Exam 3 Module 11

Front 1

What is the cell life cycle?

Back 1

The period from the birth of a new cell to the time that cell divides

Front 2

What happens prior to cell replication?

Back 2

Duplication of all its constituents

Front 3

What are the 5 phases of a normal cell cycle?

Back 3

M, G1, S, G2, G0

Front 4

What happens in the M phase of the normal cell cycle?

Back 4

Mitosis – all cellular contents duplicated

Front 5

What happens during the S phase of the normal cell cycle?

Back 5

Each of the 46 chromosomes is duplicated by the cell

Front 6

What happens during the G1 phase of the normal cell cycle?

Back 6

Cellular contents excluding the chromosomes are duplicated

Front 7

What happens during the G0 phase of the normal cell cycle?

Back 7

Resting phase

Front 8

How does cancer continue to replicate?

Back 8

Tumor cells continue to divide under conditions that send normal cells to the G0 state

Front 9

Is the cell cycle the same for tumor cells as it is for normal cells?

Back 9

Yes, except the cell is not sent to the G0 state

Front 10

How do cell cycle non-specific antineoplastics work?

Back 10

They kill normal and malignant cells to the same extent. (radiation for example)

Front 11

What are the cell cycle non-specific antineoplastics?

Back 11

Nirosoureas (Carmustine, lomustine, semustine) and radiation

Front 12

How do cell cycle phase specific antineoplastics work?

Back 12

Cells in other phases are not affected – only those specifically targeted.

Front 13

Name the M phase cell cycle phase-specific antineoplastics

Back 13

Vinca alkaloids, paclitaxel, docetaxel

Front 14

Name the S phase cell cycle phase-specific antineoplastics

Back 14

Topoisomerase inhibitors, purine, pyrimidine, and folate antimetabolites

Front 15

Name the G1 phase cell cycle phase-specific antineoplastics

Back 15

Aspariginase, prednisone

Front 16

Name the G2 phase cell cycle phase-specific antineoplastics

Back 16

Bleomycin, etoposide

Front 17

How do proliferating cell antineoplastics work?

Back 17

Agents can preferentially kill proliferating cells as opposed to resting cells (not always phase specific – can still affect all phases)

Front 18

Name the proliferating cell antineoplastics?

Back 18

Alkylating agents –nitrogen mustards, ciplatin, carboplatin and Antibiotics – Anthracyclines, dactinomycin

Front 19

Limitations of chemotherapy?

Back 19

Difference between cancer cells & normal cells is minimal – proliferation rate may differ. Useful drugs without SE do not exist. Rapidly dividing cells are also destroyed by antineoplastics.

Front 20

AE of chemotherapy antineoplastics?

Back 20

Hair loss, increased susceptibility to infection, anemia, bleeding, n/v/d/c, stomatitis, anorexia, taste changes

Front 21

Name the cytoprotective agents

Back 21

Mesna (Uromitexan), Dexrazoxane (Zinecard), and amifostine (Ethyol)

Front 22

How does Mesna (Uromitexan) work?

Back 22

Prevents hemorrhagic cystitis caused by ifosfamide, cyclophosphamide. Reacts and detoxifies toxic compound released during bioactivation of ifosfamide and cyclophosphamide.

Front 23

How does Dexrazoxane (Zinecard) work?

Back 23

Protects against cardiotoxicity of anthracyclines. Chelates iron that acts as an oxidizing agent in heart.

Front 24

How does Amifostine (Ethyol) work?

Back 24

Used with cisplatin and cyclophophamide to reduce neutropenic fever and infection. Used with platinum agents to reduce cumulative renal toxicity. Free-radical scavenger.

Front 25

AE of Amifostine (Ethyol)?

Back 25

Causes decrease in BP in 50% of patients

Front 26

What do biological response modifiers do?

Back 26

Enhance patient’s immune system

Front 27

What are the colony stimulated factors?

Back 27

Erythropoietin, darbepoietin. Filgrastim, peg-filgrastim (G-CSF). Sargramostim (GM-CSF). Thrombopoietin.

Front 28

What is erythropoietin?

Back 28

Hormone produced by the kidney that regulates red blood cell production. Induces erythropoiesis by stimulating division & differentiation of erythroid progenitor cells. Induces release of reticulocytes from bone marrow into blood. Lineage specific.

Front 29

What are the 2 erythropoietin products available?

Back 29

Epoitin (Procrit, Epogen); T1W, Qweek. And Darbepoietin (Aranesp); Q1weeks

Front 30

What are the uses for erythropoietin?

Back 30

Anemia secondary to chemotherapy, CKD, surgery, HIV therapy, HCV therapy

Front 31

What is the Black Box warning with erythropoietin?

Back 31

Increased mortality, serious cardiovascular and thromboembolic events (heart failure, MI, stroke, blood clots) and tumor progression . When treated to a higher target Hgb (13-14).

Front 32

What is important to remember in treatment with erythropoietin?

Back 32

Treat to a target Hgb of 10-12 – BB warning in effect if treated to higher targets. Use lowest dose to prevent blood transfusions.

Front 33

How is erythropoietin administered?

Back 33

IV or SubQ

Front 34

How do G-CSF and GM-CSF differ?

Back 34

G-CSF is lineage specific – neutrophils specifically. GM-CSF is multi-lineage growth factor - stimulates neutrophils as well as monocytes and macrophages.

Front 35

Why is G-CSF or GM-CSF used?

Back 35

Increases production of neutrophils, decreases incidence of infection

Front 36

AE of G-CSF and GM-CSF?

Back 36

Main side effect – bone pain

Front 37

How is G-CSF or GM-CSF administered?

Back 37

SubQ or IV

Front 38

Name of G-CSF medication?

Back 38

Filgrastim (Neupogen, G-CSF)lineage specific, Pegfilgrastirim (Neulasta, G-CSF) pegylated form

Front 39

Name of GM-CSF medication?

Back 39

Sargramostim (leukine, GM-CSF) multi-lineage growth factor

Front 40

How does thrombopoietin (TPO) work?

Back 40

Increases platelet count by binding to and activating the human TPO receptor.

Front 41

Uses for Thrombopoietin (TPO)?

Back 41

Pts with ITP when other therapies (corticosteroids, immune globulin, splenectomy have been insufficient). Not commonly used – last line agent.

Front 42

AE of Thrombopoietin (TPO)?

Back 42

If response is inadequate, patient may have neutralizing antibodies to romiplostim or TPO or bone marrow fibrosis.

Front 43

How is Thrombopoietin (TPO) administered?

Back 43

SubQ once weekly (platelet half-life is 8-11 days)

Front 44

Name of Thrombopoietin (TPO) medication?

Back 44

Romiplostim (Nplate)