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Pharmacology 2 > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

What are some of the difficulties with chemotherapy drugs?

A
  • 99.9% killed but 0.1% left still contains a lot of cells
  • no immune back up
  • PK not well known with animals
  • small therapeutic window (small margin of safety)
  • dose based on SA not BW (correlated with metabolic weight), hard to measure
  • can develope resistance (multidrug protocol)
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2
Q

What is the hardest part for clients to deal with and why is it important for them to understand?

A

adverse events are severe and very demanding, often clients dont want to deal with
think quality vs quantity of life

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3
Q

What are the three classes of Chemo drugs?

A

cycle non-specific: kills at all phases
cycle specific: spare resting cells (G0)
Phase specific: only specific phases

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4
Q

What is MOA of alkylating agents (nitrogen mustards) used for chemo?

A

binding of DNA bases, cross linking dsDNA = abnormal pairing and misreading, no replication = cell death

Cell cycle non-specific

toxic to rapidly growing cells

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5
Q

What are two alkylating agents drugs (nitrogen mustards)?

A

cyclophosphamide (procytox)

chlorambucil (leukeran)

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6
Q

What is cyclophosphamide used for, AE, and important things to know?

A

used for: carcinomas, sarcomas, feline lymphoproliferative diseases, mammary carcinomas, lymphoma

AE: bone marrow toxicity (leukopenia, thrombocytopenia, cat marrow suppression), vomiting, diarrhea
hemorrhagic cycstitis (minimize with furosemide), alopecia

Its a prodrug: need hepatic function

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7
Q

What is the use of Chlorambucil (leukeran)?

A

similar to cyclophosphamide
less potent (decreased myelosuppresion, vomitting
expensive (cats and dogs)
used for immunosuppresive for cats after predisone

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8
Q

What is the MOA of alkylating agents (nitrosoureas)?

A

also cross link DNA

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9
Q

What is one used nitrosourea? its use and AE?

A

CCNU (lomustine)

  • great oral F
    use: crosses BBB (brain tumors), lymphoma and mast cell tumours

AE: leukopenia, thrombocytopenia

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10
Q

What is a nitrosourea used for insulinomas?

A

streoptozocin (Zanosar)
- toxic to pancreatic B-cells
AE: tubular necrosis (use only with IV diruesis), type 1 diabetes, vomiting in dogs

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11
Q

What is the mechanism of action of platinum based chemotherapy drugs?

A

binds to DNA bases cross linking around the platinum ion rather than alkyl group, therefor inhibiting DNA synthesis

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12
Q

What are two platinum based drugs?

A

Cisplatin (platinol)

Carboplatin (paraplatin)

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13
Q

What is the USE and AE of Cisplatin?

A

USE: solid tumors (osetosarcoma, carcinoma, mast cell tumors, skin tumors in horses (sarcoids)
- multimodal with surgery or amputation

AE: nephrotoxicity, fatal pulmonary edema in cats, vomiting and diarrhea

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14
Q

Which animal should not be given cisplatin for chemotherapy?

A

Cats

- fatal pulmonary edema

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15
Q

What is the comparison of carboplatin to cisplatin?

A

less nephrotoxic than cisplatin
carboplatin causes thrombocytopenia
safe for cats

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16
Q

What is a conjunctive therapy used for osteosarcoma that is not a chemo drug?

A

Bisphosphonates

Drug: pamidronate

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17
Q

What are the MOA and AE of pamidronate?

A
  • inhibits osteoclasts (decreases bone resorption)
  • must treat hypercalcemia of malignancy

AE: renal excretion - nephropathy

18
Q

What is the MOA of anti-metabolites (cellular enzyme inhibitors)?

A

inhibit nucleic acid synthesis by binding to cellular enzymes responsible for Purine or Pyrimidine synthesis

19
Q

What drug is a cellular enzyme inhibitor?

A

Fluorouracil (5FU)

20
Q

What does 5FU do, whats its use and AE?

A

binds and inactivates thymidylate synthetase, required for aynthesis of thymine
USE: squamous cell carcinoma in horses (topical or IV)

21
Q

What animal should not be given 5FU and why?

A

NO for CATS

- neuro and hepatotoxic

22
Q

What is the only vet approved chemodrug?

A

Rabacfosadine (tanova)

23
Q

What is the use and AE of tanova?

A

used for lymphomas
PK: prodrug converted multiple steps to active form in cells
IV over 30mins
AE: fatal pulmonary fibrosis

24
Q

What breed of dog should not be administered Tanova?

A

West Highland White Terrier

25
Q

What are two enzyme chemotheraphy drugs?

A

Toceranib (palladia)

L-asparaginase (kidrolase)

26
Q

What is the MOA and use of Toceranib?

A

inhibits tyrosine kinase (slows down a bunch of growth factors that provide tumour with blood)
- not technically chemo
USE: cutaneous mast cell sarcoma (with or without lymph involvement)

27
Q

What is the MOA, use and AE of L-asparaginase?

A

MOA: breaks down asparagine to aspartic acid, interferes with protein synthesis

USE: some lymphoma protocols, melanoma and mast cell tumors

AE: hypersensitivity reactions, minimal myelosupression
- give antihistamine before

28
Q

What is the mOA of vinca alkaloids used for chemotherapy?

A

from periwinkle plant

binds tubulin protein, intereferes with microtubules needed for chromosomal migration

29
Q

What drug is a vinca alkaloid?

A

Vincristine (oncovin)

30
Q

What is Vincristine used for and what are the AE?

A

use: lymphoma protocols, other tumors, immune mediated thrombocytopenia (doesn’t allow lysosomes within macrophages to destroy platelets)
AE: tissue necrosis (perivascular), peipheral neuropathy, constipation, can cause neutropenia

31
Q

What antibiotic is used for anti-tumour chemo?

A

Doxorubicin (andriamycin) “red death”

32
Q

What is the MOA of doxorubicin?

A

kills throughout the cell (mostly S phase)

  • intercalates between bases of DNA molecules, blocking RNA transcription and protein synthesis
  • binds to cell membranes and alters ion transport (generates free radicals)
33
Q

what is Doxorubicin used for? PK?

A

lymphosarcoma, osteosarcoma, mammary carcinomas and other tumours

administer SLOW IV
plasma concen 20-30h
metabolized by liver (limited bile flow must alter dose)

34
Q

What are some serious and less serious AE of doxorubicin?

A

perivascular necrosis
bone marrow supression
cardiotoxicity (Fe builds up cardiomyocytes,
- Acute: cardiac arrest or ECG changes
- chronic: diffuse cardiomyopathy and cong HF

alopecia, GI, hypersensitivity from mast cell degranulation

35
Q

What Sx can help with mammary tumours?

A

Spaying

- b/c they are estrogen responsive

36
Q

What is a plant derives chemotherapy?

A

Paclitaxel (taxol)

37
Q

What is the MOA, use and AE of Paclitaxel?

A

From yew tree
MOA: polymerizes and renders useless the microtubule (similar to vincristine)

USE: many tumours in humans

AE: hypersensitivity (serious, pretreat with antihistamine, steroids, H2 blockers), Pgyp substrate (test ABCB1)

38
Q

Why are glucocorticoids used for chemotherapy? what do they do?

A

palliative care

they lys lymphoid cells
decrease inflammation from cancer or chemotherapy
decrease AE
stimulates appetite and attitude
decrease cachexia from TNF
39
Q

What NSAIDs are used and how do they help?

A

Piroxicam/meloxicam
- for transitional cell (bladder) carcinoma

deracoxib for osteosarcoma

40
Q

Does chemotherapy drug resistance happen?

A

yes

Pharmacology 2 (14 decks)

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