week 12 pharm Flashcards
what are the three main approaches to treat cancer
surgery, radiation, and drug therapy
what does a disseminated cancer mean
dissemination enables the spread of cancer from its original site,
a disseminated cancer is a cancer that has metasteseizesd
what is the cell cycle of cancer
G1: growth
S: DNA synthesis
G2: prep for mitosis
M: actual mitosis and cell division
what is growth fraction
what effect does it have on chemo
tissues will either have cells that actively proliferate or cells that rest in G0 phase.
tissues with active poliferation will have a high growth fraction
high growth fraction = more vulnerable to chemo
which tissues have a high growth fraction
bone marrow, GI epithelium, Hair, sperm
what are the 4 maim barriers to chemo successs
-it is impossible to tell if you’ve killed all the cancer
-cancers can develop resistance
-its impossible to kill every malignant cell
-you cannot target cancer cells so you have to also kill healthy cells
what are the 4 main strategies for demo success
- intermittent periods of therapy
- combination therapy
- optimize dosing schedules
- regional drug therapyw
what are the benefits to combination drug therapy for chemo
- reduces chance of resistance
- increases overall cell killing
- reduced toxicity to normal cells
what is neutropenia
low white blood cells (v high risk for infection)
what are three issues with bone marrow suppression
neutropenia, thrombocytopenia, anemia
what are the three hematopoetic growth factors
erythropoietic growth factors
leukopoeitic growth factors (filgrastim)
thrombopoetic growth factors (oprelvekin)
which hematopoetic growth factor should you only give to palliative patients
erythropoietin
why cant you give PO erythropoietin
because it degrades digestive tract
what is filgrastim
leukopoeitic growth factor that stimulates neutrophils
which type of cancer can you not give filgrastim with
bone marrow cancer
what is oprelvekin
thrombopoeitic growth factor
which type of cancer should you never give with oprelvekin
myeloid cancer
what are some adverse effects of erythropoietin
makes blood more coagulable which can increase his of stroke, MI, and DVT
which hematopoetic growth factor can only be subcut
oprelvekin
what are the 3 GI issues caused by chemo
stomatitis
diarrhea
N/V
what is stomatitis
basically its inflammation of oral mucosa that can lead to infection and canker sores
how long after chemo would you see stomatitis
2-3 days after
why does chemo cause diarrhoea
due to destruction of epithelial lining of intestine
why does chemo cause nausea and vomiting
because it directly stimulates the chemoreceptor trigger zone (remember vomiting pathways)
what are the three types of nausea d/t chemo
- anticipatory
- acute
- delayed
what drugs do patients usually take for chemo induced N/V and when do they take them
dexamethasone + ondansetron and they’ll take it 30 mins before chemo dose
when will you see alopecia after first chemo dose
7-10 days after start of treatment
when will alopecia usually peak d/t chemo
1-2 months after start of treatment
when will hair grow back after chemo
1-2 months after treatment ends
how does chemo affect reproduction in women
may cause amenorrhea and menopause symptoms
what is extravasation
leakage of a drug from blood to surrounding tissues
what is a vesicant
a cytotoxic drug that is very chemically reactive
how can you reduce risk for injury from extravasation
using a central line
what are some early signs and symptoms of extravasation with chemo
redness, swelling, and blisters around site
why does chemo cause carcinogenesis
because they damage DNA which can promote cancer to develop
which cytotoxic cancer drug is most likely to cause carcinogenesis
alkylating agents like cyclophosphamide
