Pharm 25 Objectives Flashcards
What is the INDUCTION stage for cancer chemotherapy regimen?
Chemotherapy that is administered to eradicate the cancer cells
What is the POST-REMISSION or CONSOLIDATION stage for cancer chemotherapy regimen?
Eradicate any remaining disease, systemic therapy, hematopoietic stem cell transplant, or radiation therapy
What is the MAINTENANCE stage for cancer chemotherapy regimen?
Administered after consolidation therapy to prevent recurrence.
How do you utilizing drugs at their optimal dose, schedule, and interval for chemotherapy?
- Give the highest dose the patient can tolerate and still stay on schedule
- Limit the treatment - free interval between cycles to the shortest possible time
What is the recommended/common dosing for chemotherapy?
It is recommendation is to use actual body weight, especially in curative setting
- if using actual body weight and goes over max dose, only give max dose!
What is the advantages of combination therapy?
Works by different MOA thereby decreases likelihood that resistant cancer cells will develop.
List oral (PO) administration of routes of chemotherapy drugs?
Tablet, capsule, solution, suspension
List injection administration of routes of chemotherapy drugs?
- Intravenous (IV) - Slow push, short infusion, continuous infusion
- Intramuscular (IM)
- Intraperitonel (IP) - abdominal cancers
- Intrathecal (IT) - CNS/Brain
- Intravesical (IVC) - Bladder
- Subcutaneous (SubQ)
- Topical (TOP)
What is dose density?
Shorter interval between doses
What is dose intensity?
Increase dose administered to patient
How do you combat the mechanism of tumor cells?
Surgery, radiation, and pharmotherapy
How do you combat host toxicity?
Toxicity can occur if there is a delayed time between doses which can affect the time for bone marrow to recover so you can reduce that time and use colony stimulating factors to combat toxicity from occurring.
How to you combat the inability to suppress metastasis?
Use of proteasome inhibitors and other drugs to inhibit proteasome enzymes complexes that regulate the intracellular protein homeostasis it causes the cell to starve and die, ultimately preventing metastasis
What drugs are used for pre-treatment for chemotherapy induced n/v?
Lorazepam
What are the 5HT3 drugs are used to manage chemotherapy induced n/v?
Dolasetron, Granisetron, Odansetron, Palonosetron (last for 3 days)
What are the corticosteroids drugs are used to manage chemotherapy induced n/v?
Dexamethasone, Methylprednisolone, Prednisone
What are the Substance P/Neurokinin 1 (NK1) antagonist drugs are used to manage chemotherapy induced n/v?
Aprepitant, Fosaprepitant (MC), Netupitant
What are the miscellaneous drugs are used to manage chemotherapy induced n/v?
- Prochlorperazine
- Lorazepam
- Metoclopramide
- Dronabinol
- Olanzapine
- Famotidine
- Meclizine
What antiemetic regimens are used based on the chemotherapy regimen calculated emetogenicity for LOW emetic?
dexamethasone or prochlorperazine
What antiemetic regimens are used based on the chemotherpay regimen calculated emetogenicity for MODERATE emetic?
5HT3 antagonist + steroid +/- NK1 antagonist
What antiemetic regimens are used based on the chemotherpay regimen calculated emetogenicity for HIGH emetic?
5HT3 antagonist + steroid + NK1 antagonist
Myelosuppression can lead to leukopenia and thrombocytopenia why is it important to check ANC prior to next dose and delay as needed?
If your ANC is low than you’ll need to still stay on schedule but you will need to lower the chemo dose and use a stimulating factor for protection.
Dexrazoxane is used to limit specific organ system toxicities by?
Preventing anthracycline-induced cardiotoxicity;
Mesna is used to limit specific organ system toxicities by?
Binds to acrolein to prevent cyclophosphamide-induced hemorrhagic cystitis, increase fluids and give diuretics for cisplatin-induced renal toxicity
Cytotoxic agents: cell cycle-specific classification?
Drugs that interact during a specific phase of the cell cycle, including: DNA synthesis inhibitors and mitotic inhibitors
Cytotoxic agents: cell cycle-nonspecific classification?
Drugs that are active throughout the cell cycle such as: DNA alkylating agents and most DNA intercalating agents.
Protein (Tyrosine) Kinase Inhibitors MOA?
inhibit various kinases that phosphorylate tyrosine, thereby impeding pathways promoting malignant cell transformation and proliferation
Monoclonal Antibodies MOA?
The fragment antigen binding portion of an antibody binds to a specific antigen on a particular type of cancer cell, leading to disruption of an essential cancer cell process.
- They are given IV and are prone to cause immune system toxicities
Rituximab is used to treat?
Used to treat relapsed or refractory B-cell, non-Hodgkin lymphoma
Trastuzumab is used to treat?
Metastatic breast cancer of women whose cancer cells overexpress HER2/neu. It has cardiotoxic effects whose long-term consequences are unknown.
Cetuximab is used to treat?
Colorectal cancer in combination with Irinotecan. Also used for head and neck cancer in combination with radiation therapy.
Cetuximab MOA?
As a monoclonal antibody, it binds the epidermal growth factor receptor to block the unrestricted cell growth
Bevacizumab MOA?
A humanized antibody to vascular endothelial growth factor (VEGF) that prevents binding of VEGF to receptors on endothelial cells thereby inhibits the formation of new blood vessels.
Bevacizumab is used to treat?
Metastatic colon cancer and non-small cell lung cancer.
What is the general role of hormones and their antagonist?
these agents block the hormone or prevent its synthesis.
What is the general role of cellular immunotherapy?
Utilizing the body’s own T-Cells to attack cancer cells.
What is a new cancer therapy?
CAR-T cell therapy
- immunotherapy that uses your own altered T cells to recognize and kill tumor cells
