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Pharmacology > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

cells most susceptible to chemotherapy (cytotoxicity)

A

rapidly dividing cells, euchromatin, specific phase

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2
Q

chemotherapy mechanism

A

interference with cell cycle, signaling pathways

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3
Q

angiogenic switch

A

switch to exponential growth

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4
Q

tumors clinically detectable

A

1 x 10^9 cells (1 cm^3)

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5
Q

rapidly dividing cells

A

bone marrow, hair follicle, GI, cancer

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6
Q

most common side effects of chemotherapy

A

myelosuppression, alopecia, vomiting, diarrhea

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7
Q

most myelosuppression at _____ post chemo

A

5-7 days

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8
Q

important cells after chemotherapy

A

neutrophils, platelets

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9
Q

neutrophil lifespan

A

1-7 days

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10
Q

platelet lifespan

A

6 days

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11
Q

_____ + ______ = sepsis

A

neutropenia, fever

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12
Q

septic myelosuppression treatment

A

IV broad spectrum abx within 1 hr

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13
Q

neutropenic with no fever treatment

A

oral antibiotics, monitor temp at home, out of hospital

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14
Q

GI signs ____ after chemo

A

3-5 days

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15
Q

GI supportive care drugs

A

anti-emetics, anti-diarrhea, appetite stimulation

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16
Q

chemotherapy dosing goal

A

maximum tolerated

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17
Q

chemotherapy goal

A

remission

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18
Q

fractional kill hypothesis

A

a concentration of drug will kill a constant fraction of tumor cells independent of number

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19
Q

more frequent dosing

A

kill rate > growth rate

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20
Q

Goldie-Coldman hypothesis

A

spontaneous mutations occur and develop resistance

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21
Q

chemo strategies for resistance

A

early treatment, multiagent chemo

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22
Q

MDR change due to steroid use

A

induced by long term steroid use

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23
Q

MDR1 mutation dogs chemo

A

more toxic effects

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24
Q

problem drugs MDR1

A

antiparasitics, imodium, ace, torb, chemo, apo

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25
Q

problem chemo drugs MDR1

A

vincristine, vinblastine, doxorubicin, paclitaxel

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26
Q

alkylating agents mechanism

A

addition of alkyl groups to DNA, interferes with DNA replication

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27
Q

alkylating agent cell cycle phase specificity

A

non-specific

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28
Q

alkylating agent examples

A

cyclophosphamide, chlorambucil, melphalan, lomustine

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29
Q

clinical use of cyclophosphamide

A

lymphoma, soft tissue sarcoma, round cell tumors

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30
Q

unique toxicity of cyclophosphamide

A

sterile hemorrhagic cystitis

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31
Q

cyclophosphamide MDR

A

not substrate

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32
Q

chlorambucil use

A

indolent or low grade lymphoma, chronic lymphocytic leukemia, can substitute for cyclophosphamide

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33
Q

chlorambucil unique toxicity

A

cumulative myelosuppression

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34
Q

melphalan clinical use

A

multiple myeloma

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35
Q

melphalan unique toxicity

A

cumulative myelosuppression, esp. platelets

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36
Q

lomustine use

A

lymphoma, histiocytic sarcoma, mast cell tumors

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37
Q

lomustine unique toxicity

A

hepatotoxicity (thrombocytopenia, pulmonary fibrosis)

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38
Q

drug administered with lomustine

A

denamarin

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39
Q

lomustine able to cross BBB

A

true

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40
Q

antimetabolite mechanism

A

DNA base analogs, disrupt replication

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41
Q

antimetabolite cell cycle phase specificity

A

S phase

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42
Q

antimetabolite examples

A

cytosine arabinoside, 5-fluorouracil, rabacfosadine

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43
Q

cytosine arabinoside use

A

lymphoma, acute leukemia, granulomatous meningoencephalitis

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44
Q

cytosine arabinoside crosses BBB

A

true

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45
Q

5-fluorouracil use

A

carcinomas, usually in combination

46
Q

5-fluorouracil unique toxicity

A

fatal neurotoxicity

47
Q

rabacfosadine use

A

canine lymphoma

48
Q

rabacfosadine unique toxicities

A

dermatopathies, fatal pulmonary fibrosis

49
Q

dogs that cannot have rabacfosadine

A

West Highland White Terriers, American Staffordshire Terriers

50
Q

anti-tumor antibiotics mechanism

A

intercalates DNA, disrupts replication

51
Q

anti-tumor antibiotics cell cycle phase specificity

A

non-specific

52
Q

anti-tumor antibiotics examples

A

doxorubicin, mitoxantrone, actinomycin-D, bleomycin

53
Q

doxorubicin use

A

lymphoma and leukemia, hemangiosarcoma, osteosarcoma

54
Q

doxorubicin unique toxicities

A

cumulative cardiotoxicity (dogs and humans), renal toxicity (cats)

55
Q

mitoxantrone use

A

transitional cell carcinoma, lymphoma, apocrine gland sac tumors, replace doxorubicin

56
Q

doxorubicin administration concern

A

severe vesicant

57
Q

mitoxantrone unique toxicity

A

more myelosuppressive than doxorubicin

58
Q

anti-microtubule agent mechanism

A

bind tubulin, prevent DNA replication

59
Q

anti-microtubule agent cell cycle phase specificity

A

M phase

60
Q

anti-microtubule agent examples

A

vincristine, vinblastine, taxanes

61
Q

vincristine use

A

lymphoma, transmissible venereal tumor, IMTP

62
Q

vincristine unique toxicity

A

peripheral neurotoxicity, ileus

63
Q

vinblastine use

A

MCT, lymphoma, transitional cell carcinoma

64
Q

unique toxicities of vinblastine

A

more myelosuppressive than vincristine

65
Q

vinca alkaloids MDR

A

substrates

66
Q

platinums mechanism

A

binds to DNA, creates crosslinks, inhibits replication

67
Q

platinum cell cycle phase specificity

A

non-specific

68
Q

platinum examples

A

cisplatin, carboplatin

69
Q

cisplatin use

A

osteosarcoma, transitional cell carcinoma

70
Q

cisplatin unique toxicities

A

nephrotoxicity, immediate nausea, fatal pulmonary edema in cats, ototoxicity

71
Q

carboplatin use

A

osteosarcoma, carcinomas

72
Q

carboplatin unique toxicity

A

nephrotoxic, more myelosuppressive than cisplatin

73
Q

carboplatin can be given to cats

A

true

74
Q

prednisone use

A

round cell tumors, insulinoma

75
Q

prednisone cell cycle phase specificity

A

G1

76
Q

prednisone unique toxicities

A

pu/pd/pp, v/d; suppression of adrenal-pituitary axis

77
Q

l-asparaginase mechanism

A

depletes l-asparagine

78
Q

l-asparaginase cell cycle phase specificity

A

G1

79
Q

l-asparaginase use

A

lymphoma and leukemia

80
Q

l-asparaginase unique toxicities

A

hypersensitivity, pancreatitis

81
Q

toceranib phosphate mechanism

A

tyr kinase inhibitor, prevents downstream signaling

82
Q

toceranib phosphate cell cycle phase specificity

A

G1

83
Q

toceranib phosphate use

A

mast cell tumors, neuroendocrine carcinomas

84
Q

chemo that doesn’t target rapidly dividing cells

A

l-asparaginase

85
Q

unique toxicities of toceranib phosphate

A

GI upset, PLN, hypertension, myalgia

86
Q

oncept melanoma vaccine mechanism

A

generation of anti-tyrosinase antibodies

87
Q

oncept melanoma vaccine administration

A

transdermal

88
Q

oncept melanoma vaccine use

A

oral melanoma

89
Q

unique toxicity of oncept melanoma vaccine

A

pain/redness at injection site, vitiligo and hypersensitivity reactions (rare)

90
Q

M phase drugs

A

anti-microtubule agents

91
Q

G1 phase drugs

A

prednisone, L-asparaginase, toceranib

92
Q

S phase drugs

A

antimetabolites

93
Q

non-specific drugs

A

alkylating agents, antitumor antibiotics, platinum agents

94
Q

primary therapy

A

main therapeutic for disease

95
Q

neoadjuvant therapy

A

therapy given before primary therapy

96
Q

adjuvant therapy

A

therapy given after primary therapy

97
Q

induction chemo

A

initial treatment phase with intent of remission

98
Q

maintenance chemo

A

use of chemo to maintain remission

99
Q

rescue chemo

A

protocol used after non-response or disease recurrence

100
Q

palliative chemo

A

used to reduce symptoms

101
Q

radiosensitization chemo

A

used to improve response to radiation

102
Q

maximum tolerated dose

A

highest dose without unacceptable or irreversible side effects

103
Q

maximum tolerated dose mechanism

A

cytotoxicity

104
Q

metronomic chemo

A

frequent administration of low dose for prolonged time

105
Q

metronomic chemo mechanism

A

antiangiogenesis, activate immunity

106
Q

body surface area

A

((weight in kg)^2/3 x constant)/100

107
Q

dog body surface area constant

A

10.1

108
Q

cat body surface area constant

A

10.0

109
Q

main routes of exposure to chemo

A

inhalation, ingestion

110
Q

acute chemo side effects

A

nausea, rashes, liver/kidney damage, hair loss, hearing loss, heart damage, bone marrow toxicity

111
Q

chronic chemo side effects

A

abortions and stillbirths, infertility, birth defects, increased risk of cancer

112
Q

agent that deactivates chemo

A

bleach

Pharmacology (7 decks)

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