Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Heme Midterm 3 > Chemotherapeutics > Flashcards

Chemotherapeutics Flashcards

1
Q

what is the growth fraction and will it be higher or lower in tumor cells?

A

growth fraction is the number of cells cycling compared to those in Go…it will be higher in tumors as more are growing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the log kill hypothesis for chemo

A

states that 1 round of chemo will kill 99% of cells around

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are two reasons we use combined chemo against tumors?

A
  1. tumors are often hetergenous and will have different genetic problems leading to the tumor
  2. different parts of the tumor can have different resistances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

primary chemotherapy

A

palliative therapy…cancer progressed and chemo only option

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

adjuvant chemo

A

small tumor…surgery first them chemo to follow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

neoadjuvant chemo

A

huge tumor…so chemo first then surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

radiosensitization chemo

A

some chemo drugs make cancer more susceptible to radiation so administer chemo then radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

three general types of chemos in increasing order of toxicity

A

biologics, targeted inhibitors, traditional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

three general types of chemos in increasing order of specificity of target

A

traditional, targeted inhibitors, biologics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how do phase non specific drugs work and what are they called?

A

they cross link DNA, so it cannot unwind and replicate or make RNA
alkylating agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what do alkylating agents have to help cross link?

A

bifunctional structure to bind at two different spots on the DNA strand and crosslink it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how to get resistance to alkylating agents with repair systems?

A

increased DNA repair will notice the cross link and lead to ridding of it

two modes are base excision repair and nucleotide excision repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is another way to get alkylating agent resistance?

A

glutathione can bind the agent before it is even able to act on the cell and render it ineffective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

cyclophosphamide/Ifosphamide type of chemo drug

A

alkylating or DNA cross link agent…non specific cell cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

cyclophosphamide/Ifosphamide toxicity

A

hemorrhagic cystitis…bladder bleeding

myelosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how does cyclophosphamide/Ifosphamide cause hemorrhagic cystitis?

A

given in inactive form that is broken down into active form and acrolein…the acrolein causes the bladder bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how to treat toxicity of cyclophosphamide/Ifosphamide?

A

can give Mensa that will inhibit the acrolein and yield no toxic effects of cyclophosphamide/Ifosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Bleomycin and Busulfan type of chemo drug

A

alkylating agents…DNA cross link…phase non specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Bleomycin and Busulfan toxicities

A

pulmonary fibrosis and myelosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Carmustine type of chemo agent

A

alkylating…DNA cross link…phase non specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

carmustine side effect/drug interaction

A

made with alcohol…so alcohol abusers on Antabuse will lead to high levels of acetaldehyde and BAD hangovers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cisplatin and Carboplatin type of chemo drug

A

alkylating agent…DNA cross link…stage non specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cisplatin and Carboplatin toxicities

A

renal toxicity

ototoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

mechanism of Cisplatin and Carboplatin renal toxicity? treatment?

A

wasting of K+/Mg2+ leads to renal failure…

treat with hydration and K+/Mg2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

mechanism of Cisplatin and Carboplatin ototoxicity?

A

accumulates in the cochlear duct fluid…causing inflammatory response

also enters nerves and can kill the hair cells that aid hearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

three treatments for Cisplatin and Carboplatin ototoxicity?

A

uptake inhibitors for ear canal
anti inflammatories
anti oxidants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

methotrexate mechanism and target stage as chemo drug

A

S phase…is a folate antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What does methotrexate target and inhibit? what does this not allow to be made?

A

target dihydorfolate reductase DHFR

does not allow purine ring to be made or transformation of UMP into TMP (thymidine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

3 modes of methotrexate resistance

A

decreased uptake
increase DHFR production
DHFR mutations

30
Q

methotrexates main toxicity

A

myelosuppression

31
Q

methotrexate secondary toxicity

A

mucositis…inflammation and breakdown of GI mucosa

32
Q

what is a risk with methotrexate?

A

if a patient has a 3rd space, pleural effusion of ascites, then methotrexate will enter this area and be stored until released later…can cause late toxicities

33
Q

how is methotrexate cleared?

A

renally..why 3rd space is such an issue because it doesnt get cleared

34
Q

what is a 3rd space?

A

pleural effusion or ascite

35
Q

leucovorins effects on methotrexate?

A

it is a folate replacement and is actually only taken up by normal cells rescuing them from effects of methotrexate but still letting methotrexate screw with cancerous cells

36
Q

name all six DNA alkylating non stage specific drugs?

A 
cyclophosphamide
ifosfamide
Busulfan
Carmustine
Cisplatin
Carboplatin
37
Q

purine analogs (4)

A

mercaptopurine
azathioprine
Cladribine
Pentostatin

38
Q

6-mercaptopurine toxicity

A

myelosuppression and T cell supression so more susceptible to bad infections like PJP

39
Q

cytarabine MOA

fluorouracil MoA

A

pyrimidine analog

40
Q

cytarabine toxicity

A

acute cerebellar neurotoxic

also see conjunctivitis because of being clearing in eyes

41
Q

topoisomerase inhibitors (4)

A

irinonectan
topotecan
etoposide
teniposide

42
Q

doxorubicin and daunorubicin MOA

and class

A

inserts into DNA and blocks unwinding for replication by making oxygen free radicals that damage DNA
anthracyclines

43
Q

what do doxorubicin and daunorubicin need to work?

A

iron

44
Q

irinotecan and topotecan toxicity

A

diarrhea…life threatening

45
Q

etoposide toxicity

A

myelosuppression and secondary malignancy…AML

46
Q

doxorubicin and daunorubicin toxicity

A

cardiac myocyte death

and extravasation injury

47
Q

agent to prevent doxorubicin and daunorubicin toxicity

A

dexrazoxane…prevents it by picking up iron that the drugs need

48
Q

Bleomycin MOA and stage

A

G2 phase and gets into helix and makes oxygen radicals

49
Q

dactinomycin MOA and stage

A

inhibits transcription and G2

50
Q

G2 drugs

A

bleomycin and dactinomycin

51
Q

bleomycin toxiciity

A

pulmonary fibrosis

52
Q

M phase drugs

A

vincristine, vinblastine, paclitaxel

53
Q

vincristine, vinblastine and paclitaxel MOA

A

messes with microtubules so mitosis is not effective

54
Q

vincristine and vinblastine toxicity

A

microtubules needed in nerves…can lead to peripheral neuropathy

55
Q

name of drugs that target the Raf kinase inhibitor

A

vemurafenib and dabrafenib

56
Q

HER2 inhibitors

A

cetuximab. erlotinib and trastuzumab

57
Q

trastuzomab toxicity

A

cardio toxicity

58
Q

unique allergy to cetuximab

A

from lone star tick bite…can see anaphylactic shock

59
Q

VEGF inhibitor and what is this important for

A

Bevacizumab…kidney angiogenesis

60
Q

what class of chemos is the most emetic agent?

A

alkylating agents, specifically the platins

61
Q

what other treatment do you need to consider when giving chemo

A

you must have an anti emitic plan that is intensive

62
Q

two drugs to treat anemia from chemo

A

epoietin alfa

darbepoietin alfa

63
Q

what is risk of giving EPO for chemo treatment

A

tumor growth

64
Q

two thrombocytopenia drugs that can cause lower thrombocytopenia due to an immune response

A

rTPO and PEG-rTPO

65
Q

two thrombocytopenia drugs for chemo that do not have immune response

A

romiplosim

eltromobopag

66
Q

name two drugs for neutropenia treatment with chemo

A

filgastrim (neulasta)
pegfilgastrim

these are artificial GCSFs

67
Q

side effects of filgastrim and pegfilgastrim and how do we treat it

A

moderate to severe bone pain

claritin

68
Q

what is a common oral side effect that causes eating problems of chemotherapy?

A

taste buds turnover every 10 days…dysgeusia

69
Q

what happens to parietal gland with chemo and what drug to treat it?

A

leads to dry mouth…treat with pilocarpine (parasympathetic agonist)

70
Q

how to treat neuropathy pain in the mandible/maxillary

A

make sure its not dental then manage with NSAIDs

Heme Midterm 3 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions