Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
186 Cards in this Set
- Front
- Back
|
chemotherapy targets cell _______ and _______
|
growth
replication |
|
|
there are two types of chemo cell cycle _______ and cell cycle _______-_______
|
specific
non-specific |
|
|
what are the four classes of chemo drugs
|
cytotoxic
hormones biological response modifiers targeted drugs |
|
|
cancer has a _______ growth fraction
|
higher
|
|
|
cancer growth is observable clinically and often called _______ time
|
doubling
|
|
|
how could you witness doubling time in cancer growth?
|
may be physically noticable
xray scans |
|
|
TMN
|
staging criteria
tumor size metastasis lymph node involvement |
|
|
what does the grade of cancer define
|
degree of differentiation of cells
mitotic rate of cells |
|
|
give as much chemo as possible without causing _______ side effects
|
lethal
|
|
|
kill more cancer than can _______ before the next round of chemo
|
regrow
|
|
|
TF chemo is introduced to patient in low doses in order to avoid toxic effects
|
F
first treatment given must be a high dose |
|
|
large tumors may have _______ centers
|
necrotic
|
|
|
a brain tumor would be difficult to treat with chemo therapy. why?
|
drugs often cannot cross BBB
|
|
|
3 advantages to multiple drug therapy when treating cancer
|
supression of drug resistance
increased cancer cell kill reduced injury to normla cells |
|
|
each chemo drug should work sinergistically/alone
|
alone
|
|
|
each drug should have the same/different mechanism of action
|
different
|
|
|
the drugs chose should have maximally/minimally overlapping toxicities
|
minimally
|
|
|
decision to treat depends on _______-_______ of patient and _______ of type of cancer
|
general-health
responsiveness |
|
|
80-100% karnofsky performance scale
|
able to carry on normal activity and work
no special care needed |
|
|
50-70% karnofsky performance scale
|
unable to work
able to live at home and care for most personal needs a varying amount of assistance needed |
|
|
0-40% karnofsky performance scale
|
unable to care for self
requires equivalent of instutional or hospital care disease may be progressing rapidly |
|
|
RCHOP
|
treatment for lymphoma
|
|
|
what does
RCHOP tx for lymphoma stand for? |
ritux
cyclophos hydoxydaun oncovin prednisolone |
|
|
what is a glucocorticoids role in treatment of cancer?
|
reduce NV
|
|
|
MOPP
|
tx for lymphoma
|
|
|
what does
MOPP stand for r/t tx lymphoma |
mustargin
oncovin procarbazine prednisone |
|
|
major toxicities of chemo effecting blood
|
neutropenia
thrombocytopenia anemia hyperuricemia |
|
|
major toxicities of chemo effecting digestive tract
|
stomatitis
diarrhea nv |
|
|
major toxicities of chemo effecting physical appearence and random
|
alopecia
reproductive toxicity local vesicant injury carcinogenesis |
|
|
when admin chemo watch these two immediate side effects
|
anaphylaxis
hypersensitivity |
|
|
TF you dont have to wear protective gear when admin chemo administration
|
F
you do. |
|
|
when should you give antiemetics r/t chemo admin
|
before chemo
|
|
|
two time periods chemo can be admin
|
intermitt
combo |
|
|
4 main routes to get chemo into the body
|
IV
oral intraarterial intrathecal |
|
|
body cavities chemo can be admin into
|
bladder
pleural space abdomen |
|
|
the _______ vein, which is associated with the hepatic system, can be used for chemo admin
|
portal
|
|
|
the intrathecal route delivers medicine into the _________
|
CSF
|
|
|
intra arterial infusions are used for cancers that are supplied nutrients via _________
|
arteries
|
|
|
a dilute/concentrated dose of chemo is delivered via intra arterial infusion
|
concentrated
|
|
|
cancer in these 3 tissues are treated with intra arterial infusions
|
liver
kidney bone |
|
|
your patient has a solid tumor. you would expect which type of chemo to be utilized?
|
intra arterial
|
|
|
your patient is very sensative to toxic effects of chemo. she has a solid tumor in her abdomen. you expect intra arterial radiation for two reasons
|
it is used for solid tumors
it minimizes toxic drug effects |
|
|
you are interviewing a patient preparing for chemotherapy for his liver mets. he is to recieve intra arteriole chemo. he asks "where are they going to put it in at?"
|
carotid artery (brain tumors)
hepatic artery (liver mets) |
|
|
intrathecal administration of chemo is used for which type of cancers?
|
CNS
|
|
|
intrathecal chem o is injected directly into the _________ space
|
sub arachnoid
|
|
|
the intrathecal route bypasses this barrier made of special capillaries
|
blood brain barrier
|
|
|
regional limb perfusion is chemotherapy isolated to this area of the body
|
the limbs
|
|
|
how is regional limb perfussion similar to dialysis?
|
blood supply is connected to circulating pump which goes through chemotherapy and then re-infuses
|
|
|
chemo can be delivered into body cavities. this is called _________
|
intraperitoneal
|
|
|
introperitoneal _________-_________ cancer within the cavity
|
directly-attacks
|
|
|
your patient is recieving intraperitoneal chemo and states " you mean ill be walking around with a gut full of chemo for the rest of my days?" you explain
|
intraperitoneal chemo therapy is infused into the cavity and then drained
|
|
|
this lung associated delivery is also admin of chemo into a body cavity
|
intrapleural
|
|
|
simlar to intraperitoneal chemo, intrapleural acts by _________-_________ cancer within the cavity
|
directly-attacking
|
|
|
your patient is taking chemo via intraplueral and states "will i be breathing out chemo forever ?" you explain ..
|
infusions are admin and then drained
|
|
|
Jim has come in for his intrapleural chemo infusion. you can expect to manage what symptom during the infusion
|
pain
|
|
|
a pro drug is one that is _________ by the liver to become active
|
metabolized
|
|
|
chemo has been giving to Christie. in the chart the physician note reads "chemo given with intension to improve quality of life" you know this chemo treatment is called
|
palliation
|
|
|
during palliation use of chemo, one must balance the (-) aspects of cancer with tthe (-) aspects of _________
|
chemo
|
|
|
Yuri had a tumor removed from his spine. he states "the surgeon got it all. why am i having chemo?"
you know that this type of chemo is called _________ therapy and explain it is given to _________ |
adjuvant therapy
given to help prevent recurrence of cancer |
|
|
TF adjuvant therapy will be given in small doses for the remainder of someones life in order to keep cancer in remission
|
F
adjuvant therapy is given for a PARTICULAR amount of time and then stopped |
|
|
what is jean mills going to test us on the drugs about?
|
how a particular category of drugs work
|
|
|
two classes of chemo drugs
|
cytoxic agents
anticancer II drugs |
|
|
chemical structures & physiologic actions of chemo drugs are similar/different in groups
|
simlar
|
|
|
side effets of chemo drugs are different/similar in groups
|
similar
|
|
|
resistance to one group of chemo drugs does/does not mean resistance to other groups
|
does not
|
|
|
is the synergistic approach used in the medical management of cancer?
|
yes
|
|
|
kimberly is recieving chemo through her PIV. this is dangerous if the drug is a _________
|
vesicant
|
|
|
how do alkylating agents kill cancer?
|
disrupt DNA function
cell death |
|
|
alklyating agents prevent _________ & or _________ so the cell dies
|
replication
transcription |
|
|
alkylating agents are cell cycle specific/nonspecific
|
non specific
|
|
|
what is jean mills going to test us on the drugs about?
|
how a particular category of drugs work
|
|
|
two classes of chemo drugs
|
cytoxic agents
anticancer II drugs |
|
|
chemical structures & physiologic actions of chemo drugs are similar/different in groups
|
simlar
|
|
|
side effets of chemo drugs are different/similar in groups
|
similar
|
|
|
resistance to one group of chemo drugs does/does not mean resistance to other groups
|
does not
|
|
|
is the synergistic approach used in the medical management of cancer?
|
yes
|
|
|
kimberly is recieving chemo through her PIV. this is dangerous if the drug is a _________
|
vesicant
|
|
|
how do alkylating agents kill cancer?
|
disrupt DNA function
cell death |
|
|
alklyating agents prevent _________ & or _________ so the cell dies
|
replication
transcription |
|
|
alkylating agents are cell cycle specific/nonspecific
|
non specific
|
|
|
Jill and Bob chose _______ for their wedding bands
|
platinum
|
|
|
jill and bob have _______ and _______ cancer
|
ovarian
testicular |
|
|
jill and bob take _______ compounds for chemotherapy
|
platinum
|
|
|
jill and bob get very during chemo therapy. why?
|
platinum compounds are very emetogenic
|
|
|
jill and bob ask what the adverse effects of platinum compounds are. you tell them 3 major ADE's
|
neurotoxicity
bone marrow supression ototoxcity |
|
|
jill calls because she forgot the name of her chemo drug. you list 4 common drugs to jog her memory.
|
cisplatin
carboplatin oxaplatin mitaplatin |
|
|
platinum coumpound chemo agents have the suffix -_______
|
-platin
|
|
|
anti metbolites:
wedge _______ bases prevent DNA _______ function prevent DNA _______ |
between
protein transcription |
|
|
most antimetaboliteS are cell cycle _______ specific
|
S
|
|
|
antimetab0lites never effect cell cycle _______
|
G0
|
|
|
what are 2 main folic aXid analogs
|
methotrexate
pemetrexed |
|
|
most folic acid analogS are _______ phase specific
|
S phase
|
|
|
folic acid analogs are polar/non polar
|
polar
|
|
|
what are 3 off the beaten path folic acid analogs
|
trimethoprim
pyrimethamine trimetrexate |
|
|
Pete take _______ analogs
|
pyrimidine
|
|
|
pete asks you what the pyrimidine analogs inhibit. you answer
|
the biosythesis of pyrimidines ya dummy!
|
|
|
pyridines will inhibit petes _______ phase cell cycle
|
S phase
|
|
|
pete asks how the drug will effect his DNA. you say
|
the analogs will become incorperated into the dna and rna
|
|
|
pete also wants to know how his medicine will effect the nucleic acid. you tell him
|
pyrimidine analogs disrupt nucleic acid function
|
|
|
pete thinks its funny that his drugs name is a pyrimidine. he asked if the drug has another name that starts with a P. you tell him
|
well yeah pete pyrimidines and prodrugs!
|
|
|
pete wants to know about some toxicities associated with pyrmidine use. you tell him there are 3 main problems
|
bone marrow suppresson
nv fever |
|
|
pete says. i have a solid tumor, and i know that pyrimidine is the class of drug i am taking. but what is the actual drug?
you tell him |
fluorouracil
|
|
|
jenny is a cancer patient with swallowing problem. what could her diet be?
|
PURe
|
|
|
jenny is taking a _______ analog to treat her cancer
|
purine analog
|
|
|
what are purines? think DNA
|
adenine, guanin and hypoxathine
they are bases made to make nucleic acids |
|
|
Jenny's family is confused as to what purines are used for.
you tell them these 4 primary uses of purine analogs |
cancer
immunosuppression antiviral therapy gout |
|
|
Jennys nurse calls you because she is about to crush up her pill and put them in puree MEat. she cant remember the drugs name. what is it?
|
MErcaptopurine
|
|
|
Jenny's grandson is in biochemistry. he asks you about the drug grandma is taking _______.
you tell him that _______ is _______phase specific |
MEcaptopurine is S phase specific
|
|
|
Jenny and Pete take drugs that have a similar quality. what is it?
|
they are both prodrugs
|
|
|
what is leucovorin?
|
drug admin to save good tissue during chemo
|
|
|
how does leucovorin work?
|
it blocks folic acid production
starves cells of nutrients decreases thymadine triggers apoptosis |
|
|
since leucovorin triggers apoptosis, what (controversial) procedure could it be used in?
|
abortion
|
|
|
your patient Heather has been diagnosed with cancer. she is taking a Hypomethylating agent.
|
what is her name?
what is she taking? |
|
|
Heather wants to know what specific drug she is taking
|
hypomethylating agents:
azactidine/decitabine |
|
|
heather also wants to know how her drugs work. you mention 2 points
DNA apoptosis |
inhibits dna methyltransferase
induces apoptosis |
|
|
your patient Andrew is taking an Anti tumor Antibiotic.
|
what is his name
what is he taking |
|
|
Andrew wonders where the drug he is taking comes from?
you tell him that ironically... |
the agents are isolated from cultures of streptomyces
|
|
|
Andrew knows that a lot of chemo drugs effect dna. does his?
you tell him.. |
directly bind to dna
inhibit dna/rna transciption |
|
|
Andrew wonders about the which part of the cell cycle his drug (_______) effects
|
anti tumor antibiotics
cell cycle non specific |
|
|
andrew anticipates there will be side effects from taking _______. you tell him that he is correct. the 4 areas of his body effected will be
|
hematopoietic
cardiac GI hair |
|
|
Andrew says he has a history of cardiac disease. how does this effect his chemo treatment?
|
he will take a 3 non-anthracycline (they have no cardiotoxicity)
|
|
|
Andrew has been prescribed 5 anthracyclines (class _______) for chemo. whats wrong with this?
|
anti tumor antibiotics
andrew has a hx of cardiac disease 5 anthracyclines have a cardiotoxic effect he should get 3 non anthracycline |
|
|
andrew went to the Rx store and picked up his medicine. he calls and says they gave him some drug that starts with a D.
you explain that the brand name of anthracycline is |
doxorubicin
|
|
|
Mitch is a cancer patient taking _______ inhibitors
|
mitotic inhibitors
|
|
|
Mitch is trying to explain to his daughter about the drug. he says it is cell cycle _______
|
specific
|
|
|
mitch's daughter is concerned about side effects associated with _______ inhibitors.
you name the two large ones |
neurological suppression
bone marrow suppression |
|
|
mitch and his daughter ask what the drugs are called
you explain that _______ and _______ are _______ inhibitors |
vinca alkaloids and taxanes are mitotic inhibitors
|
|
|
mitch's physician has prescribed vinca alkaloid, a _______ inhibitor. he asks where the chemical comes from.
you answer "from a variety of places that all start with V" |
vinca rosa
vincristine vinblastine vinorelbine |
|
|
mitch says "thats great that they all start with V but what do they do?"
you list that vinca rosa_______ vincristine_______ vinblastine_______ vinorelbine_______ |
vinca rosa; periwinkle plant
vincristine: periphreal nerve damage vinblastine; bone marrow suppression vinorelbine: used for non small LC |
|
|
mitch wants to know that since the drugs _______ and _______ are _______ inhibitors, they must be _______ phase specific
|
vinca alkaloid and taxanes are mitotic inhibitors that are M phase specific
|
|
|
you agree with mitch that ________ and ________ are M phase cell cycle specific drug, but you tell him that ________ also is G2 specific
|
vinca alkaloid and taxanes are m phase
taxanes are also G2 |
|
|
mitch wants to know if he will recieve his medicine via IV or orally. you tell him that
|
mitotic inhibitors are all given IV
vanca alkaloids taxanes |
|
|
which enzymes would a UIC grad nurse want to monitor during mitotic inhibitor therapy?
|
liver enzymes
|
|
|
topoisomerase I & II inhibitors
action side effects drugs |
inhibits dna enzyme topoisomerase
SE: hematopoeitc GI example: topotecan irinotecan etoposide teniposide |
|
|
what is the role of adrenocorticosteroids in chemotherapy?
|
given short period of time
used to manage complications promotes appetite and weight gain |
|
|
which cancers indicate hormone manipulation?
|
breast ( . )_( . )
prostate 8---> |
|
|
high doses of adrenocorticosteroids suppress which state of the cell cycle?
|
mitosis
|
|
|
glucocorticoids are indicated in
|
leukemia
hodgekins non hodgekins |
|
|
antiESTROGENS are indicated in
|
breast cancer
( . Y . ) |
|
|
aromatase inhibitors are indicated in
|
breast cancer
(.Y.) |
|
|
CnRH agonists are indicated in
|
prostate cancer
8====D |
|
|
CnRH ANTagonists are indicated in
|
prostate cancer
C==8 |
|
|
androgen receptor blocerks are indicated in
|
prostate cancers
tired of keyboard penises? me too :-/ |
|
|
estrogens are indicated in
|
prostate cancers
surprise!!! |
|
|
estrogen mustard is indicated in
|
prostate cancer
|
|
|
progestins are indiated in
|
renal
endometrial breast cancers |
|
|
what are the side effects of hormone treatment for prostate cancer
|
hot flash
gen pain impotence loss of libido reduced muscle mass increased adipose tissue |
|
|
how does the gonadotropin releasing hormone agonist work in the tx of prostate cancer
|
suppresses production of androgens by the testes
blocks testosterone receptors |
|
|
how long are are gonadotropin releasing hormone agonists work for the treatment of prostate cancer
|
2 years
|
|
|
gonadotropin release hormone antagonists work by _______ production of androgens by the testes
|
suppressing
|
|
|
aromatase inhibitors treat _______
|
cancer
|
|
|
Bill Mead is going through immunotherapy to fight cancer
|
immunotherapy is a Biological response Modifier
|
|
|
Bill Mead is in for his first appointment related to treatment.
you know that he may be taking one or more of 4 drugs |
interferon alfa 2a/2b
interleukin 2 BCG vaccine |
|
|
Bill Mead is interested in the interferon drugs.
you tell him 3 main points. r/t to interferon |
immunostimulants
render cancer cells nonmalignant enable host to tolerate myelosuppresive actions of anticancer drugs |
|
|
althought Bill Mead is interested in interferion treatment, he has renal cancer so you know he will get this drug
|
interleukin 2
|
|
|
what jean said inteferon is used for
|
tumors
ms hep b,c bone marrow specific cancers |
|
|
this is how jean says interferon therapy works
|
makes cells stay in dormant phase
boosts host immune system |
|
|
what jean says interferon ADR
|
shock
|
|
|
Ida comes to your floor for immunotherapy.
what are some admin/monitoring principals you ought to follow |
monitor:
hypersensitivity reactions fever fluid retention dysnea ARDS flu symptoms fatigue myalgias |
|
|
Andy is going in for his first chemo treatment. you make sure to tell him about these 3 drugs that might be given in concurance
|
Angiogenesis inhibitors
Anti-angiogenic therapy Avastatin |
|
|
Andy says the drugs that he will be taking for chemo (other than chemo) will be easy to memorize because of all of the A's
1. 2. 3. |
angiogenesis inhibitors
antiangiogenic therapy avastatin |
|
|
how do antiangiogenic therpies work?
|
they are given with chemo to attack blood vessels that surround the tumore to help stop growth
jean says to check out youtube |
|
|
another drug given with chemo has the acronym TKI
|
tyrosine kinase inhibitors
|
|
|
TKI or, _______-_______ inhibitors work by _______ cancer growth
|
tyrosine kinase inhibitors work by inhibiting cancer growth
|
|
|
all of your cancer patients are worried about loosing thier hair. you know that the main side effects of cancer are
|
leukopenia
neutropenia thrombocytopenia anemia |
|
|
define leukopenia
|
WBC <3,000
|
|
|
your patients lab results are
K+ 3.6 mg 2.5 WBC 2700 Na+ 149 what is the priority diagnosis |
leukopenia
|
|
|
what causes leukopenia in cancer patient
|
decreased production r/t cancer in marrow
increased consumption r/t infection destruction r/t autoimmune |
|
|
we know leukonpenia can be related to the cancerous effects on our bodies. what else could it be related to?
|
treatment
destruction of rapidly diving normal hematological cells resulting in decrease in production of WBC precursers |
|
|
there are some risks associated with leukopenia ( of course ) what are 4 of them?
|
increased risk for infection
septic shock organ system damage changes in ADL i dont know if these are so clearly "side effect" but w/e |
|
|
what are the neutrophils function?
|
phagocytosis
|
|
|
when the eosinophils are elevated, what kind of conditions do you expect to find?
|
allergic reactions
parasitic infections |
|
|
labs
neutrophil: <500 K 5.0 Ca+ 10 what are you thinking? |
severe risk of bacterial infections
<2500 mild risk <1000 mod risk |
|
|
what is the function of lymphocytes
|
immunity via t and b cells
|
|
|
what is the fucntion of monocytes
|
phagocytosis
|
|
|
there is a drug that stimulates granulocyte colonies. what are some parameters for giving the drug
|
dose based on nadir
dont give 24 hours before/after chemo there is short and long acting |
|
|
pete is on his 3rd round of chemotherapy. his plateletes are <15000. what is this called?
|
thrombocytopenia
|
|
|
you tell pete that <150000 is considered thrombocytopenia. in the back of your mind you know that if the number drops <_______ pete is in a bad way
|
50000
|
|
|
pete asks if his thrombocytopenia is due to his disease or the treatment. you tell him
|
disease rleated:
-decarsed production r/t cancer in marrow -increased consumption r/t DIC -increased destruction r/t bacterial or viral infection |
|
|
not only is petes thrombocytopenia related to his disease process, but also to the treatment. you tell him that
|
the chemo targets rapidly developing cells, including blood cells and platelet precursers
and that platelets decrease during masive transfucsions and fluid therapy some pharm agents cause decrease too like thiazides alcohol and estrogens |
|
|
pete wants to know how you are going to fix his platelet problem
|
transfusions
interleukin 11 |
|
|
pete doesnt like the idea of getting other peoples blood. you tell him there are some complications if he doesnt get his platelets up
|
increased bleeding time
anemia could effect ADL |
|
|
andrew is finishing up chemo strong. but his H/H are too low. what is his dx? how did this happen?
|
anemia
disease or tx related |
|
|
andrew says "i thought the chemo was supposed to make me better! now ou're telling me i am anemic" you tell him that
|
chemo targets rapidly producing cells which include blood cells
fluid therapy can dilute blood and other drugs besides chemo can cause this |
|
|
andrew wants to know "how are you going to fix me now nurse?" you reply
|
we are going to give you a RBC transfusion and give you a shot
|
|
|
andrew wants to know what is in the shot you are going to give him for his anemia
|
its epogen
|
