Med Surg: Chemotherapy Flashcards

1
Q

What is systemic therapy?

A

Drug used to destroy cells throughout the body

Destroys normal cells too

Used for cnacer that have metastasized

Damage DNA or DNA synthesis or cell division

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2
Q

What is the chemotherapy cell cycle?

A

Cell Cycle:

works in one or multiple phases

not effective in G0 (resting phase)

chemo works best with large numbers of actively dividing cells

Cell cycle non-specific:

functions ithout regard to the cell cycle, destroys all of them

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3
Q

What is the cell kill hypothesis?

A

A fraction of cells are destroyed with each round of chemotherapy until total destruction is reached

Gives the basis for repeated doses over time or the “Course” of therapy

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4
Q

What are the principles of chemotherapy?

A

Combination therapy: multiple doses of chemo, based on protocols by type of cancer, metastais, pt health

Tumore Burden: low (small & fast growth)

Adjuvant therapy: multiple types of therapy

Problems” mucous membranes, bone marrow, hair

Benefits must outweight the toxic effects: teach patients and inform them that they have been improced and that certain cancers are treated better

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5
Q

What is NADIR?

A

Time of maxiumum effect on bone marrow activity (usually 10-14 days)

Major dose limiting side effect

May need intervention such as colony stimulating factor

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6
Q

What is tumor responsiveness?

A

Some types of tumore are not as responsive to drug therapy

Brain has BBB

Liver detoxes before get there

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7
Q

How is the types of chemo selected?

A

based on tumor sensitivity

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8
Q

What are the goals of chemo?

A

Cure

Control (remission): keep small, not divide

Palliation (comfort care): minimize side effects, not usually used this way

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9
Q

What are the routes of admission?

A

Oral: horomones, to stop growth, compliance is an issue, take at home

IV: most frequent, need good access, may have tissue damange

Intra-arterial: liver & billiary, need to bypass venous system

Intra-cavity: implant

Topical

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10
Q

What are the classifications of Antineoplastics?

A

Alkylating agents: oldest, nitrogen mustard, bad side effects, cross-linking in DNA

Antimetabolites: trick body to think they are metabolites, halts division

Antitumor Antiobiotics: developed from antibiotics, non-phase specific, bind and damage DNA, block transcription, prevent division, normally paired with other drugs

Plant Alyloids: phase specific, derived from plants, cause crystalizing in spindles so spindles cant divide

Topoisomerase inhibitors: subtype of plant alkyloid

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11
Q

What are Hormones in classifiation of antineoplastics?

A

Tumore must be horomone dependent for this to work.

Can work by manipulating the environment by preventing uptake, competing and inhibiting

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12
Q

What is the biological response modifier in classification of antineoplastics?

A

Not curative, supportive

Modifies biological response to tumor cells

Boosts persons immune system by improving recognition, supporting immune system, providing protection from side effects

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13
Q

What is gene therapy in the classification of antineoplastics?

A

Mostly experimental

Helps to alter tumore cell to make it easier to destroy

bood immune system recognition and activity

Targeted therapy: combination of biological and gene therapy, monoclonial antibodies (problem with allergic reaction), antisenses drugs

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14
Q

What is the potential for tissue damage?

A

Prevention

Vesicants

Irritants

Credentialed Meds

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15
Q

What are possible side effects and management?

A

Myelosuppression: effect on bone marrow, neutropenia, thrombocytopenia

Stomatitis (mouth), Mucositis (mucous membrane), Esophogitis

Anorexia

N/V

Taste alterations

Constipation/diarrhea

Fatigue

Alopecia

Cutanous reactions

Sexual alterations

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16
Q

What are oncological emergencies?

A

Sepsis and septic shock

DIC

SIADH

Spinal cord compression

Hypercalcemia

Superior Vena Cava Syndrome

TUmor Lysis Syndrome