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55 Cards in this Set
- Front
- Back
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Four classes of drug therapies:
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Cytotoxic agents
Hormones/hormone antagonists BRMs Targeted therapies |
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Define growth fraction:
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The ratio of proliferating vs. dormant cells
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Relationship between growth fraction and chemotherapeutic response:
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Higher GF = better response
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Growth fraction of solid vs. liquid tumors:
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Solid: low GF
Liquid: high GF |
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Relationship between tumor size and response to chemo:
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Large tumors tend to be less responsive
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Relationship between tumor age and response to chemo:
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Newer tumors respond better than older ones
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What's the dose-limiting factor in chemo?
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Toxicity to normal cells
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What is the usual cause of resistance to chemotherapy?
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Change in DNA
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What are causes of resistance to chemo besides change in DNA?
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Heterogeneity of tumor cells
Limited drug access to tumor cells (CNS tumors and BBB, eg) |
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Major chemo toxicities:
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Myelosuppression
GI injury |
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Sx of neutropenia:
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Fever*
Rigors Night sweats |
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Tx for thrombocytopenia:
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Transfusion
IL 11 (oprelvekin) |
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How does Reglan work?
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Blocks dopamine receptors in the brain
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How does Zofran work? (and all -setrons)
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Blocks serotonin receptors in CNS/GI tract
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How -azine antiemetics (i.e. promethazine) work?
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Act on the CTZ to inhibit N/V
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Major vesicant chemo drugs that extravasate:
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Doxorubicin
Navelbine |
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Formula for BSA:
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Sqrt [ (H*W) / 3600 ]
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Example of an alkylating agent:
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cyclophosphamide (Cytoxan)
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Important nursing consideration for alyklating agents considering SEs:
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Keep pt hydrated!
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Example of platinum compounds:
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cisPLATIN (Platinol)
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SEs of platinum compounds:
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Highly emetogenic
Neuro- and oto-toxicity Taste changes |
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Action of anti-metabolites:
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Disrupts metabolic processes during S-phase
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Examples of anti-metabolites:
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cytarabine
methotrexate |
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Three classes of anti-metabolite:
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Pyrimidine, purine, folic acid analogs
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SEs of cytarabine:
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Myelosuppression
Neurotoxicity Stomatitis, N/V Conjunctivitis |
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SEs of methotrexate:
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Myelosuppression
Pulmonary infiltrates/fibrosis N/V/mucositis Renal damage |
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Action of hypomethylating agents:
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Induces apoptosis
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Example of hypomethylating agent:
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decitabine (Dacogen)
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SEs of hypomethylating agents:
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Myelosuppresion
N/V Flu-like sx |
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Action of anti-tumor antibiotics:
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Bind with DNA to inhibit DNA/RNA synthesis
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Two groups of anti-tumor antibiotics:
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Anthracyclines (cardiotoxic)
Non-anthracyclines (not cardiotoxic) |
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Example of an anthracycline anti-tumor antibiotic:
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doxorubicin (Adriamycin)
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Example of a non-anthracycline anti-tumor antibiotic:
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bleomycin (Blenoxane)
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SEs of doxorubicin:
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Red tint to urine/sweat/tears
Cardiotoxicity Vesicant Myelosuppression Stomatitis Alopecia Hyperpigmentation (extremities) |
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SE of bleomycin:
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Pulmonary toxicity
Stomatitis Alopecia Skin reactions |
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Two groups of mitotic inhibitors:
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Vinca alkaloids
Taxanes |
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Example of a vinca alkaloid:
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vincristine (Oncovin)
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Example of a taxane:
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paclitaxel (Taxol)
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Action of vincristine:
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M-phase specific
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SE of vincristine:
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Bone marrow sparing
Vesicant Peripheral neuropathy Very constipating |
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Action of paclitaxel:
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late G2 phase mitotic inhibitor
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SEs of paclitaxel:
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Myelosuppresion
Peripheral neuropathy Alopecia Hypersensitivity |
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Action of topoisomerase inhibitors:
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Alter the shape of supercoiled DNA in S and G2 phases
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Example of a topoisomerase inhibitor:
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irinotecan (Camptosar)
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SEs of irinotecan:
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Myelosuppression
Diarrhea N/V |
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Action of high-dose glucocorticoids:
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Suppresses mitosis
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High dose glucocorticoid SEs:
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Osteoporosis
Adrenal insufficiency Weight gain Susceptibility to infection |
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Examples of anti-estrogens:
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tamoxifen
fulvestrant |
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Examples of aromatase inhibitors:
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anastrozole
letrozole |
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Action of aromatase inhibitors:
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Block production of estrogen from non-ovarian sources (androgenic precursors)
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Examples of BRMs:
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trastuzumab (Herceptin)
rituximab (Rituxan) interleukin-2 (Proleukin) |
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SEs of BRMs:
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Flu-like sx
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SEs of Herceptin:
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Cardiotoxicity, hypersensitivity reactions
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Dosing of Herceptin:
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Loading dose (4mg/kg) first week, then 2 mg/kg per week for 52 weeks
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Example of an angiogenesis inhibitor:
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bevacizumab (Avastin)
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