Cytotoxic Chemotherapy Flashcards
How are cytotoxic chemotherapy agents classified?
On site of acticon during the cell cycle
Ankylating agents are cell cycle specific/nonspecific.
Cells can no longer ________ because DNA can’‘t ________.
nonspecific
Crosslinking DNA - can’t divide
AntimetaboliteS work on the ____ phase.
They prevent _________ by _______.
S phase
DNA replication by interfering with base pairs.
Microtubule targeting agents work on the _____ phase.
They prevent the normal _________, thereby stopping ______________.
M phase
Assembly/disassembly of microtubulin – stoping cell division
TopoisomeraSe targeting agents work on the ___ phase.
They inhibit ______ which causes __________.
S phase
inhibit topoisomerase I and II - DNA can’t unwind
Drugs are developed to determine maximum ______________.
tolerated dose (due to toxicity)
T or F. Drugs are dosed to match body weight.
F - body surface area
T or F. One agent is used to the maximum efficacy, and then switched to a different one.
F - They are combined to minimize overlapping toxicity and mechanism of resistance.
Common practice with these drugs is to treat _______________. Why?
Beyond best response
10^7 cancer cells are undetectable with radiology
Once a tumor responds to therapy, PAs should keep __________ in mind and monitor the patient with what labs?
tumor lysis syndrome
K, PO4, Ca, Uric acid, renal function
what are some drugs used to prevent and/or treat chemo toxicity?
Antiemetics - benzos, marinol, ondansteron
colony stimulating factors - treats neutropenia
How are IV drugs delivered? This is especially true for _________ chemo.
central line
vesicant
What is a common AE of these chemo agents? When should you no longer administer therapy because of this?
neutropenia
ANC less than 500
When selecting and dosing natural products, one should consider ____________.
high bilirubin
What drugs should you stop and consider before prescribing for chemo patients?
NSAIDs - ulcers, low platelets, renal function
APAP - hepatotoxic
Anticoagulants - low platelets
Describe the cycle of neutropenia commonly seen in chemo patients.
Starts to decline around day 3-5
Hit low point, nadir, at day 7-10
Return to normal around day 17-21
Name 2 ankylating agents
Carboplatin
Cyclophosphamide
Which agent is known to accumulate in the bladder? What should the patient do to avoid this?
Cyclophosphamide
stay hydrated
Methotrexate is ______________ and depletes ______.
Antimetabolite and depletes thymidine pools (antifolate).
How do you rescue a patient from severe methotrexate toxicity?
Leucovorin (activated folate)
Fluorocuracil is a ____________.
Antimetabolite - like methotraxate
What is paclitaxel? What should the patient be premedicated with to prevent anaphylactic like reaction?
Microtubule targetin agent
dexamethasone 12, 6 and 1 hr before infusion AND H1/H2 receptor blocker
Irinotecan has what AE?
Gi toxic
What is the nick name for Doxorubicin? what is the major risk?
Big red
cardiac AEs
