PHARM_OVARIAN & BLADDER CANCER

Question 1

Carboplatin/cisplatin MOA

Answer 1

forms DNA intrastrand crosslinks & adducts

Question 2

cyclophosphamide MOA

Answer 2

pro-drug of active alkylatin moiety

Question 3

Doxorubicin MOA

Answer 3

intercalator, free radical generator, topo II inhibitor

Question 4

mitomycin C MOA

Answer 4

mono- & bifunctional alkylating agent

Question 5

paclitaxel MOA

Answer 5

inhibits microtubule depolymerizeration

Question 6

thiotepa MOA

Answer 6

polyfunctional alkylator w/ loss of aziridine (alkylator) moiety

Question 7

what is the dose-limiting toxicity of cisplatin?

Answer 7

severe nephrotoxicity

Question 8

what are some of the adverse effects cisplatin?

Answer 8

ototoxicity (tinnitius & occasionally deafness)
allergic platinum rxns
dose limiting nephrotoxicity
myelosuppression
N/V

Question 9

what are some of the adverse effects of doxorubicin?

Answer 9

cumulative cardiotoxicity (CHF)
myelosuppression
heaptic dz
secondary malignancies
extravasational necrosis
N/V

Question 10

what is the main AE of mitomycin C when given IV?

Answer 10

pancytopenia

Question 11

what are the AEs of mitomycin C when given IVe?

Answer 11

• chemical cystitis

- contact dermatitis but also as palmar & plantar erythemas if contact made w/ instillate soln or void volume

Question 12

what is the main AE of thiotepa when given IV?

Answer 12

pancytopenia

Question 13

what are the AEs of thiotepa when given systemically as IV?

Answer 13

chemical/hemorrhagic cystitis
dysuria
urinary retention
renal dysfunction

Question 14

name the bladder cancer drug that causes chemical/hemorrhagic cystitis when given IVe

Answer 14

thiotepa

Question 15

how does BCG work?

Answer 15

binds to urothelial cells
activates APCs
induces production of: CTLs, NKs, LAKs, BAKs

Question 16

how long does BCG treatment last?

Answer 16

months

Question 17

how is BCG administered?

Answer 17

50 mL IVe instillation held for 1-2 hr, weekly x 6

Question 18

how is chemotherapy administered in treating epithelial ovarian carcinoma?

Answer 18

high volume Intra-peritoneal cisplatin instillation

• soln instilled & retained for period then drained off
• allows higher doses & more freq. admin of drugs

Question 19

what is the name of the protein you can measure in the blood to determine tumor prolif./drug effectiveness for epithelial ovarian carcinoma?

Answer 19

CA-125

Question 20

what are the 3 ways you can treat epithelial ovarian carcinoma?

Answer 20

may involve combo of surgery, radiation, & chemotherapy

Question 21

how is mitomycin C administered?

Answer 21

intravesicular

IV

Question 22

how is BCG administered for bladder carcinoma treatment?

Answer 22

intravesicular

Question 23

what is the most common presenting symptoms of bladder carcinoma?

Answer 23

hematuria

Question 24

what are the adverse effects of paclitaxel?

Answer 24

taxane hypersensitivity
myelosuppression
myalgia & arthralgia

Question 25

what are the main adverse effects of cyclophosphamide?

Answer 25

``` hemorrhagic cystitis (mesna is protective) blood dyscrasias-->anemia/infection Renal compromise N/V Rashes Amenorrhea/infertility Monitor for secondary malignancies pulmonary fibrosis ```

Question 26

what are some of the adverse effects of carboplatin?

Answer 26

``` dose related myelosuppresion cumulative anemia blood dyscrasias increased LFTs increased BUN & creatinine Allergic platinum reactions ```