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Pharm Exam 3 > Drug Therapy for Cancer > Flashcards

Drug Therapy for Cancer Flashcards

1
Q

what are some common endings for cancer drugs?

A

-ate, -ib, -ine, -one

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2
Q

what are the characteristics of cancer?

A
  • persist
  • invade (transformer - disguise themselves)
  • metastasize
  • immortal (don’t die)
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3
Q

does chemotherapy work better for slow-growing cancer or fast-growing cancer?

A

fast-growing cancer (chemo doesn’t work well for slow-growing cancers like prostate or thyroid)

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4
Q

what doesn’t chemotherapy work well for?

A
  • solid tumors

- slow-growing cancer

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5
Q

what are the four most common side effects of chemo? what do they have in common?

A

all rapidly growing cells - chemo kills rapidly dividing cells which are cancer cells and these cells

  • decreased immune system (low WBC)
  • fatigue (low H&H)
  • hair loss
  • GI (nausea and vomiting)
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6
Q

why do people typically need more than 1 chemotherapy drug?

A

because the chemos might work in different parts of the cell cycle

  • cell cycle-specific
  • cell cycle nonspecific
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7
Q

why would cancer patients be on steroids?

A
  • decrease inflammation so chemo can work better
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8
Q

what is the nurse’s role when counseling a patient about chemotherapy options?

A
  • guide patients to ask questions to their provider

- guide them to professional resources

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9
Q

what is the schedule of cancer treatment like?

A
  • complicated due to tolerance
  • demanding of time
  • realistic for lifestyle
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10
Q

why would drugs be alternated for cancer or stop for a period of time?

A
  • tolerance
  • to allow healthy cells that were damaged like bone marrow cells a chance to recover
  • recover platelet, WBC, and bone marrow count
  • fatal cells (not cells causing hair loss)
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11
Q

what is the Karnofsky performance scale?

A

determine who would be a good candidate for chemotherapy

  • 100 best score
  • less than 40 would not be a good candidate
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12
Q

what are the 3 reasons chemotherapy would be performed?

A
  • cure/complete response (remission)
  • control (prevent a tumor from growing, shrink a tumor in preparation for surgery)
  • palliation (less aggressive, just enough to keep a patient comfortable)
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13
Q

what needs to be known about palliation chemotherapy?

A
  • less aggressive
  • just enough to help with symptoms and keep patient comfortable, can be confusing for patient and family so inform them this is not to cure the patient’s cancer)
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14
Q

what would combination chemo be used?

A

to use medications with different side effects to limit side effects

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15
Q

what is an ommaya reservoir?

A

a way to perform direct chemotherapy
- fewer side effects
- more specific
a small, plastic device that is implanted in your brain. It allows your doctor to deliver medicine directly to the fluid around your brain and spinal cord

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16
Q

what precautions are needed when handling antineoplastics (medications used to treat cancer)?

A
  • airflow hood
  • low permeability gown
  • chemo gloves
  • face shield or googles
  • chemo waste disposal container
  • no food or drink in the area
  • DON’T CRUSH CANCER DRUGS
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17
Q

what is needed with patients’ urine after chemotherapy?

A

it is toxic

  • chemotherapy gloves when handling
  • flush toilet multiple times
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18
Q

what do you do as a nurse with a neutropenic patient?

A

very susceptible to infection

  • glove, gown, mask yourself to protect patient
  • no live plants
  • no fresh fruit or vegetables
  • limited visitors
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19
Q

how are chemo doses determined?

A

by body weight and surface area

- different for everyone

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20
Q

what is the action of alkylating agents?

A

binds to DNA and cause impaired functioning and replication to eventually kill the cell
- kills for within

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21
Q

what part of the cell cycle do alkylating agents work in?

A

non-specific

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22
Q

what is an example of an alkylating agent?

A

cyclophosphamide

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23
Q

what are the adverse effects of alkylating agents?

A
  • neutropenia
  • severe nausea and vomiting (90%)
  • bone marrow suppression
  • hair loss (alopecia)
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24
Q

what is the common ending for platinum compounds?

A

-tin

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25
Q

what is the action of platinum compounds?

A

binds to DNA and cause impaired functioning and replication to eventually kill the cell
- kills from within

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26
Q

what part of the cell cycle do platinum compounds work in?

A

non-specific

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27
Q

what are the side effects of platinum compounds?

A
  • neuropathy
  • severe nausea and vomiting
  • mild to moderate bone marrow impression
  • ototoxicity
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28
Q

what is an example of platinum compounds?

A

cisplatin

29
Q

what is the action for folic acid analogs?

A

interrupts the folic acid synthesis

30
Q

what cell cycle phase do folic acid analogs work in?

A

s phase

31
Q

what is an example of folic acid analogs?

A

methotrexate

32
Q

what are the adverse effects of folic acid analogs?

A
  • bone marrow suppression
  • oral and GI ulcers
  • renal impairment
  • GI distress
33
Q

what are examples of dose-limiting toxicities?

A

means to stop or pause treatment

  • myelosuppression
  • cardiotoxicity
  • pulmonary fibrosis
  • neurotoxicity
  • hypersensitivity
  • renal toxicity
  • tumor lysis syndrome
34
Q

what hematopoietic side effects are seen with chemo?

A
  • anemia (decreased RBC)
  • thrombocytopenia (decreased platelets)
  • leukopenia/neutropenia (decreased WBC/neutrophils)
35
Q

what are the treatments for anemia caused by chemo?

A
  • epoetin
  • darbepoetin
  • blood transfusion
36
Q

what are the treatments for thrombocytopenia caused by chemo?

A
  • oprelvekin (Neumega)

- platelet transfusion

37
Q

what are the treatments for leukopenia/neutropenia caused by chemo?

A

filgrastim (Neupogen)

38
Q

what are the gastrointestinal side effects of chemo?

A
  • anorexia
  • nausea
  • vomiting
  • mucositis (mouth sores)
  • stomatitis
  • constipation
  • diarrhea
  • pancreatitis
  • hepatic toxicity
39
Q

what kind of diet should cancer patients be on?

A

high-calorie diet (eating is really important)

40
Q

what are the genitourinary side effects of chemo?

A
  • cystitis (inflammation of the bladder)
  • hemorrhagic cystitis
  • acute renal failure
  • chronic renal insufficiency
41
Q

what are the integumentary side effects of chemo?

A
  • alopecia (emotional issues)
  • dermatitis
  • nail changes
  • hand-foot syndrome (impaired immune system)
  • hyperpigmentation
  • radiation recall
  • rash
  • extravasation
42
Q

what is extravasation?

A
  • leakage of blood, lymph, or other fluid, such as an anticancer drug, from a blood vessel or tube into the tissue around
  • why chemo needs to be given through a port
  • pain and inflammation in the SQ tissue
  • cellular/tissue damage if leakage into SQ tissue
43
Q

what are the cardiovascular side effects of chemo?

A
  • cardiac toxicity
  • extravasation
  • phlebitis (inflammation of a vein)
  • venous fibrosis (blood clots)
44
Q

what are the pulmonary side effects of chemo?

A
  • fibrosis
  • pneumonitis (inflammation of lung tissues)
  • edema
45
Q

what are the neurological side effects of chemo?

A
  • central neurotoxicity
  • ototoxicity
  • metabolic encephalopathy
  • peripheral neuropathy
46
Q

what are the mood alteration side effects of chemo?

A
  • anxiety
  • depression
  • euphoria
47
Q

what are the reproductive side effects of chemo?

A
  • infertility
  • changes in libido
  • erectile dysfunction
  • amenorrhea
48
Q

what are the metabolic side effects of chemo?

A
  • hyp/hypercalcemia
  • hypo/hyperglycemia
  • hyperphosphatemia
  • hyperuricemia
  • hypo/hyperkalemia
  • hypomagnesemia
  • tumor lysis syndrome
49
Q

what is tumor lysis syndrome?

A

no many cancer cells are killed at once and they release toxic chemicals
- hyperkalemia, hyperphosphatemia, hyperuricemia, hypomagnesemia, hypocalcemia, and acidosis

50
Q

how is a patient with tumor lysis syndrome treated?

A
  • rehydration
  • fix electrolyte imbalances
  • if pt is acidotic give sodium bicarb
  • treat/prevent gout (allopurinol)
51
Q

what are the latent effects of chemotherapy?

A
  • cognitive dysfunction
  • learning disabilities
  • changes in memory
  • secondary malignancies
52
Q

what are the two types of hormonal inhibitors typically given after cancer?

A
  • antiestrogen

- aromatase inhibitors

53
Q

what is the name of the antiestrogen hormonal inhibitor?

A

tamoxifen (nolvadex)

54
Q

what is the action of an antiestrogen hormonal inhibitor?

A

blocks estrogen receptors of breast cancer cells

55
Q

what is the use of an antiestrogen hormonal inhibitor?

A

used after breast cancer

56
Q

what are the adverse effects of an antiestrogen hormonal inhibitor?

A

similar to menopause

  • hot flashes
  • nausea and vomiting
  • fluid retention
  • blood clots
57
Q

what is the administration like for antiestrogen hormonal inhibitors?

A

20mg PO daily for 2-5 years

58
Q

what is the name of the aromatase hormonal inhibitors?

A

letrozole (Femara)

59
Q

what is the action of aromatase hormonal inhibitors?

A

inhibits aromatase which reduces estrogen levels

60
Q

what is the use of aromatase hormonal inhibitors?

A

after breast cancer or other estrogen-related cancers like ovarian cancer

61
Q

what are the adverse effects of aromatase hormonal inhibitors?

A
  • musculoskeletal pain

- fatigue

62
Q

what is the use like for aromatase hormonal inhibitors?

A

should be taken after 2-3 years of tamoxifen

63
Q

what is the common ending for biologic antineoplastic drugs?

A
  • mab
  • nib
  • mib
64
Q

what is biotherapy?

A

treatment with agents from biologic sources and or agents able to affect biologic response

65
Q

what are biologic response modifiers?

A

change the relationship between tumor and host by modifying biologic response of the host

  • body will kill cancer cells itself
  • less serious side effects
66
Q

what are the benefits of biotherapy?

A
  • an intact immune system will recognize abnormal cells and destroy them
  • cancer cells are constantly formed and destroyed by the immune system
67
Q

what is the role of biotherapy?

A
  • cure/complete response
  • control
  • maintenance
  • supportive therapy
68
Q

what are the side effects of biotherapy?

A
  • fatigue
  • flu-like symptoms
  • hypersensativity
  • infusion-related reaction
  • rashes
  • capillary leak syndrome

Pharm Exam 3 (5 decks)

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