Chemotherapy Flashcards
1
Q
cells most susceptible to chemotherapy (cytotoxicity)
A
rapidly dividing cells, euchromatin, specific phase
2
Q
chemotherapy mechanism
A
interference with cell cycle, signaling pathways
3
Q
angiogenic switch
A
switch to exponential growth
4
Q
tumors clinically detectable
A
1 x 10^9 cells (1 cm^3)
5
Q
rapidly dividing cells
A
bone marrow, hair follicle, GI, cancer
6
Q
most common side effects of chemotherapy
A
myelosuppression, alopecia, vomiting, diarrhea
7
Q
most myelosuppression at _____ post chemo
A
5-7 days
8
Q
important cells after chemotherapy
A
neutrophils, platelets
9
Q
neutrophil lifespan
A
1-7 days
10
Q
platelet lifespan
A
6 days
11
Q
_____ + ______ = sepsis
A
neutropenia, fever
12
Q
septic myelosuppression treatment
A
IV broad spectrum abx within 1 hr
13
Q
neutropenic with no fever treatment
A
oral antibiotics, monitor temp at home, out of hospital
14
Q
GI signs ____ after chemo
A
3-5 days
15
Q
GI supportive care drugs
A
anti-emetics, anti-diarrhea, appetite stimulation
16
Q
chemotherapy dosing goal
A
maximum tolerated
17
Q
chemotherapy goal
A
remission
18
Q
fractional kill hypothesis
A
a concentration of drug will kill a constant fraction of tumor cells independent of number
19
Q
more frequent dosing
A
kill rate > growth rate
20
Q
Goldie-Coldman hypothesis
A
spontaneous mutations occur and develop resistance
21
Q
chemo strategies for resistance
A
early treatment, multiagent chemo
22
Q
MDR change due to steroid use
A
induced by long term steroid use
23
Q
MDR1 mutation dogs chemo
A
more toxic effects
24
Q
problem drugs MDR1
A
antiparasitics, imodium, ace, torb, chemo, apo
25
problem chemo drugs MDR1
vincristine, vinblastine, doxorubicin, paclitaxel
26
alkylating agents mechanism
addition of alkyl groups to DNA, interferes with DNA replication
27
alkylating agent cell cycle phase specificity
non-specific
28
alkylating agent examples
cyclophosphamide, chlorambucil, melphalan, lomustine
29
clinical use of cyclophosphamide
lymphoma, soft tissue sarcoma, round cell tumors
30
unique toxicity of cyclophosphamide
sterile hemorrhagic cystitis
31
cyclophosphamide MDR
not substrate
32
chlorambucil use
indolent or low grade lymphoma, chronic lymphocytic leukemia, can substitute for cyclophosphamide
33
chlorambucil unique toxicity
cumulative myelosuppression
34
melphalan clinical use
multiple myeloma
35
melphalan unique toxicity
cumulative myelosuppression, esp. platelets
36
lomustine use
lymphoma, histiocytic sarcoma, mast cell tumors
37
lomustine unique toxicity
hepatotoxicity (thrombocytopenia, pulmonary fibrosis)
38
drug administered with lomustine
denamarin
39
lomustine able to cross BBB
true
40
antimetabolite mechanism
DNA base analogs, disrupt replication
41
antimetabolite cell cycle phase specificity
S phase
42
antimetabolite examples
cytosine arabinoside, 5-fluorouracil, rabacfosadine
43
cytosine arabinoside use
lymphoma, acute leukemia, granulomatous meningoencephalitis
44
cytosine arabinoside crosses BBB
true
45
5-fluorouracil use
carcinomas, usually in combination
46
5-fluorouracil unique toxicity
fatal neurotoxicity
47
rabacfosadine use
canine lymphoma
48
rabacfosadine unique toxicities
dermatopathies, fatal pulmonary fibrosis
49
dogs that cannot have rabacfosadine
West Highland White Terriers, American Staffordshire Terriers
50
anti-tumor antibiotics mechanism
intercalates DNA, disrupts replication
51
anti-tumor antibiotics cell cycle phase specificity
non-specific
52
anti-tumor antibiotics examples
doxorubicin, mitoxantrone, actinomycin-D, bleomycin
53
doxorubicin use
lymphoma and leukemia, hemangiosarcoma, osteosarcoma
54
doxorubicin unique toxicities
cumulative cardiotoxicity (dogs and humans), renal toxicity (cats)
55
mitoxantrone use
transitional cell carcinoma, lymphoma, apocrine gland sac tumors, replace doxorubicin
56
doxorubicin administration concern
severe vesicant
57
mitoxantrone unique toxicity
more myelosuppressive than doxorubicin
58
anti-microtubule agent mechanism
bind tubulin, prevent DNA replication
59
anti-microtubule agent cell cycle phase specificity
M phase
60
anti-microtubule agent examples
vincristine, vinblastine, taxanes
61
vincristine use
lymphoma, transmissible venereal tumor, IMTP
62
vincristine unique toxicity
peripheral neurotoxicity, ileus
63
vinblastine use
MCT, lymphoma, transitional cell carcinoma
64
unique toxicities of vinblastine
more myelosuppressive than vincristine
65
vinca alkaloids MDR
substrates
66
platinums mechanism
binds to DNA, creates crosslinks, inhibits replication
67
platinum cell cycle phase specificity
non-specific
68
platinum examples
cisplatin, carboplatin
69
cisplatin use
osteosarcoma, transitional cell carcinoma
70
cisplatin unique toxicities
nephrotoxicity, immediate nausea, fatal pulmonary edema in cats, ototoxicity
71
carboplatin use
osteosarcoma, carcinomas
72
carboplatin unique toxicity
nephrotoxic, more myelosuppressive than cisplatin
73
carboplatin can be given to cats
true
74
prednisone use
round cell tumors, insulinoma
75
prednisone cell cycle phase specificity
G1
76
prednisone unique toxicities
pu/pd/pp, v/d; suppression of adrenal-pituitary axis
77
l-asparaginase mechanism
depletes l-asparagine
78
l-asparaginase cell cycle phase specificity
G1
79
l-asparaginase use
lymphoma and leukemia
80
l-asparaginase unique toxicities
hypersensitivity, pancreatitis
81
toceranib phosphate mechanism
tyr kinase inhibitor, prevents downstream signaling
82
toceranib phosphate cell cycle phase specificity
G1
83
toceranib phosphate use
mast cell tumors, neuroendocrine carcinomas
84
chemo that doesn't target rapidly dividing cells
l-asparaginase
85
unique toxicities of toceranib phosphate
GI upset, PLN, hypertension, myalgia
86
oncept melanoma vaccine mechanism
generation of anti-tyrosinase antibodies
87
oncept melanoma vaccine administration
transdermal
88
oncept melanoma vaccine use
oral melanoma
89
unique toxicity of oncept melanoma vaccine
pain/redness at injection site, vitiligo and hypersensitivity reactions (rare)
90
M phase drugs
anti-microtubule agents
91
G1 phase drugs
prednisone, L-asparaginase, toceranib
92
S phase drugs
antimetabolites
93
non-specific drugs
alkylating agents, antitumor antibiotics, platinum agents
94
primary therapy
main therapeutic for disease
95
neoadjuvant therapy
therapy given before primary therapy
96
adjuvant therapy
therapy given after primary therapy
97
induction chemo
initial treatment phase with intent of remission
98
maintenance chemo
use of chemo to maintain remission
99
rescue chemo
protocol used after non-response or disease recurrence
100
palliative chemo
used to reduce symptoms
101
radiosensitization chemo
used to improve response to radiation
102
maximum tolerated dose
highest dose without unacceptable or irreversible side effects
103
maximum tolerated dose mechanism
cytotoxicity
104
metronomic chemo
frequent administration of low dose for prolonged time
105
metronomic chemo mechanism
antiangiogenesis, activate immunity
106
body surface area
((weight in kg)^2/3 x constant)/100
107
dog body surface area constant
10.1
108
cat body surface area constant
10.0
109
main routes of exposure to chemo
inhalation, ingestion
110
acute chemo side effects
nausea, rashes, liver/kidney damage, hair loss, hearing loss, heart damage, bone marrow toxicity
111
chronic chemo side effects
abortions and stillbirths, infertility, birth defects, increased risk of cancer
112
agent that deactivates chemo
bleach
