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Reproduction Pharmacology > Drugs to Treat Ovarian and Bladder Cancer > Flashcards

Drugs to Treat Ovarian and Bladder Cancer Flashcards

1
Q

OVARIAN CANCER DRUGS:

A 
Carboplatin  
Cisplatin
Cyclophosphamide 
Doxorubicin 
Paclitaxel
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2
Q

BLADDER CANCER DRUGS:

A 
Bacillus Calmette-Guerin, BCG
Cisplatin 
Doxorubicin 
Mitomycin C
Thiotepa
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3
Q

Epithelial Ovarian Carcinoma One of the most common?

A

Gynecologic malignancies; fifth most frequent cause of cancer death in women.

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4
Q

Most important risk factor?

A

Family history of a 1st degree relative.

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5
Q

Germline mutations in what genes substantially increase risk vs.general population

A

BRCA1/BRCA2

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6
Q

Prophylactic oophorectomy may be considered after?

A

The age of 35 if childbearing is complete.

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7
Q

What protein is elevated in Epithelial Ovarian Carcinoma?

A

CA-125 (cancer antigen-125) protein level is elevated in most ovarian cancer cells.

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8
Q

What Δ in blood is a measure of tumor proliferation/drug effectiveness?

A

CA-125 (cancer antigen-125) protein level

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9
Q

Chemotherapy involves High volume?

A

IP cisplatin instillation. Solution instilled and retained for a period, then drained off. Allows higher doses and more frequent administration of drugs.

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10
Q

Epithelial Ovarian Carcinoma Biologics and “targeted” therapies?

A

Under investigation, but at present none has received approval for routine clinical use.

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11
Q

Epithelial Ovarian Carcinoma Treatment may involve a combination of?

A

Surgery (bilateral salpingo-oophorectomy or debulking), radiation (external and instilled P32) and chemotherapy.

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12
Q

Bladder Carcinoma is the (blank) most common

A
  • 7th most common cancer in men
  • Most (70%) are transitional cell carcinoma
  • Most (70%) are superficial upon initial presentation
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13
Q

Bladder Carcinoma most common presenting symptom

A

Hematuria

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14
Q

Bladder Carcinoma with Non-muscle-invasive cancer treatment?

A

Trans-urethral resection (TUR) & regular cystoscopy to monitor for recurrence/progression.

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15
Q

Bladder Carcinoma with Non-muscle-invasive cancer drug therapy?

A

– Intravesicular (IVe) instillation of mitomycin C
– >1 year of IVe Bacillus Calmette-Guérin (BCG)
– Additional IVe drugs for high risk patients

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16
Q

BCG Instillation Used after?

A

TURBT and in treatment of CIS

17
Q

BCG Instillation Method & Requirements?

A
  • 50 mL instillation held for 1-2 hr; weekly x 6
  • Good response rates for prophylaxis, for CIS, & for eradication of residual disease
  • Activity requires an intact immune system
18
Q

BCG Instillation Mechanism:

A

– Binds to urothelial cells
– Activates APCs
– Induces production of effector cells (CTLs, NKs, LAKs, BAKs)
– Peak response in 6-24 hr; increasing with successive cycles
– Sustained effect over months

19
Q

Carboplatin MECHANISM

A

Forms DNA intrastrand crosslinks and adducts

20
Q

Cisplatin MECHANISM

A

Forms DNA intrastrand crosslinks and adducts

21
Q

Cyclophosphamide MECHANISM

A

Pro-drug of active alkylating moiety

22
Q

Doxorubicin MECHANISM

A

Intercalator, free radical generator, topo II inhibitor

23
Q

Mitomycin C MECHANISM

A

Mono- & bi-functional alkylating agent

24
Q

Paclitaxel MECHANISM

A

Microtubule stabilizer inhibiting depolymerizer

25
Q

Thiotepa MECHANISM

A

Polyfunctional alkylator with loss of aziridine (alkylator) moiety

26
Q

Carboplatin ISSUES

A

Allergic (platinum) reactions. Dose-related myelo-suppression; cumulative anemia. Dose related N/V. Blood chemistry dyscrasia, increase hepatic enzymes, BUN & creatinine.

27
Q

Cisplatin ISSUES

A

Allergic (platinum) reactions. Dose-related severe nephrotoxicity, myelosuppression, & N/V. Significant ototoxicity (tinnitus and occasionally deafness) reported in children

28
Q

Cyclophosphamide ISSUES

A

Blood dyscrasias leading to anemia/infection. Renal compromise, hemorrhagic cystitis (mesna is protective), N/V, rashes. Amenorrhea/infertility. Monitor for 2° malignancies. Pulmonary fibrosis

29
Q

Doxorubicin ISSUES

A

Myelosuppression, CHF, hepatic disease. 2° malignancies, extravasational necrosis, N/V

30
Q

Mitomycin C ISSUES

A

Pancytopenia (when used IV); chemical cystitis; contact dermatitis but also as palmar and plantar erythemas if contact made with instillate solution or void volume

31
Q

Paclitaxel ISSUES

A

Taxane hypersensitivity; myelosuppression; Myalgia & arthralgia

32
Q

Thiotepa ISSUES

A

Pancytopenia (when used IV); dysuria, urinary retention, chemical/hemorrhagic cystitis; renal dysfunction

Reproduction Pharmacology (9 decks)

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