Chemotherapy Flashcards

1
Q

what are the roles of chemotherapy?

A

systemic disease
adjuvant therapy of solid tumors
palliative care
cytotoxicity

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2
Q

what is important in veterinary conventional chemotherapy?

A

lower doses than in human therapy
goal is to prolong life but not cure
dogs have relatively high tolerances for chemotherapy associated nausea

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3
Q

what is chemotherapy the sole treatment for?

A

hematopoietic malignancies:
lymphoma
leukemia
multiple myeloma
mast cell disease

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4
Q

what is chemotherapy an adjuvant therapy for?

A

high metastatic rate tumors: hemangiosarcoma and osteosarcoma

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5
Q

chemotherapy drugs are ______________ by nature

A

cytotoxic

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6
Q

are most chemotherapy drugs selective or non-selective?

A

non-selective
kill any rapidly dividing cell

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7
Q

what does protocol mean in chemotherapy?

A

set sequence of drugs given to treat a disease

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8
Q

how is chemotherapy dosed?

A

meter squared basis mostly: correlated to metabolic rate
some mg/kg

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9
Q

why does chemotherapy cause gastrointestinal side effects?

A

highest turnover rate of any cell in body: basal columnar cells in crypts
each crypt produces 300-400 cells/day

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10
Q

what gastrointestinal side effects do we see with chemotherapy?

A

vomiting
diarrhea
3-7 days after chemotherapy

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11
Q

why does chemotherapy cause immune system damage?

A

neutrophils active 3-5 hours: short half life
constant replacement
causes gap in maturation sequence when due to be released into circulation

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12
Q

an animal is at risk for opportunistic infection when the neutrophil count is ___________________

A

less than 1000

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13
Q

what leads to sepsis with chemotherapy?

A

neutropenia tends to occur synchronously with gut disruption
translocation of pathogenic gut bacteria
neutropenia with diarrhea worsens risk for sepsis

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14
Q

what is the most life-threatening complication from chemotherapy?

A

sepsis

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15
Q

what doses are more likely to be associated with adverse effects?

A

higher doses

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16
Q

what are two drugs with biliary excretion?

A

vincristine and doxorubicin

17
Q

what does ABCB1-1delta (MDR1) code for?

A

p-glycoprotein

18
Q

what drugs does an ABCB1-1delta mutation complicate?

A

vincristine
vinblastine
doxorubicin
mitoxantrone
taxanes

19
Q

what has chronic exposure to hazardous drugs been associated?

A

serious health effects: decreased fertility, increased cancer risk

20
Q

what are needle free syringes for?

A

chemotherapy drugs

21
Q

what makes needle free syringes safe?

A

prevents accidental needle sticks
prevent aerosolization
minimizes potential exposure to hazardous drugs

22
Q

what are some OSHA requirements for administration of chemotherapy?

A

closed system transfer devices
hood: containment segregated compounding area

23
Q

what are some oral chemotherapies?

A

chlorambucil
lomustine
cyclophosphamide
melphalan

24
Q

what do chlorambucil and lomustine do?

A

damage DNA

25
what can chronic use of chlorambucil lead to?
irreversible bone marrow damage- thrombocytopenia
26
what is one non-chemo drug that can act like chemotherapy?
prednisone
27
what does L-aspariganase do?
hydrolyzes asparagine to aspartic acid inhibits protein synthesis
28
how do we treat tumors?
multimodality approach chemotherapy radiation therapy surgery immunotherapy
29
what characterizes gastrointestinal side effects from chemotherapy?
vomiting and diarrhea 3-7 days after chemotherapy microbiome disruption with proliferation of pathogenic bacteria
30
how long does it take to go from a promyelocyte to a neutrophil?
180 hours 7.5 days
31
how is carboplatin excreted?
renal
32
why is it important to know if a patient has a ABCB1 gene mutation for chemotherapy?
high risk of toxicity with chemotherapy
33
what leads to apoptosis with chlorambucil?
DNA damage
34
what cancers can L-aspariganase be used in?
lymphoma leukemia
35
what is a unique side effect of vincristine?
paralytic ileus due to neurotoxin
36
what is sterile hemorrhagic cystitis due to?
acrolein accumulation within the bladder
37
what does palladia target?
mutated c-kit
38
what pathogens are common in sepsis with chemotherapy?
E. coli Strep
39
what is grade 4/severe toxicity neutropenia?
<500/microliter