

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23
Q

True or false: Hydration with acidic fluids is recommended in patients taking methotrexate.

A

False: alkalinized fluids

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24
Q

Penicillin, cephalosporins, salicylates, and folic acid are drug drug interactions with what drug?

A

Methotrexate

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25
Q

Which drug is incorporated into DNA as a false base, inhibiting DNA polymerase?

A

Cytarabine (antimetabolite)

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26
Q

Ara-C syndrome is an adverse effect of what drug?

A

Cytarabine

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27
Q

What are symptoms of ara-C syndrome?

A

Rash on palms and soles of feet, fever, malaise, flu-like symptoms

28
Q

What drug binds to tubulin and inhibits microtubule formation?

A

Vincristine (Vinca Alkaloid, plant derivative)

29
Q

Is vincristine cell cycle specific?

A

Yes

30
Q

Is Cytarabine cell cycle specific?

A

Yes

31
Q

Is methotrexate cell cycle specific?

A

Yes

32
Q

What drugs have hepatic metabolism by CYP 3A4?

A

Both plant derivatives (Cincristine and Etoposide)

33
Q

Which chemotherapeutic agent does NOT cause myelosuppression?

A

Vincristine (plant derivative)

34
Q

Which drug causes constipation, vesicant, and SIADH?

A

Vincristine

35
Q

Which drug inhibits topoisomerase II and causes DNA strand breaks?

A

Etoposide

36
Q

Which drug should be given via IV for over 30 minutes to minimize risk of hypotension?

A

Etoposide

37
Q

Which drug has secondary malignancies as a toxicity?

A

Etoposide

38
Q

Cell kill is concentration dependent (proportional to dose)

A

Cell cycle nonspecific agents

39
Q

What are the classes of cell cycle nonspecific agents?

A

Alkylating agents and antitumor antibioitcs

40
Q

Cyclophosphamide and ifosfamide are examples of what class?

A

Alkylating agents

41
Q

Which alkylating agent has a narrow therapeutic index?

A

Cyclophosphamide

42
Q

What does mesna do?

A

Prevents hemorrhagic cystitis in patients taking cyclophosphamide or ifosfamide by binding acrolein.

43
Q

Which agent has dose-limiting toxicity of myelosuppression and hemorrhagic cystitis, SIADH, and cardiotoxicity?

A

Cyclophosphamide

44
Q

Which agent is recommended to be taken with cyclophosphamide and ifosfamide? What does it do?

A

Mesna – binds acrolein in the bladder, which is a product of the drugs’ metabolism.

45
Q

Hepatic metabolism to active metabolites and acrolein

A

Cyclophosphamide and ifosfamide

46
Q

What side effects differ from cyclophosphamide and ifosfamide?

A

Ifosfamide also has risk of CNS toxicity and renal electrolyte wasting (phoshorus, bicarbonate, potassium).

47
Q

Which agent has non-enzymatic metabolism and requires pretreatment IV hydration?

A

Cisplatin

48
Q

Toxicities: N/V is severe and delayed.

A

Cisplatin

49
Q

Peripheral neuropathy, renal toxicity, ototoxicity, hepatotoxicity, mild myelopsuppression

A

Cisplatin

50
Q

Which agent is not protein bound and has NO hepatic metabolism?

A

Carboplatin

51
Q

Which agent uses AUC dosing? What is AUC dosing?

A

Dose based on target exposure; takes GFR into consideration. Carboplatin uses this.

52
Q

N/V less severe, but more myelosuppression.

A

Carboplatin

53
Q

Cisplatin and Carboplatin are examples of what class?

A

Alkylating Agents (cell cycle nonspecific)

54
Q

Doxorubicin and daunorubicin are examples of what?

A

Anthracyclines (antitumor antibiotics) They are highly pigmented, planar molecules,

55
Q

What is the MOA of anthracyclines?

A

Multifactorial. DNA intercalation and topoisomerase II inhibition.

56
Q

Which agent has biliary excretion?

A

Anthracyclines

57
Q

Which agent requires dose adjustment for hepatic dysfunction but NOT for renal dysfunction?

A

Anthracyclines

58
Q

Which agent has toxicities: cardiotoxicity (acute, early chronic (within 1 year) or late chronic (5-20 years), vesicant, and urine discoloration?

A

Anthracyclines

59
Q

What are the benefits of combination chemotherapy? (3)

A
  1. Increases number of cells exposed to cytotoxic effects
  2. Allows for use of lower doses of each component
  3. Decreases development of drug resistance
60
Q

Methotrexate drug interactions: Compete for renal excretion (2)

A

Cephalosporins, penicillin

61
Q

Methotrexate drug interactions: Displacement of methotrexate from protein binding sites (2)

A

Salicylates and sulfonamides

62
Q

Methotrexate drug interactions: Decreased cellular transport (1)

A

Penicillin

63
Q

Which antimetabolite has urinary excretion as metabolites?

A

Cytarabine

64
Q

Rash on palms of hands and soles of feet and flu-like symptoms are a sign of what?

A

Ara-C syndrome from cytarabine

65
Q

Which agent is fatal if given intrathecally?

A

Vincristine

66
Q

What should you do when giving etoposide to minimize hypotension?

A

IV infusion over at least 30 minutes

pharm/tox final (5 decks)

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