Vascular - Phamacology

Question 1

Outline the selective principals of selective toxicity

Answer 1

• ability of a drug to kill a micro-organism without harming it’s host

Question 2

Identify commonly used cytotoxic agents

Answer 2

• genotoxic drugs
  
  • affect nucleic acids & alter function, may directly bind to DNA, impedes replication
  • ## are Alkylating agents, Intercalating agents, Enzyme inhibitorsalkylating agents
  • interfere with DNA replication and transcription by modifying DNA bases
  • Daunorubicin, Doxorubicin, Epirubicin
• enzyme inhibitors
  
  • inhibit enzymes that are crucial to DNA replication
  • Decitabine, Etoposide, Irinotecan
• antimetabolites
  
  • cell-cycle specific, attack cells at very specific phases in the cycle, stopping normal development and division
  • must be administered when tumor cells are proliferating
  • Methotrexate, 5-Fluorouracil
• mitotic poisons: spindle inhibitors
  
  • interfere with mechanics of cell division, block formation of spindle fibres when cells seperate, without fibres or bundles, cells die
  • vicristine, vinblastine

Question 3

Describe common adverse effects of cytotoxic agents

Answer 3

• early
  
  • GIT: nausea, vomiting, anorexia, constipation, diarrhoea, mucositis, hypersensitivity reactions, fever, headache, hypotension, weakness, pain, blistering & necrosis of skin
• delayed
  
  • alopecia, suppression of bone marrow cells - thrombocytopenia, agranulocytosis, anaemia, leucopaenia, impaired wound healing, erythema of hands / feet, photosensitivity, stomatitis, oesophagitis, mouth ulcers
• late
  
  • suppressed ovarian / testicular function, cardiotoxicity, neurotoxicity, nephrotoxicity, hepatotoxicity, ototoxicity, nail changes, mood swings “chemo brain”, fatigue

Question 4

Describe safe handling of cytotoxic agents and care considerations when caring for patients having chemotherapy

Answer 4

• wear gloves, goggles, gown
• use care when storing, can’t be accessed accidentally
• chemo can remain in body for up to three days after treatment, passed in urine & stool, need to flush toilet twice for 48hrs post
• vomit can also contain traces, wear gloves
• dispose of everything in hazardous waste - purple for chemo

Question 5

Outline mechanisms of actions and clinical uses of hemostatic drugs

Answer 5

• to prevent bleeding in patients with thrombocytopenia
• prevent platelet aggregation and block the coagulation cascade, thrombus formation, and fibrin deposition
• anticoagulants, thrombolytics (dissolve clots)
• clinical uses - in patients with clotting issues due to surgery, disease states such as DVT, PE, heart conditions, to maintain consistency of blood flowing around body

Question 6

Discuss blood products and their uses

Answer 6

• Red Blood Cells
  
  • carry oxygen & remove carbon dioxide
  • indicated in anemia, conditions where RBCs don’t function as they should & people with severe bleeding / haemorrhage
• Platelets
  
  • components of blood that assist with clotting
  • indicated in cancer patients, with bone marrow suppression, people receiving chemotherapy, severe blood loss
• Plasma
  
  • fluid in which RBCs, WBCs & platelets are suspended, contains all coagulation factors
  • indicated in replacement of clotting factors - surgery, trauma, diseases which impair clotting - ie - liver disease

Question 7

Revise blood group compatibility

Answer 7

• O-
  
  • compatible with all
• O+
  
  • AB+, A+, B+, O+
• B-
  
  • AB+, AB-, B+, B-
• B+
  
  • AB+, B+
• A-
  
  • AB+, AB-, A+, A-
• A+
  
  • AB+, A+
• AB-
  
  • AB+, AB-
• AB+
  
  • AB+