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Oral Medicine- Cancer > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Chemo: Name two indications

A
  1. Used primarily for organ preservation in advanced disease
  2. May be used for palliative treatment or in combination with radiation therapy for post-operative high-risk cases
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2
Q

Chemo: Name three approaches to treatment

A
  1. Neoadjuvant therapy
  2. Adjuvant therapy
  3. Concurrent chemo+ radiation
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3
Q

Chemo: Define neoadjuvant therapy

A

Induction; chemo given before surgery or radiation

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4
Q

Chemo: Define Adjuvant Therapy

A

Chemo+ radiation simultaneously after surgery

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5
Q

Chemo: Adjuvant therapy is used when?

A

In high-risk patients to reduce metastatic burden

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6
Q

Chemo: Concurrent chemo + radiation if used for

A

Cure or organ preservation

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7
Q

What type of chemo is the standard of care for tumors in oropharynx

A

Concurrent chemo + radiation

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8
Q

Define Radiosensitizing effect

A

Chemo makes radiation more effective

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9
Q

Chemo: Three MOA

A
  1. Interfere with cell proliferation
  2. Relative selectivity against cancer cells
  3. Cancer cells are most sensitive to these drugs when the cells are actively going through the cell cycle
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10
Q

Chemo: Which types of cells are more susceptible to drugs that interfere with cell growth and division?

A

Metabolically active cells

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11
Q

Cancer: A single malignant cell can expand clonally to give rise to what?

A

A tumor

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12
Q

Cancer: What needs to happen to “cure” cancer?

A

Every malignant cell must be destroyed

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13
Q

Cancer: How is chemotherapy administered?

A

Multiple cycles of chemotherapy must be given at the highest tolerable dose with the most frequent tolerable interval to achieve a cure.

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14
Q

Cancer: Describe how chemo works with first-order kinetics

A

A constant fraction of tumor cells are killed with each cycle of chemo

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15
Q

What types of tumors do not respond well to chemo? Why?

A

Solid tumors; because they have slower growth/division of these cells

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16
Q

Solid Tumors: What do solid tumors often require in treatment?

A

Often require radiation and/or surgery as well

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17
Q

Solid Tumors: What is the justification for using combination drug therapy?

A

Resistance to chemotherapy drugs may develop

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18
Q

Combo Chemotherapy includes drugs that act on what?

A

Different molecular targets, at different phases of the cell cycle and with different dose-limiting toxicities

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19
Q

Combo Chemotherapy reduce the emergence of what?

A

Drug resistance

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20
Q

Combo Chemotherapy allows each individual drug to be given at its _____ tolerable dose

A

Highest

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21
Q

Combo Chemotherapy offers what types of benefits?

A

Synergistic benefits

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22
Q

Combo Chemotherapy is typically used as _____ dosing

A

Intermittent

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23
Q

What types of cancers require combo chemotherapy?

A 
Hodgkin's Disease
Testicular Cancer
Breast Cancer
Ovarian Cancer
Cervical Cancer
Bladder Cancer
Lung Cancer
Cancer of the head and neck
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24
Q

Drugs used to Treat Head and Neck Cancer:

Alkylating Agents Mechanism

A

Alkylate DNA, probably at guanine, as the primary mechanism for cell death.
Interfere with DNA, RNA and proteins to prevent cell metabolism and division.

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25
Q

Drugs used to Treat Head and Neck Cancer:

Three types of alkylating agents

A
  • Cisplatin
  • Carboplatin
  • Cyclophophamide
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26
Q

Drugs used to Treat Head and Neck Cancer: Cylophosphamide is an ____ agent and is used to treat what?

A

Alkylating agent

Multiple cancers, bone marrow transplants

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27
Q

Drugs used to Treat Head and Neck Cancer: Function of antimetabolites

A

Serve as fraudulent substrates for biochemical interactions; interfere with growth of rapidly prolferating cells

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28
Q

Drugs used to Treat Head and Neck Cancer: What are two examples of antimetabolites

A

Methotrexate and 5-fluorouracil

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29
Q

Drugs used to Treat Head and Neck Cancer: Methotrexiate is used to treat ____

A

Autoimmune diseases and multiple cancers

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30
Q

Drugs used to Treat Head and Neck Cancer: 5-fluorouracil is what type of analog

A

Pyrimidine analog

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31
Q

Drugs used to Treat Head and Neck Cancer: Alkyloids (Vinca) are derived from what?

A

Periwinkle plant (Vinca rosea)

32
Q

Drugs used to Treat Head and Neck Cancer: Alkyloids MOA

A

Inhibit mitotic division by interfering with microtubular proteins involved in the formation of mitotic spindles

33
Q

Drugs used to Treat Head and Neck Cancer: Alkyloids (Vinca) examples (2)

A

Vinblastine and vincristine

34
Q

Drugs used to Treat Head and Neck Cancer: Alkyloids (Vinca) treat what two cancers

A

Hodgkin’s Lymphoma and other lymphomas

35
Q

Drugs used to Treat Head and Neck Cancer: What is a major side effect of Alkyloids that may cause hearing loss (ototoxic)

A

Neurotoxicity

36
Q

Drugs used to Treat Head and Neck Cancer: Taxanes MOA

A

Inhibit DNA, RNA and protein synthesis; inteferes with mitotic phase (G2), inhibiting cell replication

37
Q

Drugs used to Treat Head and Neck Cancer: Two examples of taxanes

A

Docetaxel and paclitaxel

38
Q

Drugs used to Treat Head and Neck Cancer: Antibiotics are derivatives from

A

Streptomyces

39
Q

Drugs used to Treat Head and Neck Cancer: Antibiotic MOA

A

Inhibits DNA, RNA and protein synthesis

40
Q

Drugs used to Treat Head and Neck Cancer: Antibiotics are most effective for

A

Solid mass tumors

41
Q

Drugs used to Treat Head and Neck Cancer: Antibiotics Examples (3)

A

Bleomycin
Doxorubicin
Mitomycin

42
Q

Chemo: Define Biological therapy

A

Uses substances made from living organisms to treat cancer

43
Q

Chemo: What does it mean when Tumor-infiltrating lymphocytes are found in and around tumors?

A

It is a sign that the immune system is responding to the tumor

44
Q

Chemo: How does a patient’s tumor respond when it has TILs around it?

A

Better than peole whose tumors don’t contain them

45
Q

Chemo: Monoclonal antibodies is a type of targeted therapy, which is a type of ______

A

Immunotherapy

46
Q

Chemo: Monoclonal antibodies are ___ ____ proteins created in a lab

A

Immune system

47
Q

Chemo: What do monoclonal antibodies do?

A

Mark cancer cells so that the immune system will better recognize and destroy them.

48
Q

Chemo: What are two examples of monoclonal antibodies?

A

Rituximab and cetuximab

49
Q

Chemo: What does rituximab do?

A

Binds to a protein called CD20 on B cells and some types of cancer cells

50
Q

Chemo: Cetuximab is what type of inhibitor? What is it used for?

A

Epidermal Growth Factor Receptor Inhibitor; advanced or metastatic head and neck cancer

51
Q

Chemo: How do monoclonal antibodies work for leukemia and lymphoma tx?

A

Bring t cells close to cancer cells, helping the immune cells kill the cancer cells

52
Q

Chemo: Immune system modulators are a type of _______

A

Immunotherapy

53
Q

Chemo: Immune system modulators are used to treat what types of cancers?

A

Advanced cancers

54
Q

Chemo: What are two examples of immune system modulators?

A

Cytokines and hematopoietic growrth factors

55
Q

Chemo: What are three examples of cytokines?

A

Interferons and interleukins

56
Q

Chemo: Interferons activate

A

Natural killer cells

57
Q

Chemo: Interleukin function

A

T cell growth factor; boosts the number of WBCs

58
Q

Chemo: Hematopoietic growth factors function

A

Cytokines that are used to reduce side effects from cancer treatment

59
Q

Chemo: What are three examples of Hematopoietic growth factors

A

Erythropoietin, IL-11 and GM-CSF/G-CSF

60
Q

Chemo: Erythropoietin function

A

Increases production of red blood cells

61
Q

Chemo: IL-11 function

A

Increases the production of platelets

62
Q

Chemo: Immunomodulatory drugs are ____ ____ modifiers

A

Biological response

63
Q

Chemo: Immunomodulatory drugs stimulate the immune system by doing what two things

A
  1. Cause cells to release IL-2

2. Angiogenesis inhibitors

64
Q

Chemo: Angiogenesis inhibitors function

A

Stop growth of blood vessels; cuts of blood supply to tumors

65
Q

Chemo: Immunomodulatory drugs example

A

Thalidomide

66
Q

Describe why chemo drugs have a low therapeutic index

A

Lack of specificity -> affect malignant cells as well as rapid but normally proliferating cells

67
Q

What types of healthy tissues does chemo affect?

A

Bone marrow, skin and intestinal mucosa

68
Q

Where do signs of chemo toxicity appear?

A

Blood dyscrasias
Ulcerations of oral mucosa and other sites in GI tract
Nausea/vomiting

69
Q

Symptoms of chemo toxicity:

Supression of bone marrow (blood dyscrasias) symtpoms

A

Fatigue, immunosupression, infection susceptibility, thrombocytopenia

70
Q

Symptoms of chemo toxicity: GI disturbances symptoms

A

Nausea, vomiting, diarrhea
Dehydration and electrolyte imbalances
Changes in gut flora

71
Q

Symptoms of chemo toxicity: Dermatological reaction symptoms

A

Skin lesions, ulcerations

Hair loss

72
Q

Symptoms of chemo toxicity: Hepatoxocity symptoms

A

Enzymatic induction or inhibition via P450 en zymes

73
Q

Systemic Effects of Chemo: Describe neurotoxicity symptoms

A

Parasthesia, reduced gastric motility alteration in hormone release, hearing/vestibular disorders

74
Q

Symptoms of chemo toxicity: Nephrotoxicity symptoms

A

Hyperurecemia from excess cell destruction and byproducts

Altered drug renal clearance

75
Q

Oral Mucositis develops how quickly after tx? When does it subside?

A

7 to 14 days after chemo and when lowest WBC.

Subsides 1-2 weeks after chemo ends

76
Q

Chemo: Secondary infections occur when WBC is below

A

2000

Oral Medicine- Cancer (8 decks)

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