Cytotoxic Chemotherapy

Question 1

How are cytotoxic chemotherapy agents classified?

Answer 1

On site of acticon during the cell cycle

Question 2

Ankylating agents are cell cycle specific/nonspecific.

Cells can no longer ________ because DNA can’‘t ________.

Answer 2

nonspecific

Crosslinking DNA - can’t divide

Question 3

AntimetaboliteS work on the ____ phase.

They prevent _________ by _______.

Answer 3

S phase

DNA replication by interfering with base pairs.

Question 4

Microtubule targeting agents work on the _____ phase.

They prevent the normal _________, thereby stopping ______________.

Answer 4

M phase

Assembly/disassembly of microtubulin – stoping cell division

Question 5

TopoisomeraSe targeting agents work on the ___ phase.

They inhibit ______ which causes __________.

Answer 5

S phase

inhibit topoisomerase I and II - DNA can’t unwind

Question 6

Drugs are developed to determine maximum ______________.

Answer 6

tolerated dose (due to toxicity)

Question 7

T or F. Drugs are dosed to match body weight.

Answer 7

F - body surface area

Question 8

T or F. One agent is used to the maximum efficacy, and then switched to a different one.

Answer 8

F - They are combined to minimize overlapping toxicity and mechanism of resistance.

Question 9

Common practice with these drugs is to treat _______________. Why?

Answer 9

Beyond best response

10^7 cancer cells are undetectable with radiology

Question 10

Once a tumor responds to therapy, PAs should keep __________ in mind and monitor the patient with what labs?

Answer 10

tumor lysis syndrome

K, PO4, Ca, Uric acid, renal function

Question 11

what are some drugs used to prevent and/or treat chemo toxicity?

Answer 11

Antiemetics - benzos, marinol, ondansteron

colony stimulating factors - treats neutropenia

Question 12

How are IV drugs delivered? This is especially true for _________ chemo.

Answer 12

central line

vesicant

Question 13

What is a common AE of these chemo agents? When should you no longer administer therapy because of this?

Answer 13

neutropenia

ANC less than 500

Question 14

When selecting and dosing natural products, one should consider ____________.

Answer 14

high bilirubin

Question 15

What drugs should you stop and consider before prescribing for chemo patients?

Answer 15

NSAIDs - ulcers, low platelets, renal function
APAP - hepatotoxic
Anticoagulants - low platelets

Question 16

Describe the cycle of neutropenia commonly seen in chemo patients.

Answer 16

Starts to decline around day 3-5
Hit low point, nadir, at day 7-10
Return to normal around day 17-21

Question 17

Name 2 ankylating agents

Answer 17

Carboplatin

Cyclophosphamide

Question 18

Which agent is known to accumulate in the bladder? What should the patient do to avoid this?

Answer 18

Cyclophosphamide

stay hydrated

Question 19

Methotrexate is ______________ and depletes ______.

Answer 19

Antimetabolite and depletes thymidine pools (antifolate).

Question 20

How do you rescue a patient from severe methotrexate toxicity?

Answer 20

Leucovorin (activated folate)

Question 21

Fluorocuracil is a ____________.

Answer 21

Antimetabolite - like methotraxate

Question 22

What is paclitaxel? What should the patient be premedicated with to prevent anaphylactic like reaction?

Answer 22

Microtubule targetin agent

dexamethasone 12, 6 and 1 hr before infusion AND H1/H2 receptor blocker

Question 23

Irinotecan has what AE?

Answer 23

Gi toxic

Question 24

What is the nick name for Doxorubicin? what is the major risk?

Answer 24

Big red

cardiac AEs