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1Fall24 PoA II > Oncology pt2 > Flashcards

Oncology pt2 Flashcards

1
Q

What are the principal benefits of continuous infusion via catheters for cancer pain? (2)

A
  • ↓ systemic side effects
  • Technique and equipment ubiquitous.
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2
Q

Chemotherapy target cells in different phases of their ________.

A
  • Cell cycle
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3
Q

How do alkylating agents work?
Whats an example of an alkylating agent?

A
  • Damage cell DNA in all phases of the cell cycle causing them to be unable to reproduce.
  • Example: Cisplatin (Nitrosurea) [-platins]
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4
Q

What is a severe side effect of alkylating agents?

A

Dose-dependent cause of leukemia 5-10 years after treatment.

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5
Q

What types of cancers do antimetabolites commonly treat?

A
  • Breast
  • Ovary
  • Intestines
  • Leukemias
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6
Q

How do antimetabolites work?

A

Interfere with DNA and RNA

act as substitute for normal building blocks

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7
Q

What are two examples of antimetabolites?

A
  • Methotrexate
  • 5-Fluorouracil (5-FU)
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8
Q

How do Anti-tumor antibiotics treat cancer?

A
  • Interfere with enzymes copying DNA
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9
Q

What are examples of anti-tumor antibiotics?

A

-cins

Doxorubicin, bleomycin, mitomycin-C

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10
Q

What type of cancer drugs have life-time dosing limits?
Why?

A

Anti-tumor antibiotics because they permanently damage cardiac tissue in large doses.

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11
Q

Which chemotherapy class increases the risk of a second cancer developing? How do these drugs work?

A

Topoisomerase Inhibitors

  • plant alkaloids that prevent strands of DNA from being separated to copy

treat leukemias, lung, ovarian, GI, colorectal, and pancreatic cancers

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12
Q

Which chemotherapeutic agent is a plant alkaloid that damages cells in all phases through the prevention of protein synthesis?

A

Mitotic Inhibitors

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13
Q

Which chemotherapeutic class may cause peripheral neuropathy?

A

Mitotic inhibitors

(-Taxels and vincristine, vinblastine, etc.)

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14
Q

What normal cells are most likely to be damaged due to chemotherapy? (4)

A
  • Bone marrow blood forming
  • Hair follicles
  • GI tract (including mouth)
  • Reproductive systems
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15
Q

What drug can inhibit hormonal contraceptives?

And thus result in unexpected baby’s.

A

Aprepitant (neurokinin 1 antagonist)

may inhibit hormonal contraceptives x28 days

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16
Q

How does marijuana treat nausea/vomiting? What should be considered by the CRNA with marijuana use?

A

Depresses CNS vomiting center

more effective than phenothiazines

  • Consider that marijuana decreases anesthetic requirements 15-30%
17
Q

What is radiation’s effects on the peripheral vascular system?

A

Coagulopathy

6x increase in embolic events

18
Q

What is radiation’s effects on tissues treated for head and neck cancers? (3)

A
  • hypothyroidism
  • Carotid artery disease
  • Possible airway complications
19
Q

What is radiation’s effects on the chest wall and/or breasts?

A
  • Pericarditis
  • Cardiomyopathy
  • Valvulopathies
  • Dysrhythmias

cardiac abnormalities

20
Q

What is the possible effect of radiation on the lungs??

A

Radiation pneumonitis

pulmonary abnormalities

21
Q

What chemotherapeutic agent is known to cause cardiomyopathy?

A

Adriamycin

22
Q

What chemotherapeutic agent is known to cause pulmonary toxicity?

A

Bleomycin

especially with use of high FiO2

23
Q

What chemotherapeutic agents are known to cause peripheral neuropathy?

A
  • Cisplatin
  • Vincristine (mitotic inhibitor)
24
Q

What preoperative lab abnormalities might be seen in a cancer patient? (4)

A
  • ↓ RBCs
  • ↓ WBCs
  • ↓ PLTs
  • ↑ Ca⁺⁺
25
Q

Why is hypercalcemia common in cancer?

A

Many drugs are toxic to bone marrow thus causing breakdown and releasing Ca⁺⁺ into the bloodstream.

26
Q

What test is useful for testing for adrenal insufficiency?

A

ACTH stimulation test

27
Q

Why is adrenal insufficiency often seen in cancer patients?

A

Steroid treatments

28
Q

Why is tumor resection a risk factor for tumor recurrence? (3)

A
  • Tumor cells can spread into blood stream
  • Residue can remain behind
  • Localized spread via lymphatics
29
Q

Why is inflammation and surgical stress bad for cancer patients?

A

Surgical stress → elevated COX₂ expression → PG’s and thromboxanes → promoted cell survival and cancer cell growth

30
Q

How long can inflammation and stress last post surgery?

A

last for weeks

31
Q

β adrenergic receptors at the sites of tumor growth will upregulate cancer cell activity via nerve fiber delivery of _______.

A

norepinephrine

32
Q

What drug class directly stimulates cancer cell proliferation and invasion, inhibits leukocyte migration, and inhibits NK cell activity?

A

Opioids

33
Q

How do volatiles adversely affect cancer patients? (2)

A
  • Induce chemo resistance
  • Inhibit NK cells
34
Q

What effects does propofol have on cancer cells? (2)

A
  • Decreases migration
  • Promotes apoptosis
35
Q

Long term administration of NSAIDS _______ proliferation of cancer cells.

A

decreases proliferation

36
Q

Cancer types diagram

Flip Card

A
37
Q

Chemotherapy is a cancer treatment used to do what? (4)

A
  • kill cancer cells
  • shrink tumors
  • prep for bone marrow transplant
  • control overactive immune dz (s/a lupus or RA)
38
Q

What consideration/complication is associated with bleomycin?

A

can cause pulmonary complications s/a oxygen toxicity

avoid using high levels of FiO₂ if taking bleomycin

1Fall24 PoA II (34 decks)

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