Oncology pt2 Flashcards
What are the principal benefits of continuous infusion via catheters for cancer pain? (2)
- ↓ systemic side effects
- Technique and equipment ubiquitous.
Chemotherapy target cells in different phases of their ________.
- Cell cycle
How do alkylating agents work?
Whats an example of an alkylating agent?
- Damage cell DNA in all phases of the cell cycle causing them to be unable to reproduce.
- Example: Cisplatin (Nitrosurea) [-platins]
What is a severe side effect of alkylating agents?
Dose-dependent cause of leukemia 5-10 years after treatment.
What types of cancers do antimetabolites commonly treat?
- Breast
- Ovary
- Intestines
- Leukemias
How do antimetabolites work?
Interfere with DNA and RNA
act as substitute for normal building blocks
What are two examples of antimetabolites?
- Methotrexate
- 5-Fluorouracil (5-FU)
How do Anti-tumor antibiotics treat cancer?
- Interfere with enzymes copying DNA
What are examples of anti-tumor antibiotics?
-cins
Doxorubicin, bleomycin, mitomycin-C
What type of cancer drugs have life-time dosing limits?
Why?
Anti-tumor antibiotics because they permanently damage cardiac tissue in large doses.
Which chemotherapy class increases the risk of a second cancer developing? How do these drugs work?
Topoisomerase Inhibitors
- plant alkaloids that prevent strands of DNA from being separated to copy
treat leukemias, lung, ovarian, GI, colorectal, and pancreatic cancers
Which chemotherapeutic agent is a plant alkaloid that damages cells in all phases through the prevention of protein synthesis?
Mitotic Inhibitors
Which chemotherapeutic class may cause peripheral neuropathy?
Mitotic inhibitors
(-Taxels and vincristine, vinblastine, etc.)
What normal cells are most likely to be damaged due to chemotherapy? (4)
- Bone marrow blood forming
- Hair follicles
- GI tract (including mouth)
- Reproductive systems
What drug can inhibit hormonal contraceptives?
And thus result in unexpected baby’s.
Aprepitant (neurokinin 1 antagonist)
may inhibit hormonal contraceptives x28 days
How does marijuana treat nausea/vomiting? What should be considered by the CRNA with marijuana use?
Depresses CNS vomiting center
more effective than phenothiazines
- Consider that marijuana decreases anesthetic requirements 15-30%
What is radiation’s effects on the peripheral vascular system?
Coagulopathy
6x increase in embolic events
What is radiation’s effects on tissues treated for head and neck cancers? (3)
- hypothyroidism
- Carotid artery disease
- Possible airway complications
What is radiation’s effects on the chest wall and/or breasts?
- Pericarditis
- Cardiomyopathy
- Valvulopathies
- Dysrhythmias
cardiac abnormalities
What is the possible effect of radiation on the lungs??
Radiation pneumonitis
pulmonary abnormalities
What chemotherapeutic agent is known to cause cardiomyopathy?
Adriamycin
What chemotherapeutic agent is known to cause pulmonary toxicity?
Bleomycin
especially with use of high FiO2
What chemotherapeutic agents are known to cause peripheral neuropathy?
- Cisplatin
- Vincristine (mitotic inhibitor)
What preoperative lab abnormalities might be seen in a cancer patient? (4)
- ↓ RBCs
- ↓ WBCs
- ↓ PLTs
- ↑ Ca⁺⁺
Why is hypercalcemia common in cancer?
Many drugs are toxic to bone marrow thus causing breakdown and releasing Ca⁺⁺ into the bloodstream.
What test is useful for testing for adrenal insufficiency?
ACTH stimulation test
Why is adrenal insufficiency often seen in cancer patients?
Steroid treatments
Why is tumor resection a risk factor for tumor recurrence? (3)
- Tumor cells can spread into blood stream
- Residue can remain behind
- Localized spread via lymphatics
Why is inflammation and surgical stress bad for cancer patients?
Surgical stress → elevated COX₂ expression → PG’s and thromboxanes → promoted cell survival and cancer cell growth
How long can inflammation and stress last post surgery?
last for weeks
β adrenergic receptors at the sites of tumor growth will upregulate cancer cell activity via nerve fiber delivery of _______.
norepinephrine
What drug class directly stimulates cancer cell proliferation and invasion, inhibits leukocyte migration, and inhibits NK cell activity?
Opioids
How do volatiles adversely affect cancer patients? (2)
- Induce chemo resistance
- Inhibit NK cells
What effects does propofol have on cancer cells? (2)
- Decreases migration
- Promotes apoptosis
Long term administration of NSAIDS _______ proliferation of cancer cells.
decreases proliferation
Cancer types diagram
Flip Card
Chemotherapy is a cancer treatment used to do what? (4)
- kill cancer cells
- shrink tumors
- prep for bone marrow transplant
- control overactive immune dz (s/a lupus or RA)
What consideration/complication is associated with bleomycin?
can cause pulmonary complications s/a oxygen toxicity
avoid using high levels of FiO₂ if taking bleomycin
