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Pharm 323 Spring 22 > chemo > Flashcards

chemo Flashcards

exam 4

1
Q

antineoplastics are what? and what is the goal?

A

anti cancer drugs

goal: kill or stop growth of cancer cells

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2
Q

what is a strategy for chemothearpy? (mix of 2 types to have specific effects)

A

mix of cell-cycle-specific + NOT cell-cycle-specific

one that has to be going through that cell cycle to have effect and one that has killing action regardless of where cell is

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3
Q

chemotherapy targets which type of cells? + where are these found?

A

rapidly dividing cells

hair, GI, bone marrow (RBCs, WBCs, platelets), sperm

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4
Q

describe what chemotherapy dose-limiting side effects are?

A

when we might have to DELAY chemo b/c of killing too many normal cells

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5
Q

what is growth fraction?

A

ratio of replicating cells vs number of resting cells

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6
Q

high growth fraction =

low growth fraction =

A

high = better chemo response (lymphoma)

low = less response to chemo, radiation or other therapies (solid tumors)

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7
Q

surgery r/t cancer therapy is for what? and can also cause what? (therapeutic effect)

A

for debulking the tumor

can stimulate cells to move from resting to replication so chemo will be effective

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8
Q

what is neoadjuvant chemo?

A

chemotherapy before surgery to shrink tumor

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9
Q

chemotherapy doses are determined by what?

A

total body surface area

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10
Q

“standard” chemo course of therapy is what? why do we set it up this way?

A

treatments every 3-4 weeks with 6-12 treatments total (patient specific)

give normal cells a chance to replenish, heal, repair

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11
Q

knowing many chemotherapies are vesicants or irritants, what should we watch out for? what should we do if this occurs?

A

extravasation

if occurs: know antidote + don’t remove IV before checking, call pharmacy about antidote**

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12
Q

how is chemotherapy tx often formulated (drugs) and why?

idk how to ask this, lol

A

combination therapy to have different MOA for best results targeting from different angles

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13
Q

what PPE and protective measures are used during prep and administration of chemo? (4 - specific + 1 broad)

A
  1. special gloves, gown, mask
  2. yellow bag
  3. chemo spill kit
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14
Q

name some precautions for pat excrement r/t chemotherapy (5)

some are facility dependent, but good to know

A
  1. wear gloves when handling body fluids
  2. double flush toilet?
  3. dispose in proper chemo bags
  4. chux over toilet?
  5. chemo precautions on door
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15
Q

What is the expected outcome related to hair
loss for the patient who is undergoing chemotherapy?

a. Hair loss may be permanent.
b. Hair regrowth usually begins about 1 month after completion of chemotherapy.
c. New hair growth will likely be identical to previous hair growth in color and texture.
d. Viable treatments exist for the prevention of alopecia.

A

b

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16
Q

what are the types of N/V with chemotherapy? (4)

A

acute, anticipatory, delayed, breakthrough

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17
Q

what 2 things are most effective for CINV? (broad)

A
  1. premedicate

2. combo therapy

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18
Q

what combination is most efficacious to prevent chemo induced N/V?

A

aprepitant, ondansetron + dexamethasone

19
Q

most chemo causes BM suppression, leading to what…..

A

neutropenia –> infection

anemia –> perfusion + oxygenation issues

thrombocytopenia –> bleeding

20
Q

re: BM suppression, what do we need to monitor for and what might need to happen?

A

monitor levels before rounds of chemo

  • ABX if needed
  • blood products
  • platelets
  • filgrastim
  • postpone chemo if needed to replenish the cells
21
Q

what is nadir?

A

time of lowest blood cell count after chemotherapy

22
Q

(facility dependent), but for this class, neutropenic is defined as what?

A

ANC <500

23
Q

if we find that a patient due for chemo is neutropenic, what would happen?

A

start neutropenic precautions + hold chemo dose

24
Q

what drug therapy can be used for neutropenia?

A

filgrastim

stimulates neutrophil production by BM

25
Q

SE of filgrastim + precaution for this drug

A

bone pain

don’t give within 24 hours of chemo

26
Q

what is stomatitis? + priority intervention?

A

inflammation of oral mucosa

intervention: ASSESS OFTEN

27
Q

what interventions can we initiate for stomatitis r/t chemotherapy? (6)

A
  1. magic mouthwash
  2. CHG mouthwash
  3. swish+spit
  4. lidocaine
  5. baking soda + saline rinses
  6. antifungal (if candida)
28
Q

4 major classes of chemotherapy

A
  1. cytotoxic drugs
  2. hormones + hormone antagonists
  3. targeted drugs
  4. biologic response modifiers
29
Q

what is the MOA of hormones + hormone antagonists? (chemotherapy)

A

slow growth of tumors by blocking hormones that are essential to its growth

30
Q

SE of hormone/hormone antagonist therapies for cancer (7)

A
  1. hot flashes
  2. decreased libido
  3. gynecomastia
  4. hirsutism
  5. nausea
  6. fatigue
  7. vaginal dryness
31
Q

prototype for selective estrogen-receptor modifiers (SERM) for cancer treatment

A

tamoxifen

32
Q

MOA of tamoxifen

A

block estrogen receptors on breasts (tx or prevention of breast cancer)

33
Q

tamoxifen shows an improvement in what 2 things?

A
  1. bone density

2. lipid profiles

34
Q

tamoxifen can increase risk of what things? (5)

A
  1. DVT
  2. PE
  3. MI
  4. Stroke
  5. endometrial cancer
35
Q

SE of tamoxifen (4)

A
  1. GI distress (N/V)
  2. hot flashes
  3. fluid retention
  4. menstrual irregularities
36
Q

MOA of targeted therapies

A

target proteins that control how cancer cells grow, divide + spread

37
Q

2 types of targeted therapies + their MOA

A

“nibs”: target receptor INSIDE cells

“mabs”: target receptor OUTSIDE of cell

38
Q

re: targeted therapies, “mabs” function in 3 ways…..

A
  1. carry toxins (DELIVER)
  2. mark cancer cells for destruction (FLAG)
  3. prevent from growing (BLOCK)
39
Q

SE of “mabs” (2)

A
  1. infusion rxns (IV or SubQ)

2. allergic rxn (rash, fever, chills)

40
Q

SE of “nibs”

A

depends on specific receptors that are targeted

not sure how in depth she wants us to go, chemo PPT slide 24…. too much info…..

41
Q

biological response modifiers / immunomodulators =

+ what are the 2 types we discuss for chemotherapy?

A

any drug that affects the immune system

  1. immunostimulants
  2. immunosuppressants
42
Q

immunostimulant therapy =

A

interleukins + interferons –> stimulate immune system to do its thing

43
Q

immunosuppressant therapy =

A

steroids (prednisone + dexamethasone)

Pharm 323 Spring 22 (18 decks)

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