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sav NUR 326 > final exam week 7 (2) > Flashcards

final exam week 7 (2) Flashcards

1
Q

chemo
goal =
#1 kill every ______ and produce a _______
#2 if they cant _____ – control _________ and offer _______

A

chemo
goal =
#1 kill every cancer cell and produce a cure
#2 if they cant cure – control growth and offer palliation

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2
Q

____– rest
____– cell growth
____– DNA synthesis
____ – prepare to divide
____ – mitosis

A

GO – rest
G1 – cell growth
S – DNA synthesis
G2 – prepare to divide
M – mitosis

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3
Q

_________= the ration of proliferating cells to resting cells

Chemo works best with higher or lower growth fraction?

A

Growth fraction

higher - (so cancer cells are proliferatiing more than they are resting)

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4
Q

Young Malignant tumors vs old
_________
- initially grow very fast
- (high growth fraction)
____________
- as tumor size increases = rate of proliferation decreases
- (low growth fraction)
- necrotic core
- decreased nutrient supply at core
- more cells in resting phase (G0)
- more difficult to treat

A

Young Malignant tumors
- initially grow very fast (high growth fraction)
old malignant tumors
- as tumor size increases = rate of proliferation decreases (low growth fraction)
- necrotic core
- decreased nutrient supply at core
- more cells in resting phase (G0)
- more difficult to treat

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5
Q

chemo barriers to success
1. cure = 100% of cancer cells die

must use _____ dose throughout treatment for 100% kill = same dose therapy
this is hard for patient to tolerate

A

same

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6
Q

chemo barriers to success
2. late detection = _____ response
- metastasis
- ____ tumor less responsive
- patient more debilitated by disease

A
  1. late detection = poor response
    - metastasis
    - old tumor less responsive
    - patient more debilitated by disease
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7
Q

chemo barriers to success

  1. solid tumors respond ______
    - ___ growth fraction (chemo works best on high growth fraction tumors)
    - ______ blood supply – hard to get treatment to them
A
  1. solid tumors responds poorly
    - low growth fraction (chemo works best on high growth fraction tumors)
    - limited blood supply – hard to get treatment to them
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8
Q

chemo barriers to success
4. drug _______
cancer cells _______ constantly
drug resistant mutations will flourish (natural selection)

A
  1. drug resistance
    cancer cells mutate constantly
    drug resistant mutations will flourish (natural selection)
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9
Q

chemo barriers to success
5. cell_________
ongoing mutation
cells differ greatly – different responses to drugs
older tumor = ___creased heterogeneity

A
  1. cell heterogeneity
    ongoing mutation
    cells differ greatly – different responses to drugs
    older tumor = increased heterogeneity
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10
Q

chemo strategies for success
1. intermittent chemo
goal = 100% cancer cell death with limited normal cell injury

we want to give enough time between chemo doses to let the normal cells _______, but not too long

A
  1. intermittent chemo
    goal = 100% cancer cell death with limited normal cell injury

we want to give enough time between chemo doses to let the normal cells recover, but not too long

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11
Q

chemo strategies for success
2. combination therapy
better than just one drug

adv
- reduces drug _______
- reduced ______ cell injury
- increases cancer cell____

disadv
- toxicities/interactions

*pay attention to drug toxicities so your not doubling up on toxicities to certain organs
Ex: nephrotoxic drugs

A
  1. combination therapy
    better than just one drug

adv
- reduces drug resistance
- reduced normal cell injury
- increases cancer cell kill

disadv
- toxicities/interactions

*pay attention to drug toxicities so your not doubling up on toxicities to certain organs
Ex: nephrotoxic drugs

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12
Q

chemo strategies for success
3. optimal dosing

dosing schedule
- ____ results
- cell cycle _______ agents
- keeps active drug present in body

A
  1. optimal dosing

dosing schedule
- max results
- cell cycle specific agents
- keeps active drug present in body

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13
Q

chemo strategies for success
4. regional therapy

not systemic
- access to tumors
- _____ drug concentrations
- __crease systemic toxicity

A
  1. regional therapy

not systemic
- access to tumors
- high drug concentrations
- decrease systemic toxicity

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14
Q

magic mouth wash
Rx cocktail for ______
Treats oral symptoms or curative?
- lidocaine
- Mylanta
- Diphenhydramine
- Nystatin
- Prednisolone
- Distilled water
Swish, gargle, spit
Q 6 hours
May be swallowed if esophageal involvement

A

magic mouth wash
Rx cocktail for stomatitis
Treats oral symptoms, not curative
- lidocaine
- Mylanta
- Diphenhydramine
- Nystatin
- Prednisolone
- Distilled water
Swish, gargle, spit
Q 6 hours
May be swallowed if esophageal involvement

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15
Q

chemo Other toxicities
Reproductive
- Developing fetus
- Testes sterility

Women –
Men –

A

Other toxicities
Reproductive
- Developing fetus
- Testes sterility

Women – do not become pregnant
Men – consider sperm banking

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16
Q

Anti cancer agents
1. ________– cause cell death
2. _________ – antiestrogen drugs, block effects of hormones on tumor
3. ________ – alters body’s response to cancer by stimulating immune sysem
4. _______ – target cancer cells directly

Cytotoxic agents
Biologicals
Targeted drugs
Hormonal agents

A

Anti cancer agents
1. Cytotoxic agents – cause cell death
2. Hormonal agents – antiestrogen drugs, block effects of hormones on tumor
3. Biologicals – alters body’s response to cancer by stimulating immune sysem
4. Targeted drugs – target cancer cells directly

17
Q

Drug regiman often includes drugs that are phase specific and non-phase specific = increases cancer cell kill

Non specific drug vs specific
- Doxorubicin
- methotrexate
- Cyclophosphasmide
- vincristine

A
  • N
  • S - S phase
  • N
  • S - M phase
18
Q
  • Ondasetron
  • Promethazine
  • Dexamethasone
  • Magic mouthwash
A

Drugs that treat toxicities

19
Q

Cell cycle specific drugs vs Cell cycle non-specific drugs?
1. Work only at a specific phase,
2. Implications = often used with cell specific drugs
3. Problem = cant interrupt cells in G phase resting phase, b/c they are out of cell cycle
4. Works at all cell cycle phases,
5. Problem = not as effective to our proliferating cells
6. Implications = must stay in body for a long time to be effective so all cells make it through to the phase
7. doesn’t work in G phase
8. works in G phase

A
  1. S
  2. NS
  3. S
  4. NS
  5. NS
  6. S
  7. S
  8. NS
20
Q

cancer pharm
Cytotoxic drugs:
MOA?

Cyclophosphamide

Doxorubicin

Methotrexate

Vincristine

A

MOA - Disrupt DNA synthesis
Disrupt mitosis

21
Q
  1. Cytotoxic drugs: Alkylating agents - Cyclophosphamide
  2. Cytotoxic drugs: Antitumor abx - Doxorubicin
  3. Cytotoxic drugs: Antimetabolites - Methotrexate
  4. Cytotoxic drugs: Mitotic inhibitors: vinca alkaloids - Vincristine
A

cancer pharm

22
Q

cancer pharm

2
Cell cycle non-specific

2
Cell cycle specific

Vincristine
Doxorubicin
Methotrexate
Cyclophosphamide

A

NON
1. Cyclophosphamide

  1. Doxorubicin

SPECIFIC
3. Methotrexate

4 .Vincristine

23
Q
  1. Cell cycle specific - S phase
  2. Cell cycle specific – M phase

Vincristine
Doxorubicin
Methotrexate
Cyclophosphamide

A
  1. Methotrexate
  2. Vincristine
24
Q

cancer pharm

s/e
Bone marrow suppression
n/v
hairloss
+
Viscant
Hemorrhagic cystitis
Sterility
Discoloration of skin and nails
Bladder injury

Vincristine
Doxorubicin
Methotrexate
Cyclophosphamide

A

Cyclophosphamide

25
Q

cancer pharm
s/e
Bone marrow suppression
n/v
hairloss
+
Cardiotoxicity
Acute and delayed reaction
Red color urine and sweat

Vincristine
Doxorubicin
Methotrexate
Cyclophosphamide

A

Doxorubicin

26
Q

cancer pharm
s/e
Bone marrow suppression
n/v
hairloss
+
Nephrotoxicity
Hepatoxicity
Fetal death and abnormalities

Vincristine
Doxorubicin
Methotrexate
Cyclophosphamide

A

Methotrexate

used for RA and lupus too

27
Q

cancer pharm
s/e
s/e
(NO Bone marrow suppression)
n/v
hairloss
+
Peripheral neuropathy
Vesicant

Vincristine
Doxorubicin
Methotrexate
Cyclophosphamide

A

Vincristine

28
Q
  1. Blocks serotonin receptors on vagal nerve and in the chemoreceptor trigger zone
  2. Blocks dopamine recpetors in the chemoreceptor trigger zone

Promethazine
Ondansetron

A
  1. Ondansetron
  2. Promethazine
29
Q

cancer pharm

indications
1.Chemo, radiation, post-op n/v

2.Chemo, radiation, post-op, general n/v

Promethazine
Ondansetron

A
  1. Ondansetron
  2. Promethazine
30
Q

cancer pharm
s/e

1.h/a
diarrhea
dizzy

2.respiratory depression
drowsy/sedation

Promethazine
Ondansetron

A
  1. Ondansetron
  2. Promethazine
31
Q

cancer pharm
implications:

  1. works better with steroid
  2. BLACK BOX WARNING
    Resp depression <2 y/o
    Gangrenous extravasation

Promethazine
Ondansetron

A
  1. Ondansetron
  2. Promethazine
32
Q
  • Immune checkpoint inhibtors – all immune cells to response more strongly to cancer
  • T cell transfer theraoy – boost natural T cell ability to fight cancer
A

Biologics (immunotherapy)

33
Q
  • Monoclonal antibodies – mark cencer cells so theyre better seen by the body’s immune system
  • Treatment vaccines – boosting immune systems response to cancer
A

Biologics (immunotherapy)

34
Q
  • Immune system modulators – enhance the body’s immune response against cancer – prevents or slows tumor growth and spread of cancer
A

Biologics (immunotherapy)

35
Q

MOA
Uses body;s immune system to kill cencer cells
Revs up immune system

A

Biologics (immunotherapy)

36
Q

s/e
pain
swelling
soreness
flu like s/e
weight gain
diarrhea
risk for infection

A

Biologics (immunotherapy)

sav NUR 326 (19 decks)

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