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605 Pharmacology > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

Therapeutic Index for Chemotherapy?

A

very narrow, less than two-fold

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2
Q

BAG Signs

A

Bone Marrow
Alopecia
Gastrointestinal

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3
Q

How does chemotherapy target specific cells?

A

based on rate of division of the target cells

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4
Q

% of dogs that will die from cancer

A

25%

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5
Q

Is cancer always malignant or life threatening?

A

no (lipomas, sebaceous adenomas)

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6
Q

Metabolic Derangements of Cancer (3)

A

-Hypercalcemia (–> changes in renal blood flow and neuromuscular conjunctions)
-Hypoproteinemia
-Hyperproteinemia

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7
Q

6 Possible Routes of Administration for Chemotherapy Drugs

A
  1. IV
  2. Oral
  3. Intralesional
  4. Intracavitary
  5. IM
  6. SQ
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8
Q

What is the systemic effect of chemotherapy dependent on?

A

absorption of drug into the bloodstream

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9
Q

With which route of administration is absorption the most variable?

A

oral

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10
Q

Do we see alopecia in dogs and cats?

A

Not really because of the differences in hair follicles between humans and animals (exception would be the dogs that need groomed)

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11
Q

What % of IV drugs are absorbed?

A

100% (you literally put the drug in the bloodstream)

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12
Q

Advantages of Oral Administration

A

no specialized medical care required, can reach people who may not normally have access

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13
Q

Disadvantages of Oral Administration

A

bioavailability can be affected by many other factors (transit time (incl. short bowel syndrome), pH, presence of food, how fatty is that food, owner compliance, etc)

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14
Q

Intralesional Administration

A

directly administer immune-stimulating agents into the cancerous lesion

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15
Q

Intracavitary Administration

A

results in a higher concentration of the drug being locally absorbed at the site of disease

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16
Q

Intravascular (Liquid) Tumors

A

flowing in the bloodstream or lymphatics; highly dependent on protein binding

ex: lymphoma, leukemia, and myeloma

17
Q

Extravascular (Solid) Tumors

A

tumors that must be perfused by the bloodstream, therefore are highly dependent on vascularity

18
Q

Why is it difficult to get very large tumors to respond to chemotherapy?

A

areas of poor or even avascularization so cannot get the drugs to their target; these tumors also often develop a necrotic center

19
Q

Antineoplastic Drug Distribution and Interstitial Pressure

A

requires interstitial pressure to diffuse out of the bloodstream and into the tissues

20
Q

Main target of antineoplastic drugs?

A

DNA (so remember your drug needs to be able to cross certain membranes to gain access to the nucleus)

21
Q

Confounding Variables at the Anatomic Level (4)

A
  1. Sanctuary Sites
  2. Third Spacing
  3. Aberrant Blood Vessels
  4. High interstitial pressures
22
Q

Sanctuary Sites

A

areas of the body protected by an additional barrier, such as the blood-brain, eye, or prostate

23
Q

Third Spacing

A

accumulation of fluid from the blood within areas of the body that normally contain little fluid and anything within becomes non-functional (so if drugs are here, they’re not getting where you want them to go)

24
Q

Effect of High Interstitial Pressure?

A

less chemotherapy getting where it needs to go (it won’t be able to leave the blood vessels)

25
Q

Confounding Variables at the Cellular Level (2)

A
  1. Ability to pass through membranes
  2. Retention within a target cell
26
Q

Antineoplastic Drug Metabolism and Genetic Polymorphisms

A

variability between species and within species

27
Q

Thiopurine methyltransferase

A

dogs have this enzyme but cats don’t, so the drug Azathioprine would only be effective for dogs

28
Q

4 Components of Pharmacokinetics

A
  1. Absorption
  2. Distribution
  3. Metabolism
  4. Excretion
29
Q

2 Main Routes of Antineoplastic Excretion

A
  1. Kidney
  2. Liver/biliary system
30
Q

Kidney excretion

A

tubules responsible for active secretion or reabsoprtion

31
Q

Liver excretion

A

conjugate drugs to affect solubility to excrete them through the biliary tract

32
Q

Confounding Factors in Antineoplastic Excretion

A
  1. Renal tubular insufficiency (dec. clearance and inc. half-life)
  2. Renal glomerular disease (like a protein-losing nephropathy)
  3. Biliary Obstruction
33
Q

NCI (National Cancer Institute) Match in Humans

A

molecular analysis for therapy choice (look at DNA and many targeted cancer drugs)

34
Q

Pharmacogenomics

A

personalized medicine that uses genomic tools to screen for differences

605 Pharmacology (11 decks)

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