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SUMPHARM > ONCOLOGY > Flashcards

ONCOLOGY Flashcards

1
Q

what is cancer?

A

Uncontrolled cellular growth- gene translocation, tumor stem cell repeat cell growth, proliferation. Radiation, Viral- turn on genes

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2
Q

What is definite goals for cures of cancer?

A

Must eradicate all cancer cells. Control of Cancer. Palliation-relief of SX. 50% of pts cured. 10% cured w/ chemo

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3
Q

What are treatments for Cancer?

A

surgery, radiation, chemo-drugs, hormonal, immunotherapy, molecular targeted therapy

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4
Q

What is most effective and traditional modality?induction therapy?

A

induction therapy. Other Neoadjuvant-B4, Adjuvant

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5
Q

Why does cancer inc fast, then plateau?

A

Environment either space of lack of metabolism ceases, thus sx start to occur.

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6
Q

Why is chemo given in cycles?

A

Time for health cells to recover. Chemo response depend on tumor growth curve. Maximizes malignant cell kill. DEC drug resistance

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7
Q

What is chemo schedule and dosing based on?

A

Body surface area using ht and wt

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8
Q

How do tumor cell become resistant

A
  1. Primary- non response 2. Acquired-MDR1 gene make protein to efflux the drug. like erythromycin
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9
Q

Describe the cell cycles?

A

G0- resting G1- makes proteins for DNA S- DNA replication G2-components for mitosis M- mitotic cell divides

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10
Q

What occurs if the cell detect DNA damage?

A

Cell cycle stops at check point 1 and after G2 p53 triggers apoptosis

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11
Q

How do drugs use the cell cycle?

A

RX either 1. cell cycle specific-ONLY for replicating cells or Cell cycle non specific- active in proliferating and resting phase

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12
Q

What CCSA affect G1-S phase?

A

Topoisomerase II inhib G1-S- Etoposide

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13
Q

What CCSA affect S phase?

A

Antimetabolites- MTX purine etc

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14
Q

What agents CCSA block G2-M phase?

A

Topoisomerase I- -otecan,

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15
Q

What agents affect the M phase?

A

Taxanes- taxels

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16
Q

What agent affect eh microtubules during M phase?

A

Tubulin interactive agents- stines

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17
Q

What agent act in both cell and non cell cycle?

A

Antitumor ABX- Bleomycin-Mphase ONLY

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18
Q

What agents are Cell cycle Nonspecific?

A

Alkylating-zine+ 2. Antitumor 3. Platinum-platin 4 Anthracycline-rubicin

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19
Q

What do hormonal agents affect?

A

Growth G1

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20
Q

All chemotherapy may have this ADE?

A
  1. Myelosuppression- BM neutropenia falls 1. 5-7, 2. nadir lowest point at 7-10 day 3. Recover 14-26 day (hence chemo 21-28 cycle . Anemia, Thrombocytopenia B. GI-MTX d/t cell turnover fast and die fast, SEVERE N/V/D, constipation C. Alopecia- rapid turnover cells D- Paresthesia
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21
Q

What agent attache an analog like guanin to DNA to break or link DNA strands so the cell cannot read DNA correctly? What are results

A

Cyclophosphamide Ifosfamide- Alkylating

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22
Q

How do cells build resistance to Alkylating agents?

A
  1. INC repair of DNA 2. DEC uptake of RX 3. INC glutathione
23
Q

WHat is MC unique ADE from Cyclophosphamide?

A

Hemorrhagic cystitis and severe N/V D/t Acrolein metabolite

24
Q

What agent that is alkylating causes skin pigmentation, pulmonary fibrosis, and adrenal dfx?

A

Busulfan

25
Q

What are mech to prevent hemorrhagic?

A

MESNA-mercaptoethanesulfonate Na- binds to acrolein in bladder to form nontoxic and excretion

26
Q

What agents are similar in crosslinking DNA straing like alkylating agents, disrupts DNA synthesis, and any cell cycle phase?

A

Cisplatin, Carboplatin, Oxaliplatin

27
Q

Which platin requires saline sol, avoid if SCr>1.5, with the MOST N/V, Ototoxicity, Peripheral neuropathy

A

Cisplatin

28
Q

Which platin cause thrombocytopenia?

A

Carboplatin

29
Q

Which platin cause neurological abnormal sensation to cold, Remind pt to where gloves, moisturize avoid cold,. may lead to sensory loss?

A

Oxaliplatin

30
Q

This agent are ferment of species of streptomyces and inhibit topoisomerase?

A

Antitumor ABX-Doxorubicin, Epirubicin, Bleomycin

31
Q

What are the most concerning ADEs in antitumor ABX?

A

Cardiotoxicity, flushing

32
Q

Which antitumor toxicity agent causes pulmonary issue, avoid COPD, and causes hyperpigmentation of the hands?

A

Bleomycin

33
Q

Why are ECG baseline required for Doxorubicin and Daunorubicin?

A

*IRREversible cardiotoxicity- Arrhythmias, dilated cardiomyopathy, CHF- Risk: elderly, children, female, HTN. AVOID if ejection fraction <45%, angina, arrhythmia, or MI

34
Q

What dose should not be exceed in DD, if given previous radiation therapy involved in heart?

A

550mg if

35
Q

What can protect heart with Doxo and Dauno?

A

Iron chelator-Dexrazoxane

36
Q

What agents cause palmar erythrodysesthesia and red color urine?

A

Doxorubicin and Daunorubicin

37
Q

What agents are antimetabolites that interfere with DNA RNA formation, thus inhibiting enzymes important to DNA synthesis>

A

ANTIMETabolites- Folate: MTX, Pemetrexed, Pyrimidine- KFU, Capecitabine, Gemcitabine

38
Q

Which antimetable are for colon and breast?

A

5FU and Capecitabine

39
Q

MTX inhibits dihydrofolate reductase, but this leads to what ADE?

A

Stomatitis, mucosit, skin, myelosuppression. Renal toxic, Hepatotoxicity, pulmonary fibrosis

40
Q

WHich agent will rescue host tissue from MTX relying on fact that some cancer cells do not express folate and cannot take up?

A

LEUCOVORIN. Give in combo* to DEC MTX toxicity in high dose

41
Q

WHat agent is used w/ planttinum TX for lung cancer and Folic and B12 reduce toxic?

A

PEMETREXED

42
Q

What pyrimidine analog blocks DNA and is used as cream for actinic keratosis for basal cell carcinoma?

A

5 fluorouracil- ADE Hyperpigmentation. Hand foot syndrome

43
Q

WHat is the antidote for OD of 5FU

A

Uridine Triacetate-prevent cell death via RNA

44
Q

Which agent has less ADE of common antimetabolite and converts to 5-FU in liver?

A

CAPECITABINE

45
Q

What agents are derived from periwinkle vinca alkaloid plant and inhibit tubulin in mitosis during M phase?

A

Vinblastine, Vinorelbine, Vincristine

46
Q

Which vinca alkaloid cause paresthesia in fingers and toes, stocking glove like?

A

VINCRISTINE- vesicants can escape from vein

47
Q

What agents are derived from periwinkle vinca alkaloid plant and enhance tubulin polymerization inhibiting mitosis during M phase?

A

Paclitaxel and Docetaxel- peripheral neuropathy, Allergic rxn, PRE trex with antihistamine, steroids.

48
Q

Which antimicrobic has less ADE?

A

Albumin bound paclitaxel nanoparticle

49
Q

Which agent used G2/M cell cycle, uses microtubule, but has LESS drug resistance d/t efflux and affinity?

A

ERIBULIN- from marine sponge

50
Q

What is ADE of Eribulin?

A

QT prolong and Peripheral neuropathy

51
Q

Which taxane has poor affinity multidrug resistance in resistant tumors?

A

CABAZITAXEL

52
Q

This agent inhibit topoisomerase, which inhibit unwinding of DNA strand w/ ADE of neutropenia?

A

Topotecan-ovarian cancer

53
Q

This TOP I has diarrhea toxicity?

A

Irinotecan- colon

54
Q

WHat dose Etoposide Topoisomerase II inhib treat?

A

LUNGs

SUMPHARM (26 decks)

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