Chemotherapy Flashcards
what are the roles of chemotherapy?
systemic disease
adjuvant therapy of solid tumors
palliative care
cytotoxicity
what is important in veterinary conventional chemotherapy?
lower doses than in human therapy
goal is to prolong life but not cure
dogs have relatively high tolerances for chemotherapy associated nausea
what is chemotherapy the sole treatment for?
hematopoietic malignancies:
lymphoma
leukemia
multiple myeloma
mast cell disease
what is chemotherapy an adjuvant therapy for?
high metastatic rate tumors: hemangiosarcoma and osteosarcoma
chemotherapy drugs are ______________ by nature
cytotoxic
are most chemotherapy drugs selective or non-selective?
non-selective
kill any rapidly dividing cell
what does protocol mean in chemotherapy?
set sequence of drugs given to treat a disease
how is chemotherapy dosed?
meter squared basis mostly: correlated to metabolic rate
some mg/kg
why does chemotherapy cause gastrointestinal side effects?
highest turnover rate of any cell in body: basal columnar cells in crypts
each crypt produces 300-400 cells/day
what gastrointestinal side effects do we see with chemotherapy?
vomiting
diarrhea
3-7 days after chemotherapy
why does chemotherapy cause immune system damage?
neutrophils active 3-5 hours: short half life
constant replacement
causes gap in maturation sequence when due to be released into circulation
an animal is at risk for opportunistic infection when the neutrophil count is ___________________
less than 1000
what leads to sepsis with chemotherapy?
neutropenia tends to occur synchronously with gut disruption
translocation of pathogenic gut bacteria
neutropenia with diarrhea worsens risk for sepsis
what is the most life-threatening complication from chemotherapy?
sepsis
what doses are more likely to be associated with adverse effects?
higher doses
what are two drugs with biliary excretion?
vincristine and doxorubicin
what does ABCB1-1delta (MDR1) code for?
p-glycoprotein
what drugs does an ABCB1-1delta mutation complicate?
vincristine
vinblastine
doxorubicin
mitoxantrone
taxanes
what has chronic exposure to hazardous drugs been associated?
serious health effects: decreased fertility, increased cancer risk
what are needle free syringes for?
chemotherapy drugs
what makes needle free syringes safe?
prevents accidental needle sticks
prevent aerosolization
minimizes potential exposure to hazardous drugs
what are some OSHA requirements for administration of chemotherapy?
closed system transfer devices
hood: containment segregated compounding area
what are some oral chemotherapies?
chlorambucil
lomustine
cyclophosphamide
melphalan
what do chlorambucil and lomustine do?
damage DNA
what can chronic use of chlorambucil lead to?
irreversible bone marrow damage- thrombocytopenia
what is one non-chemo drug that can act like chemotherapy?
prednisone
what does L-aspariganase do?
hydrolyzes asparagine to aspartic acid
inhibits protein synthesis
how do we treat tumors?
multimodality approach
chemotherapy
radiation therapy
surgery
immunotherapy
what characterizes gastrointestinal side effects from chemotherapy?
vomiting and diarrhea 3-7 days after chemotherapy
microbiome disruption with proliferation of pathogenic bacteria
how long does it take to go from a promyelocyte to a neutrophil?
180 hours
7.5 days
how is carboplatin excreted?
renal
why is it important to know if a patient has a ABCB1 gene mutation for chemotherapy?
high risk of toxicity with chemotherapy
what leads to apoptosis with chlorambucil?
DNA damage
what cancers can L-aspariganase be used in?
lymphoma
leukemia
what is a unique side effect of vincristine?
paralytic ileus due to neurotoxin
what is sterile hemorrhagic cystitis due to?
acrolein accumulation within the bladder
what does palladia target?
mutated c-kit
what pathogens are common in sepsis with chemotherapy?
E. coli
Strep
what is grade 4/severe toxicity neutropenia?
<500/microliter
