Chemotherapy Flashcards
cells most susceptible to chemotherapy (cytotoxicity)
rapidly dividing cells, euchromatin, specific phase
chemotherapy mechanism
interference with cell cycle, signaling pathways
angiogenic switch
switch to exponential growth
tumors clinically detectable
1 x 10^9 cells (1 cm^3)
rapidly dividing cells
bone marrow, hair follicle, GI, cancer
most common side effects of chemotherapy
myelosuppression, alopecia, vomiting, diarrhea
most myelosuppression at _____ post chemo
5-7 days
important cells after chemotherapy
neutrophils, platelets
neutrophil lifespan
1-7 days
platelet lifespan
6 days
_____ + ______ = sepsis
neutropenia, fever
septic myelosuppression treatment
IV broad spectrum abx within 1 hr
neutropenic with no fever treatment
oral antibiotics, monitor temp at home, out of hospital
GI signs ____ after chemo
3-5 days
GI supportive care drugs
anti-emetics, anti-diarrhea, appetite stimulation
chemotherapy dosing goal
maximum tolerated
chemotherapy goal
remission
fractional kill hypothesis
a concentration of drug will kill a constant fraction of tumor cells independent of number
more frequent dosing
kill rate > growth rate
Goldie-Coldman hypothesis
spontaneous mutations occur and develop resistance
chemo strategies for resistance
early treatment, multiagent chemo
MDR change due to steroid use
induced by long term steroid use
MDR1 mutation dogs chemo
more toxic effects
problem drugs MDR1
antiparasitics, imodium, ace, torb, chemo, apo