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72 Cards in this Set
- Front
- Back
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What is the last checkpoint beyond which a cell can't be stopped from dividing?
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G1 checkpoint
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What are the three classes of dividing cells?
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Expanding
Renewing Static |
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What is the proportion of dividing cells in a tumor mass known as?
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growth fraction
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The fraction of cells undergoing mitosis in a tumor describes...
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...mitotic index
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The time required for a tumor population to double is the...
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...doubling time!
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T or F:
As a tumor increases in size, the doubling time decreases concurrently. |
False!
Doubling time gets longer! |
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Describe the growth fraction and mitotic index of...
...small tumors. |
High GF
High MI |
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Describe the growth fraction and mitotic index of...
...large tumors. |
Low GF
Low MI |
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Describe the growth fraction and mitotic index of...
...normal tissues. |
Low GF
Low MI prolonged doubling time |
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What is the cell-kill hypothesis of chemotherapy?
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chemo kills a constant proportion of cells, not a constant number.
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T or F:
Anti cancer pharmacology follows first-order kinetics. |
True
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What is the approximate proportion of cells killed with each chemo treatment?
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2 to 4 logs
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Which alkylating agent is the most important chemotherapeutic in veterinary medicine?
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Cyclophosphamide
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Which chemotherapeutic drugs act by creating cross-linked DNA? What DNA substrate is specifically affected?
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Alkylating agents alkylate N7 of guanine.
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What alkylating agent is used for multiple myeloma?
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Melphalan
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Which drug is used for low grade lymphomas? For high grade?
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low - Chlorambucil
high - Cyclophosphamide |
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Which class of chemotherapeutic drugs act as "poison apples" or false precursors?
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Antimetabolites
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T or F:
Antimetabolites are most active during the G1 phase. |
False!
Most activity is in S phase! |
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Which antimetabolites are used for lymphoma?
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Cytosine arabinoside (acute leukemia and lymphoma)
Methotrexate (lymphoma and carcinoma) |
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What bacterial or fungal products have the same activity as the alkylating agents?
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Antitumor antibiotics
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What cell phase are the alkylating agents specific to? How about the antitumor antibiotics?
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both are cell phase nonspecific
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How can tumor cells become resistant to methotrexate?
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They can express dihydrofolate reductase which breaks methotrexate's bond to tetrahydrofolic acid.
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Which antimetabolites are used against carcinomas?
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Methotrexate (lymphoma & carcinoma)
5-fluorouracil (carcinoma) |
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Which drug gives the finger to carcinomas?
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5-FU (5-fluorouracil)
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Which antimetabolites are used against leukemias?
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cytosine arabinoside (acute leukemia & lymphoma)
6-thioguanine (acute myelogenous leukemia) 6-mercaptopurine (leukemia) |
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Which antimetabolites are used against immune-mediated hematologic diseases?
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azathioprine
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Which antitumor antibiotics are used against lymphoma?
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All of em!
Doxorubicin, bleomycin, and actinomycin-D |
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Which antitumor antibiotic is red?
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Doxorubicin
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What is the action of plant alkaloids?
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Destroys mitotic spindle
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T or F:
Plant alkaloids are M-phase specific. |
True!
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What is the BIG plant alkaloid? What is it used for?
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Vincristine!
used for lymphomas and sarcomas |
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Which tumor cells have steroid receptors? What drug class targets these?
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Lymphocytes, plasma cells, and mast cells are targeted by adrenal corticosteroids.
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Which anticancer agents can penetrate the blood brain barrier?
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Adrenal corticosteroids
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Which anticancer agent is useful in paraneoplastic syndromes?
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Adrenal corticosteroids
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Which drugs activity includes inter and intrastrand DNA crosslinking?
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Pt containing drugs (Cisplatin and carboplatin)
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T or F:
Pt containing anticancer drugs are contraindicated in the cat. |
False!
While cisplatin is contraindicated, carboplatin is OK! |
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T or F:
Carboplatin is not nephrotoxic. |
True!
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Which anticancer drug is derived from E. coli? What is it used for?
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L-asparaginase is lymphoma specific
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What transmembrane feature, coded by ABCB1, can reduce tumor cells response to pharmacologic therapy?
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Multidrug resistance pump
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Which group of chemotherapeutic drugs are given in a single bolus?
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cell cycle phase non-specific
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Continuous administration of very small doses of cytotoxic agents describes...
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...metronomic application
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Which chemotherapy drug class is most commonly dosed metronomically?
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Alkylating agents
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What are the goals of metronomic dosing?
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Anti-angiogenic effect
Immunostimulatory effect |
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How are most cell cycle specific drugs given?
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fractionated schedules or infusions
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T or F:
Due to their first order kinetics, chemotherapeutic drugs are given on a per-unit-mass basis. |
False!
They are given on a per-unit-surface area basis (Body Surface Area or BSA) |
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What is the the most common and important toxicity of chemotherapy?
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Bone Marrow Suppression (myelosuppression).
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T or F:
Cats are more sensitive than dogs to myelosuppression. |
True!
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T or F:
Severe anemia can be a result of myelosuppression by chemotherapy. |
False!
anemia is rare and usually mild to moderate |
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Which 'penia occurs first with myelosuppressive chemotherapy? What usually follows?
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Granulocytopenia followed by thrombocytopenia
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T or F:
Animals lacking the ABCB-1 gene are less susceptible to chemotherapy. |
False!
ABCB-1 codes for multidrug resistance pump; if this is gone, then drugs are more potent and thus more toxic! |
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T or F:
Granulocytopenia (neutropenia) is usually the most serious and dose-limiting cytopenia. |
True!
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What are some nutritional deficiencies that can increase bone marrow suppression?
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Folate and vitamin B12
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Choose cell-cycle phase specific or non-specific drug...
...produces the most rapid granulocytopenic response. |
Cell cycle phase specific
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Choose cell-cycle phase specific or non-specific drug...
...has a longer nadir for granulocytopenia. |
Cell cycle phase nonspecific
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At what level of neutropenia is sepsis a risk? What level of neutropenia is associated with fever and sepsis?
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<1000/uL (sepsis risk)
<500/uL (fever + sepsis) |
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What drug is commonly used to prophylactically counteract the sequelae of neutropenia (ie sepsis)? In which dogs should this be avoided?
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TMS (TriMethoprim Sulfa); should be avoided in black and tan dogs
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What is an important side effect of cisplatin?
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Nausea
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What are some drugs that can cause nausea, vomiting, and mucositis?
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Methotrexate, doxorubicin, cyclophosphamide
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What are important side effects of vincristine?
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nausea & emesis; ileus, costipation (high doses), and autonomic neuropathy
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What drug or drugs are used to treat chemo-induced nausea?
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Ondansetron
Metaclopramide Dolasetron Maropitant |
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What drug or drugs are used to treat chemo-induced mucositis?
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NONE are effective! metaclopramide can increase gastric motility though...
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Which chemotherapeutic drugs commonly cause hypersensitivity reactions?
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L-asparaginase (E. coli protein)
Doxorubicin |
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What is the hallmark of doxorubicin hypersensitivity reaction?
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Ear pinna turn red
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How can hypersensitivity reactions to chemo be reduced?
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Pretreat w/antihistimine;
Pretreat w/corticosteroids; |
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What drugs should be used during a hypersensitivity reaction to chemotherapy?
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Diphenhydramine &/or epinephrine
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What are the signs of dermatologic toxicity to chemotherapeutic agents? Which drug can cause ALL of these signs?
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Tissue necrosis
Delayed hair growth/alopecia Hyperpigmentation (Doxorubicin can cause all these) |
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Which dogs are more prone to alopecia due to chemotherapy?
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Poodles, maltese, some terriers
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How can local tissue necrosis be prevented?
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Use butterfly or indwelling catheter;
Check patency of line; Don't inject if in doubt |
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Which chemo agent is an important cause of cardiac toxicity?
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Doxorubicin
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What is 5-FU used for in cats?
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Nothing! It gives the biggest "FU" it can to the cat by killing it - fatal CNS toxicity!
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What is an important side-effect of cyclophosphamide?
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Sterile hemorrhagic cystitis
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What type of toxicity does cisplatin exhibit in cats?
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Pulmonary toxicity
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