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Pharm Part II > E3: Cancer Drugs > Flashcards

E3: Cancer Drugs Flashcards

1
Q

What are the 3 main steps of cancer growth?

A

1.Transformation 2.Proliferation 3.Metastasis

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2
Q

________: When a cell with normal growth changes into a cell with dysregulated growth (malignancy)

A

Transformation

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3
Q

Transformation is mainly attributed to ______ damage: inherited, gene mutations, alterations/loss in regulatory proteins

A

GENETIC damage

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4
Q

________: Growth of transformed cells into a tumor

A

Proliferation

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5
Q

Proliferation of a tumor is an increase in the ______ of cells

A

NUMBER of cells (not their size)

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6
Q

Proliferation: Critical cell cycle events include the synthesis of DNA (__ phase) and the division of the parent cell into 2 daughter cells (__ phase = ______)

A

synthesis (S phase)….M phase mitosis

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7
Q

Most antineoplastic drugs target _______ cells

A

DIVIDING

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8
Q

Original tumor may respond well to chemotherapy, but _______ lesions may be less responsive = poor prognosis

A

metastatic

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9
Q

Most chemotherapy agents interfere with cell _______

A

proliferation

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10
Q

What is the critical gene that can asses of a cell can be repaired or not? If the damage can not be repaired what happens in a normal situation?

A

p53 gene….apoptosis

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11
Q

The p53 gene is a _______ that functions as a tumor _______

A

transcription factor…tumor supressor

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12
Q

p53 is _______ after many different stressors: UV radiation, oncogenes, DNA damaging drugs

A

INDUCED

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13
Q

If _____ gene is damaged, tumor suppression is severely reduced

A

p53

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14
Q

Cancers that express p53 (leukemias, lymphomas, testicular cancer) = highly _______ to chemotherapy

A

RESPONSIVE

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15
Q

Cancers that acquire a mutation in p53 are _______ responsive or resistant to DNA- damaging chemotherapy drugs

A

minimally

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16
Q

Chemo drugs act under ______ kinetics.

A

First-order

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17
Q

______ tumors DO NOT respond well to chemotherapy and often require _______ and/or ______ as well

A

SOLID… radiation… surgery

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18
Q

Current emphasis on cancer chemotherapy is use of drug _________ therapy

A

combination

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19
Q

G0 = ______ phase

A

resting

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20
Q

G1 = ____ phase; occurs after ______; genes for replication are activated

A

gap…mitosis

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21
Q

S = DNA _______

A

synthesis

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22
Q

G2 = second gap phase; “_______”; DNA REPAIR progresses

A

premitosis

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23
Q

Which phase does DNA repair progress?

A

G2

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24
Q

Cell-cycle ______ (drugs affects one phase)….Cell-cycle ________ (drug affects any/all phases)

A

specific…non-specific

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25
Q

Which cycles are considered interphase?

A

G0/G1–>S–>G2 (M is only one not in interphase)

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26
Q

Perspective: What are the 7 classes of Chemo Drugs?

A

1.Alkylating Agents 2.AntiMetabolites 3.Platinum Complexes 4.Vinca Alkyloids 5.Hormonal Agents 6.Antibiotics 7.Thalomide

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27
Q

Oral Manifestations of Chemo: Concern is that complications pose __________ risk and/or may dictate the need to temporarily discontinue treatment

A

econdary infection

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28
Q

Oral complications of Chemo pose great ________ to the patient

A

discomfort

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29
Q

Mgmt of Oral Complications during Chemo: Good _____ control…Pain control with ________

A

plaque…topical anesthetics

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30
Q

Mgmt of Oral Complications during Chemo: Salivary replacement for _________

A

xerostomia

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31
Q

Mgmt of Oral Complications during Chemo: _____ due to caries risk…Antifungals… Antivirals… Antimicrobial _______ or dentifrices

A

Fluorides… mouthrinses

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32
Q

What is the extremely painful oral condition when on chemo that is best treated with ICE CHIPS?

A

Oral Mucositis

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33
Q

What are the 4 major oral manifestations of Chemo tx?

A

1.Oral Mucositis 2.Candidiasis 3.Black Hairy Tongue (antibiotics) 4.Viral Lesions

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34
Q

All chemo drugs have a ___ therapeutic index.

A

LOW

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35
Q

What are 3 major areas/ signs of the toxicity of chemo drugs?

A

1.BLOOD dyscrasias 2.Ulcerations of ORAL mucosa/GI tract 3.Nausea/Vomiting

36
Q

Alkylating agents transfer alkyl groups to important cell constituents. When alkylating DNA, which nucleotide is it most likely alkylating to start cell death?

37
Q

DO alkylating agents target a specific part of the cell cycle?

A

NO, Alkylating agents are cell-cycle NON-specific (drugs combine with cells in any phase of the cycle)

38
Q

For Alkylating agents, __________ is common outcome of treatment

A

Susceptibility to infection

39
Q

What is the most common example of an alkylating agent?

A

Cyclo-phosph-AMIDE

40
Q

Antimetabolites are __ phase specific

41
Q

Nitrogen mustard is a class of _________

A

alkylating agents

42
Q

The 3 classes of antimetabolites are all antagonists, which antagonists are they?

A

1.Folic Acid Antagonists 2.Purine Antagonists 3.Pyrimidine Antagonists

43
Q

What is an example of a folic acid antagonist?

A

meth-o-trex-ATE

44
Q

Folic Acid antagonists inhibit DNA/Nucleic acid synthesis by blocking the enzyme ____________.

A

Di-Hydro-Folate Reductase

45
Q

______ antagonists inhibit enzymes that convert hypoxanthine ribonucleotide to adenine and xanthine ribonucleotide

46
Q

What is an example of a PURINE Antagoinist? Inhibits ____ AND ____ synthesis.

A

MER-CAP-TO-PURINE

47
Q

What are the two Pyrimidine antagonists that “really kick people’s buts”?

A

Fluoro-Uracil “5-FU” and CYT-ARA-BINE “Ara-C”

48
Q

Which cell cycle phase do Pyrimidine antagonists target?

A

Since they are antimetabolites- they target S phase

49
Q

In Platinum complex drugs they inhibit ____ synthesis and repair, which induces cell death.

50
Q

Platinum complex drugs are platinum ions surrounded by _______ ions.

51
Q

What is an example of a Platinum Complex drug? (Hint what do they all have in their name?)

A

they all have “Plat” in their name…CARBO-PLATIN

52
Q

What is ALMOST always a toxicity associated with Platinum derived meds?

A

OTOTOXICITY—Hearing loss

53
Q

VINCA alkyloids-is this a cell cycle-specific drug? If so, what cycle(s) does this affect?

A

Yes, M and S phases

54
Q

VINCA alkyloids-Inhibit mitotic division by interfering with ________ proteins involved in the formation of mitotic spindles.

A

microtubular

55
Q

What are the two examples of Vinca Alkyloids? (you better not get this wrong)

A

VIN-BLAST-INE and VIN-CRIST-INE

56
Q

What is a common side effect of the Vinca Alkyloids?

A

NeuroToxicty—Hearing loss specifically

57
Q

Melissa is on Vinca Alkyloids for lymphoma, but what is the one indication Dr. S pointed out in lecture?

A

Kaposi’s Sarcoma

58
Q

Which cell cycle phase do Hormonal Agents interfere with?

A

Hormones interrupt cells in G phase

59
Q

What are the 5 hormonal agents used in Chemo therapy?

A

1.Estrogens 2.Androgens 3.Progestins 4.Glucocorticoids 5.TAM-OX-IF-EN

60
Q

What are the two main Cancers indicated for the use of Estrogens? What is the form of Estrogen administered?

A

1.PROSTATE!!!! 2.Mammary…Ethinyl EstraDiol

61
Q

Who would you give ANDROGENS to for Cancer therapy?

A

POSTmenopausal women with Mammary Cancer

62
Q

Testosterone propionate and FLU-OXY-mesterone are drugs in the ______ family. What are they used for?

A

ANDROGEN….POSTmenopausal women with Mammary Cancer

63
Q

What are the two main indications for Progestin chemotheraputics?

A

1.RENAL 2.Endometrial cancers

64
Q

What are the two Progestin drugs?

A

1.MED-ROXY-PROGESTERONE 2.MEG-ES-TROL

65
Q

What is the hormone of choice for these indications? hematologic; lymphomas; bone metastases; immunosuppression for organ transplantation

A

GLucoCorticoids

66
Q

What is the only drug Dr. S gave us for the Glucocorticoid family?

A

PRED-NIS-ONE

67
Q

The anti tumor effects of PRED-NIS-ONE may be related to inhibition of _______ transport, phosphorylation, or induction of cell death in immature ________

A

glucose…. lymphocytes

68
Q

What is the hormonal agent that competitively binds to ESTROGEN receptors on tumors and other target tissues?…What cancer is it indicated for?

A

TAM-OX-IFEN…breast cancer

69
Q

TAM-OX-IFEN Decreases ______ synthesis and inhibits _______ effects

A

DNA… estrogen

70
Q

Which phases of the cell cycle does TAM-OX-IFEN act on? Is this cytostatic or cytosidal?

A

G0 and G1…cytostatic

71
Q

uterine cancer, stroke, pulmonary emboli, liver problems, osteoporosis are the adverse effects of what hormonal drug?

A

TAM-OX-IFEN

72
Q

Mech of Action for Antibiotics: ________ bind with DNA to inhibit cell division

A

Cytotoxins

73
Q

What phase do antibiotics attack cells?

A

haha TRICK question…non-cell cycle specific AND Cell cycle specific!!

74
Q

What type of tumors are ANTIBIOTICS most effective for?

A

Solid mass tumors

75
Q

What is the ONE Antibiotic drug Dr. S said TO KNOW?! What is is indicated for?

A

DAUN-O-RUB-ICIN CITRATE (DaunoXome)….HIV-assoc Kaposi’s sarcoma

76
Q

What do MOST, if not all the Antibiotic Chemo Agents end in?

A

“-CIN”

77
Q

What is the Angiogenesis inhibitor, immunosuppressant, TNF blocking agent used in multiple myeloma, AIDS-related pathos ulcers?

A

THAL-ID-O-MIDE

78
Q

What drug did we talk about that is the CLASSIC model drug for Teratogens?

A

THAL-ID-O-MIDE

79
Q

WHAT ARE THE 8, yes 8 Systmemic Effects of Chemotherapy?

A

1.Bone Marrow Suppression 2.GI Disturbances 3.Dermatological Reactions 4.HepatoToxicity 5.NeuroToxicity 6.NephroToxicity 7.Immune Deficiency 8.Infertility

80
Q

What are 2 signs of bone marrow suppression in systemic effects of Chemo?

A

1.Fatigue 2.ImmunoSuppression

81
Q

What are two major signs of GI disturbances in Chemo effects?

A

1.Nausea/Vomiting/Diarrhea 2.Change in Gut Flora

82
Q

What are 2 examples of Dermatological reactions to Chemo therapy?

A
  1. Skin lesions/ ulcerations 2.AloPecia
83
Q

What is the systemic effect of Chemo tx on Hepatotoxicity?

A

Enzymatic INDUCTION or INHIBITION via P450 enzymes

84
Q

What is the main NeuroToxicity from Chemo Therapy that we discussed?

A

Hearing Disorders

85
Q

In the Nephrotoxicity assoc with Chemo, there is _________ from excess cell destruction and byproducts. This is Treated with _________ to inhibit Uric Acid production and resultant Urema.

A

HYPERuremia…ALLOpurINOL

86
Q

In the immune deficiency consequence of Chemo, what are the two possible outcomes?

A

1.Susceptible to infection 2.Secondary Malignancy

87
Q

Chemo can cause infertility because it inhibits _________ and ________

A

spermatogenesis and oogenesis

Pharm Part II (28 decks)

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