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Advanced Pharm Fall 24' > Patho And Pharm Of Neoplasia > Flashcards

Patho And Pharm Of Neoplasia Flashcards

1
Q

What is a neoplasm?

A

Abnormal mass of tissue, growth exceeds and is uncoordinated with normal tissues

Neoplasm is also referred to as a new growth.

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2
Q

What does the term ‘tumor’ refer to?

A

A non-specific term meaning lump or swelling

Often synonymous with neoplasm.

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3
Q

Define cancer.

A

Any malignant neoplasm or tumor

Cancer indicates a more severe, invasive type of neoplasm.

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4
Q

What is metastasis?

A

Discontinuous spread of a malignant neoplasm to distant sites

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5
Q

What is the cell type origin of carcinoma?

A

Epithelial origin

Examples include basal cell carcinoma and breast carcinoma.

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6
Q

What is the cell type origin of sarcoma?

A

Connective tissue or muscle

Examples include osteosarcoma and Kaposi’s sarcoma.

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7
Q

Which cell types are involved in leukemias and lymphomas?

A

Immune cells

Examples include Hodgkin’s lymphoma and acute myelogenous leukemia (AML).

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8
Q

Identify traditional treatments for neoplasia.

A
  • Surgery
  • Radiation
  • Chemotherapy
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9
Q

List new methods of cancer treatment.

A
  • Target cell pathways
  • Stem cell transplantation
  • Angiogenesis inhibition
  • Gene therapy
  • Cancer vaccines
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10
Q

What is primary chemotherapy?

A

Primary treatment is chemotherapy

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11
Q

What is the goal of chemotherapy in advanced disease?

A

Limit spread, improve quality of life (QOL)

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12
Q

What is neoadjuvant chemotherapy?

A

Chemotherapy induced to reduce tumor size prior to and after surgery

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13
Q

What is the purpose of adjuvant chemotherapy?

A

Reduce incidence and resurgence of tumor after surgery

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14
Q

What are the goals of chemotherapy?

A
  • Disease-free survival (DFS)
  • Overall survival (OS)
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15
Q

How can chemotherapy be administered?

A
  • Intravascular (peripheral vs central lines)
  • Oral
  • Topical
  • Intra cavity
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16
Q

What are common general toxicities of cytotoxic drugs?

A
  • Nausea & Vomiting
  • Bone marrow depression
  • Alopecia
  • Oligospermia, impotence, ↓ ovulation
  • Abortion, fetal death, teratogenicity
  • Carcinogenicity
  • Hyperuricemia
  • Immunosuppression
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17
Q

True or False: Cancer cells have normal mechanisms for suppressing cell growth.

A

False

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18
Q

What are cell cycle specific agents (CCS)?

A

Act against specific proteins involved in cell cycle progression

Examples include 5-FU, paclitaxel, vinblastine.

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19
Q

What are cell cycle nonspecific agents (CCNS)?

A

Effect not reliant on cell cycle progression

Examples include mitomycin, platinum analogs, doxorubicin.

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20
Q

What is the purpose of combination drug therapy?

A

Negates the effects of resistances of the different drugs

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21
Q

What is primary resistance in cancer treatment?

A

Mutations prevent the drug from working (e.g., p53)

22
Q

Define acquired resistance in cancer treatment.

A

Drug treatment selects for resistant strains

23
Q

What do alkylating agents do?

A

Transfer alkyl group to target (DNA), making it inactive

24
Q

What are antimetabolites?

A

Inhibit DNA synthesis (folate pathway)

25
Q

What are natural products in cancer treatment?

A

Plant-derived agents and their derivatives

26
Q

What are antitumor antibiotics?

A

Bacterial and fungal derived agents

27
Q

What are hormonal agents used for in cancer treatment?

A

Either hormones or inhibitors of hormonal signaling

28
Q

What are miscellaneous agents in cancer treatment?

A

Do not fit in other groups, include inhibitors and monoclonal antibodies

29
Q

What is the largest and most diverse class of anti-neoplastic drugs?

A

Alkylating Agents
* Either alkylate DNA or interfere by crosslinking (platinum compounds)

30
Q

List the alkylating agents groups:

A

Groups:
* Nitrogen Mustards
Cyclophosphamide, Chlorambucil
* Nitrosureas
Carmustine, lomustine, streptozocin
* Alkyl Sulfonate
Busulfan
* Platinum Analogs
Cisplatin, carboplatin

31
Q

What is the mechanism of action of cyclophosphamide?

A

Most commonly used alkylating agent for various neoplastic conditions

32
Q

What is the slowest acting and least toxic alkylating agent?

A

Chlorambucil

33
Q

What is the primary use of nitrosoureas?

A

Meningeal/Brain tumors
Adverse Effects:
* Delayed bone marrow suppression
* Visceral fibrosis, renal damage

34
Q

What is a common use of cisplatin?

A

Testicular cancer (85%-95% curative)

35
Q

Key Cisplatin Facts

A

Administered IV
* Highly bound to plasma proteins
* Concentrates in kidney, intestine, testes
* Poorly penetrates BBB
* Slowly excreted in urine

36
Q

List common adverse effects of cisplatin.

A
  • Emesis
  • Nephrotoxicity
  • Peripheral neuropathy
  • Ototoxicity
37
Q

What is methotrexate used for?

A

Methotrexate is a folate antagonist
* Inhibits dihydrofolate reductase (DHFR) and interferes with DNA/RNA synthesis

38
Q

Cytotoxic actions of Methotrexate

A
  • Predominant on bone marrow
  • Ulceration of intestinal mucosa
  • Crosses placenta interferes with embryogenesis
    *fetal malformations and death
39
Q

Immunosupressive action of Methotrexate

A

Prevents clonal expansion of B & T lymphocytes

40
Q

Anti-Inflammatory action of methotrexate

A

Interferes with release of inflammatory cytokines

41
Q

What do purine antagonists interfere with?

A

Nucleic acid synthesis
* 6-Mercaptopurine (6-MP), 6-Thioguanine, Azathioprine

42
Q

What are the main uses of pyrimidine antagonists?

A

Stomach, colon, breast, ovarian, liver cancers
* 5 Fluorouracil (5-FU), cytarabine, gemcitabine

43
Q

What is the mechanism of action of vinca alkaloids?

A

Block tubulin polymerization leading to dissolution of mitoticspindle and cell death

44
Q

What do taxanes do in cancer treatment?

A

Stabilize mitotic spindle so the cell cannot depolymerize and eventually lead to cell death

45
Q

What is the mechanism of action of antitumor antibiotics?

A

Intercalation in DNA, blocking DNA & RNA synthesis

46
Q

What are corticosteroids used for in cancer treatment?

A

Leukemias and lymphomas
prednisolone

47
Q

What is the role of selective estrogen receptor modulators (SERM) like tamoxifen?

A

Block estrogen effects in breast cancer

48
Q

What is the primary goal of cancer treatment?

A

Remission, suppression, or no treatment

49
Q

What constitutes a cure (Remission)

A
  • Repeated maximally tolerated individual dosing
  • Given as frequently as tolerated in carefully timed cycles
50
Q

Micellaneous Agents: What are ibs? Are they the same as MABs?

A

If there is an ib, it means that it is going to inhibit tyrosine kinase growth factors. Not the same as MABs

51
Q

List the strategies to reduce cancer risk.

A
  • Avoid tobacco
  • Maintain healthy weight
  • Regular physical activity
  • Eat healthy
  • Limit alcohol consumption
  • Protect your skin
  • Know your family history
  • Have regular checkups
52
Q

What drug treats all forms of cancer?

A

Trick question, no drug treats all cancers.
* every case is a little bit different

Advanced Pharm Fall 24' (18 decks)

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