Ready To Study: Cancer Pharmacology

Question 1

In a person who is ________, cells proliferate/reproduce, and there is cell renewal and replacement which occurs in an orderly fashion. There is a balance between cells lost and cells produced.

Answer 1

Healthy

Ex. When you have a cut on your hand and the cut is healed the cells stop reproducing.

Question 2

In a patient with _____ their cell production is unregulated, so when we are speaking about anti-neoplastics.

Answer 2

Cancer

Question 3

Which is another name for the classification of medications that we use to treat cancer we are looking for cells that are growing without any regulation. Proliferation is a the production of new cells.

Answer 3

Anti-Neoplastics

Question 4

___________ is the maturation of cells, so this means that cells start out all looking alike.

Answer 4

Differentiation

[Ex. Like an egg and a sperm, they all look alike, the sperm fertilizes the egg then the egg begins to differentiate.]

Question 5

When a cell _______ it doesn’t look like other eggs anymore it starts to look like something different and as this process occurs, the cell grows into a baby, the baby is born, and the older you get the more you look like who you are. Babies in the nursery kinda look all the same but as you get older, you differentiate and that’s what happens with cells.

Answer 5

differentiates

Question 6

We start with a _____ cell at birth but the cells develop and they could develop into a liver cell, lung cell, brain cell, or a skeletal muscle cell and they all look different so that is the process of differentiation.

Answer 6

Stem

Question 7

When we are talking about looking at cancer cells when the pathologist gets a sample of a tumor that was removed during surgery this is called a biopsy and the pathologist looks at those cells under a microscope they may look like a lung cell in some respects but they look somewhat different because they are malignant. What type of cell is this?

Answer 7

Poorly differentiated cancer cell

Question 8

The less the cell looks like a lung cell and the more they look like a stem cell this is the considered undifferentiated.
The less that cell has differentiated when it becomes a cancer cell the more ______ the cell becomes.

Answer 8

malignant

Study Tip: THIS IS BAD.

Question 9

Poorly differentiated cancer means that the patient has a _______ prognosis than someone that has a well differentiated cancer.

Answer 9

worse

Question 10

Less Differentiation = ?

Answer 10

More Malignant

Question 11

What is the difference between undifferentiated and differentiated cancer cell growth?

Answer 11

Undifferentiated means that the cancer developed in the earlier phases of that cells development.
Differentiated means that the cancer developed in the later phase of that cells development.

Question 12

_______ cells have uncontrolled growth.

Answer 12

Cancer

Question 13

Cancer cells have altered biochemical properties (e.g. hormone production) and other substances and some of those substances are called ________ that we can actually test for in blood tests or urine tests or other types of tests.

Answer 13

Tumor Markers

Question 14

Cancer cells have _______ which results in new mutations.

Answer 14

Genetic Instability
REMEMBER: Cancer cells begin with a genetic mutation. The more malignant the cancer cells are the more capable they are of metastasizing.

Question 15

Cancer cells have the ability to metastasize. Metastasizing is a spread of the cancer from a primary site to other body sites. These cells are ______ to therapy.

Answer 15

Resistant

Question 16

A patient started with only lung cancer and that lung cancer has spread to the brain. The patient will have a diagnosis of both lung cancer and brain cancer, but the brain cancer is a metastasis from the lungs so we will say lung cancer with brain ____.

Answer 16

mets

This is the abbreviation for metastasis.

Question 17

The more malignant the cancer cell = an _________ in the cancer cells capacity for metastasis.

Answer 17

Increase

Study Tip: Metastasis is also abbreviated “Mets”

Question 18

________ is the spread of cancer from one body site to other body sites.

Answer 18

Metastasis

Question 19

___________ drugs act on a specific phase of the cell cycle so it acts on cells that are actively dividing.

Answer 19

Cell-cycle specific anti-neoplastic drugs.
Ex. 
Anti-metabolites 
Vinca plant alkaloids 
Just an FYI.

Question 20

_______ drugs are effective against rapidly growing tumors these medications are also effective against actively reproducing normal cells.

Answer 20

Cell-cycle specific anti-neoplastic drugs
IMPORTANT: Remember that anything that an anti-neoplastic does to a cancer cell it is ALSO going to do to the normal cells too and that is when we get some of our adverse or side effects from these medications.

Question 21

Cell-cycle specific anti-neoplastics are for tumors that grow ______ and cell-cycle non-specific are for the ______ growing tumors.

Answer 21

Fast
Slow
Ex. If you have a patient that is getting chemotherapy you can look and see what they are getting and that can help you figure out if they are having a rapid or slow growing tumor.

Question 22

Antitumor antibiotics
Alkylating agents
Hormones
Steroids 
These are effect against slowly growing tumors. Would these be considered cell cycle specific or cell cycle non-specific drugs?

Answer 22

Cell-cycle non-specific anti-neoplastic drugs

Study Tip: some antibiotics can work as an anti-neoplastic.

Question 23

_________ drugs are for the slower growing tumors, they can acts on cells at any time whether they are actively dividing or resting and it doesn’t matter where in the cell cycle that the cell is in.

Answer 23

Cell-cycle non-specific anti-neoplastic drugs

Question 24

_________ are the MOST effect against slowly growing tumors.

Answer 24

Steroids

Question 25

The Goal of Treatment with anti-neoplastic drugs is to kill as many cancer cells as possible, while doing the least possible harm to as many ______ cells as possible.

Answer 25

healthy
Study Tip: For this reason we give combinations of anti-neoplastic drugs therapy. Different classes of anti-neoplastics use synergistic and additive drugs to hopefully enable us to use less of the medication and help us to avoids some toxic effects.

Question 26

Anti-Neoplastic Medications:
R-CHOP is used to treat ______ and each letter represent a different medication. It can be abbreviated R-CHOP or CHOP-R.
Rituxan is a medication given for _______.
Cyclophosphamide is an ________ agent.
Hydroxydoxorubicin is an anti-neoplastic ________.
Oncovin is considered both a _____ and a _______ drug.
Prednisone is considered a ______ drug.

Answer 26

Lymphoma
Immunotherapy
Alkylating
Antibiotic
Vinca Alkaloid & Anti-Leukemic 
Steroid
Study Tip: FYI ON THESE DRUGS. We don’t have to memorize these but we need to know what it is when we see it.

Question 27

This may be severe and protracted.

This is an example of what adverse reaction to anti-neoplastic drugs?

Answer 27

Nausea and Vomiting
Study Tip: Protracted means multiple emesis over an extended period of time.
REMEMBER: Adverse Reactions are dependent on the specific anti-neoplastic drug being used to treat the cancer.

Question 28

Inflammation of the lining of any of the soft-tissue structures of the mouth. This is usually a painful condition, associated with redness, swelling, and occasional bleeding from the affected area. Bad breath > Halitosis may also accompany the condition.
This is an example of what adverse reaction to anti-neoplastic drugs?

Answer 28

Stomatitis
REMEMBER: Since the medications are working on destroying rapidly dividing cells and your GI tract is lined with epithelial cells that are replaced at a very rapid rate this is what causes the nausea, vomiting, and stomatitis.
Study Tip: Adverse Reactions are dependent on the specific anti-neoplastic drug being used to treat the cancer.

Question 29

ASK ARBOGAST? This is caused to prevent infertility after chemotherapy. This is an example of what adverse reaction to anti-neoplastic drugs?

Answer 29

Gonadal suppression

Study Tip: Adverse Reactions are dependent on the specific anti-neoplastic drug being used to treat the cancer.

Question 30

This results in anemia caused by decreased production of RBC, by destruction of RBC, or by loss of blood.
This is an example of what adverse reaction to anti-neoplastic drugs?

Answer 30

Bone marrow suppression

Study Tip: Adverse Reactions are dependent on the specific anti-neoplastic drug being used to treat the cancer.

Question 31

With IV chemotherapy you will have to be extremely careful with your IV site and check it frequently for blood return because an IV can be good and not have a blood return. When you aspirate and pull back you should always get blood with the chemotherapy patient
This is an example of what adverse reaction to anti-neoplastic drugs?

Answer 31

Pain during IV administration.

REMEMBER: You may not always get blood return if there is just normal saline running, but w/ normal saline, the risk of extravasation is not as dire as with infusing an anti-chemotherapy drug.

Question 32

No blood return means ?

Answer 32

When you go into a running IV with a syringe and when you aspirate and pull back you should always get blood with the chemotherapy.

Question 33

If the patient doesn’t have a blood return when you are infusing chemotherapy you have to stop it and have to re-site the IV. This is an example of what adverse reaction to anti-neoplastic drugs?

Answer 33

Pain during IV administration
REMEMBER: You will not be giving IV chemotherapy as a student AT ALL and not even as a RN until you go through a certification course.
Study Tip: Adverse Reactions are dependent on the specific anti-neoplastic drug being used to treat the cancer.

Question 34

__________ drugs can be given through peripheral IV’s so sometimes people will be get it done outpatient and will get an IV started every time but sometimes people get central lines too and that is an individual decision between the pt and the doctor.

Answer 34

chemotherapy

Question 35

Hepatotoxicity and GI disturbances are commonly seen in patients that are being given these medications.
This is an example of what adverse reaction to anti-neoplastic drugs?

Answer 35

Adverse Reactions

Study Tip: Adverse Reactions are dependent on the specific anti-neoplastic drug being used to treat the cancer.

Question 36

If your patient is getting chemotherapy the nurse would pre-medicate the patient with an anti-emetic like Zofran or Ondansetron because it’s better to prevent nausea than try to treat it when is active.
This is an example of what nursing intervention that should be implemented when treating cancer?

Answer 36

Prevent and treat adverse effects.

Study Tip: It is always better to prevent an adverse effect than it is to treat it.

Question 37

Monitor:
CBC
Hgb and Hct 
WBC 
Platelets 
This is an example of what nursing intervention that should be implemented when treating cancer?

Answer 37

Monitor lab results
Study Tip: The nurse will monitor these labs because all of those can be low due to bone marrow depression r/t the cancer disease process.

Question 38

Monitor for toxicity depending on the medication your giving; you are going to have to look into your resources, drug guide, or online data base to see what is being effected by the medication your giving.
This is an example of what nursing intervention that should be implemented when treating cancer?

Answer 38

Assess specific organs > this varies by the medication being given.

Question 39

The nurse must be meticulous in maintenance of the IV site and infusion devices. There is no margin for error. You have to really, really be careful. You DO NOT want to mess up your IV site.
This is an example of what nursing intervention that should be implemented when treating cancer?

Answer 39

Maintain vascular access

Question 40

Maintain and monitor kidney function. The patients need to have working kidneys to properly excrete the chemotherapy medication.
This is an example of what nursing intervention that should be implemented when treating cancer?

Answer 40

Promote fluid intake

Question 41

Demonstrate presence during disease process, especially for changes in body image and sexuality. The patient is going to be feeling terrible, they might be scared that they are going to die. They might be worried about family and their children. If they are a younger patient they might be worried about their parents so whatever their concerns are give them a chance to talk about it.
This is an example of what nursing intervention that should be implemented when treating cancer?

Answer 41

Provide emotional support

Question 42

Let the patient know we will give you medicine for nausea and if they get nauseated it will be a good idea to eat crackers before they get out of bed.
Remind them to drink ginger ale because ginger ale because ginger is a non-pharmacological treatment for nausea.
This is an example of what nursing intervention that should be implemented when treating cancer?

Answer 42

Patient Education about what to expect with cancer treatment.

Study Tip: The patient also needs to know when to call the doctor.

Question 43

Inform the patient about precautions they should take if immunocompromised when they go home. This is an example of what nursing intervention that should be implemented when treating cancer?

Answer 43

Patient Education.
Study Tip: There are a lot of precautions that need to be taken in a patient getting treated for cancer.
Study Tip: Patient’s can be so immunocompromised that someone needs to thoroughly clean their house before they can even be discharged to go home.

Question 44

Categories of Anti-neoplastics:
___________ drugs affect DNA synthesis,

Categories of Anti-neoplastics:
___________ drugs replace proteins required for DNA synthesis. These are cell cycle specific.

Answer 44

Alkylating Drugs
REMEMBER: These are effective against rapidly growing cells.

Anti-Metabolite Drugs
Study Tip: This is an FYI.

Question 45

Categories of Anti-neoplastics:
_________ drugs suppresses immune system and blocks RNA synthesis. They also alter cell metabolism by changing the hormonal environment surrounding hormone sensitive tumors.

Categories of Anti-neoplastics:
________ drugs inhibit DNA or RNA synthesis. They also prevents mitosis because they are a cell cycle specific agent so they cause cell death because the cells don’t divide.

Answer 45

Hormonal Drugs
Study Tip: This is an FYI.

Vinca Alkaloid
REMEMBER: This drug is effective against rapidly growing cells.
Study Tip: This is an FYI.

Question 46

When giving the patient this type of therapy the nurse must be aware that some cancers grow in the presence of hormones and other cancers are killed by hormones so we just have to be aware of that and know what we are giving the patient. What medication is this patient being given?

Answer 46

Hormone Medication Therapy

Question 47

These are some of the side effects that we manage with medication and never forget that there are also non-pharmacological measures that you can take as a nurse to help decrease ______, ______, and ______. Bone marrow suppression is something that requires medication to reverse the effects of cancer and also to treat pain.

Answer 47

Nausea
Vomiting
Pain

Question 48

Believe it or not nausea and vomiting is an evolutionary advantage that we have; it is very unpleasant but it serves a vital purpose because it prevents us from ingesting ______ substances.

Answer 48

toxic
Study Tip: FYI research on n/v is done on ferrets because rats don’t vomit “figures” they deserve it but they don’t vomit.

Question 49

If something looks gross ir tastes/smells disgusting. It is so our brain is programmed not to eat it. Some things have a “bad” look, smell, taste, so throwing is our back up system to get rid of ingested toxins. These are causes of what signs and symptoms caused by cancer?

Answer 49

Nausea and Vomiting

Question 50

The brain has a variety of receptors for potential toxins and stimulation of that induces this defense mechanism.
These are causes of what signs and symptoms caused by cancer?

Answer 50

Nausea and Vomiting

Question 51

Memory of previous experiences so if something made you throw up at one time and you remember that, that memory is just enough to make you nauseated when you are exposed to that.
These are causes of what signs and symptoms caused by cancer?

Answer 51

Nausea and Vomiting

Question 52

When nausea is a response to medical therapy there is not a survival advantage there is actually a disadvantage. This may increase morbidity and mortality if we have pts that are getting dehydrated, malnourished, and have electrolyte imbalances so we have to address nausea and treat it; hopefully prevent it. ________ can cause DEATH!

Answer 52

Nausea and Vomiting