chemotherapeutic drugs

Question 1

how do chemo drugs work?

Answer 1

tumor cells are derived from normal cells in which proliferation is poorly controlled
Most anticancer agents act by inhibiting cell proliferation
This is acheived by damaging DNA or preventing DNA repair
Newer agents selectively target cancer cells by using monoclonal antibody technology

Question 2

classifications of chemo meds

Answer 2

alkylating drugs, antimetabolites, plant alkaloids, antibiotics, enzymes, synthetics, hormones

Question 3

Doxorubicin used for

Answer 3

metastatic adenocarcinoma of breast, carcinoma of bladder, bronchogenic carcinoma, metastatic carcinoma of the thyroid, oat cell, and osteogenic carcinoma

Question 4

Doxorubicin causes

Answer 4

rdiomyopathy (acute left ventricular failure has been reported 2 months after cessation of treatment with doxorubicin during general anesthesia), wide range of cardiac problems from nonspecific ST-T changes to PVC, SVT, decreased QRS voltage. Onset is insidious with dry cough to heart failure that is unresponsive to inotropic drugs or mechanical ventricular devices.

Question 5

Bleomycin

Answer 5

testicular cancer

Question 6

bleomycin side effects

Answer 6

Patients with lymphomas may develop hyperthermia, hypotension, and hypoventilation.

Serious side effect is pulmonary toxicity-produces pulmonary endothelial damage to necrosis type 1 and proliferation of type 2 alveolar cells. Interstitial fibrosis develops and may progress to the entire lung.

Early reports of postoperative respiratory failure in bleomycin-treated patients suggest that either arterial hyperoxia or excessive crystalloid administration played an important role in the exacerbation of pulmonary fibrosis.

Inhaled FIO2 30% or below to be maintained in bleomycin-treated patients. Replace fluids with colloids instead of crystalloids (Also need to limit FIO2 with patients treated with mitomycin).

Question 7

anesthetic implications of stomatitis

Answer 7

makes placement of pharyngeal airways, LMA’s and esophageal caths questionable

Question 8

anesthetic implications of drug-induced cardiac, hepatic or renal dysfunction

Answer 8

response to inhaled and injected drugs may be altered