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;
52 Cards in this Set
- Front
- Back
|
What is the MOA of alkylating agents?
|
form covalent bonds with electrophilic portions of DNA strand and cause DNA breakage and/or prevent replication
|
|
|
What are major side effects of alkylating agents as a class?
|
dose limiting myelosuppresion, alopecia, pulmonary fibrosis, leukemogenesis, infertility, and teratogeneity
|
|
|
What are some examples of alkylating agents?
|
busulfan, carboplatin, carmustine, chlorambucil, cisplatin, cyclophosphamide, darcarbazine, ifosfamide, mechlorethamine, oxaliplatin, procarbazine, temozolomide, thiotepa
|
|
|
What is the MOA of antimetabolites?
|
all are cell cycle specific. mechanisms vary throughout the class however, they essentially mimic a naturally occuring substance and interfere with DNA replication
|
|
|
What are the major side effects of antimetabolites as a class?
|
myelosuppression, mucocitis, skin rashes, and chemical hepatitis
|
|
|
What are some examples of antimetabolites?
|
azacitidine, capecitabine, cladribine, cytarabine, fludarabine, fluoracil, gemcitabine, hydroxyurea, 6-mercaptipurine, methotrexate, pemerexed
|
|
|
What is the MOA of antimicrotubule agents?
|
disrupts formation of and/or prevents proper functioning of microtubules, depending on the agent, thus preventing cell replication
|
|
|
What are the side effects of antimicrotubule agents as a class?
|
myelosuppression
|
|
|
What are some examples of antimicrotubule agents?
|
docetaxel, paclitaxel, estramustine, vinblastine, vincristine, vinorelbine
|
|
|
What are examples of tyrosine kinase inhibitors
|
imatinib, gefitinib
|
|
|
What are the major class effects of tyrosine kinase inhibitors?
|
periorbital edema and eye pain, skin rash
|
|
|
What are examples of monoclonal antibodies?
|
trastuzumab, rituximab, ibrotumomab, gemtuzumab, cetuximab, bevacizumab, alemtuzumab
|
|
|
What is the MOA of monoclonal antibodies?
|
bind only to cancer proliferation specific antibodies
|
|
|
What are the major class effects of monoclonal antibodies?
|
myelosuppression, skin rash, increased LFT's
|
|
|
What class of drug is bortezomib?
|
proteosome inhibitor
|
|
|
What are the side effects of bortezomib?
|
diarrhea, fever
|
|
|
What are some examples of biologically directed cancer therapies?
|
tyrosine kinase inhibitors, monoclonal antibodies, proteosome inhibitors
|
|
|
What are some examples of endocrine agents in cancer therapy?
|
antiandrogens, antiestrogens, LH releasing hormone agents
|
|
|
What is the MOA of anti androgen agents?
|
inhibits androgen uptake and binding in target tissue
|
|
|
What are the major class effects of antiandrogens?
|
hot flashes, gynecomastia, breast tenderness, decreased libido, hepatotoxicity
|
|
|
What are examples of anti androgens?
|
bicalutamide, flutamide, nilutamide
|
|
|
What are examples of antiestrogens?
|
aminogluthemide, anastrazole, exemestane, fulvestrant, letrozole, megestrole, tamoxifen, toremifene
|
|
|
What is the MOA of antiestrogens?
|
multiple, including the inhibition of conversion of androgens to estrogens and receptor antagonism
|
|
|
What are the major class effects of antiestrogens?
|
hot flashes, nausea, lethargy/weakness, fluid retention/edema
|
|
|
What are examples of LH releasing hormone agents?
|
goserelin, leuprolide, abarelix
|
|
|
What is the MOA of LH releasing hormone agents?
|
multiple and combined including inhibition of gonadotropin by feedback from stim. of steroidogenesis by increased FSH and LH, direct GnRH competition, LH and FSH suppression, reduced testosterone secretion from the testes
|
|
|
What are the major class effects of LH releasing hormone agents?
|
testicular atrophy, decreased libido, gynecomastia, hot flashes, increased LFT's, CHF, thrombosis, injection site pain, decreased bone density
|
|
|
What is the MOA of topoisomerase active agents?
|
inhibition of topoisomerase which then prevents the breaking and building of the PDE DNA backbone during cell replication
|
|
|
What are the major class effects of topoisomerase active agents?
|
myelosuppression, mucocitis
|
|
|
What are examples of topoisomerase active agents?
|
irinotecan, toptecan, daunorubicin, doxorubicin, epirubicin, etoposide, idarubicin, mitxantrone
|
|
|
How does chemotherapy work?
|
kills cancer cells by damaging DNA, interfering with DNA synthesis, or inhibiting cell division
|
|
|
Why is chemotherapy given in cycles?
|
to allow normal cells to recover from the toxic effects of chemotherapy
|
|
|
How do you select agents for combination chemotherapy?
|
should have single agent activity against the specific type of tumor, should have different MOA's, no overlapping toxicities
|
|
|
When is primary chemotherapy indicated?
|
hematologic malignancies, solid tumors that have metastasized, induction chemotherapy
|
|
|
When is adjuvant chemotherapy indicated?
|
after curative surgery or radiation to kill any undetectable tumor, is standard Tx in breast and colorectal Ca, ovarian Ca can benefit from also
|
|
|
What is the goal of neoadjuvant chemotherapy?
|
reduce tumor with chemotherapy or hormonal therapy to increase chances that surgery or radiation will work
|
|
|
What are disadvantages to neoadjuvant chemotherapy?
|
tumor can be resistant or pt can experience toxicities, time to surgery can be lost
|
|
|
T or F? Tumor markers are diagnostic.
|
False. They are only confirmatory
|
|
|
What are GI complications of chemotherapy?
|
N/V/D, xerostomia, oral mucositis/stomatitis, esophagitis
|
|
|
What should you monitor on pts taking EPO?
|
CBC because these pts are more susceptible to thromboembolic events
|
|
|
What are the most common drugs associated with myelosuppression?
|
carboplatin, topotecan, etoposide
|
|
|
What are most common cancer drugs to cause hepatotoxicity?
|
asparaginase, carmustine, cytarabine, streptozocin, mercaptopurine
|
|
|
What chemo drugs are most commonly associated with cardiotoxicities?
|
anthracyclines, fluorouracil, alkylating agents, herceptin
|
|
|
What chemo drugs are most commonly associated with neurotoxicities?
|
cytarabine, L-aspariginase, methotrexate, fluorouracil, Interferon A, fludarabine, alkylating agents, vinca alkaloids
|
|
|
What chemo drugs are most commonly associated with nephrotoxicity?
|
cisplatin, carmustine, lomustine, ifosfamide, plicamycin, streptozosin
|
|
|
What are some dermatologic manifestations of chemotherapy?
|
alopecia, nail pigment changes, hyperpigmentation of skin, hand-foot syndrome, acneiform, dry skin, SJS, herpes and fungal infections, hypersensitivity reactions
|
|
|
What is acute tumor lysis syndrome?
|
hyperuricemia, hyperphosphatemia, hypocalcemia, hyperkalemia
|
|
|
Tx of extravasation?
|
1. stop injection immediately; aspirate any drug remaining in the tubing or needle
2. contact physician asap 3. instill an antidote if indicated 4. remove the needle 5. ice and elevation x 24-48hrs 6. document the drug, suspected volume, and Tx 7. check site freq. x 5-7 days 8. early surgical consult |
|
|
What labs should be monitored in patients taking CSF's?
|
CBC, LFT's, platelets, BUN
|
|
|
When should staging of cancer be done?
|
at initial diagnosis and periodically during Tx to assess response
|
|
|
What are some paraneoplastic effects?
|
SIADH, hypercalcemia, Cushing's syndrome, Addison's disease, DIC
|
|
|
When is radiation indicated for cancer?
|
areas where surgery cannot reach, when surgery could cause disfigurement or disability, allows Tx to multiple metastatic sites simultaneously,
|
