Unit 2: Chemotherapy Flashcards

1
Q

3 types of chemotherapy

A

Primary chemotherapy
Neoadjuvant chemotherapy
Adjuvant chemotherapy

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2
Q

Primary Chemotherapy

A

Chemo is the primary treatment.

Usually
— not curative 
— for advanced metastatic disease 
— for symptom relief
Curative in a small subset of patients
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3
Q

Neoadjuvant chemotherapy

A

Idea: shrink cancer and then resect the tumor

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4
Q

Adjuvant chemotherapy

A

Idea: resect tumor and then use chemo to kill any remaining cancer cells

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5
Q

All chemo is given based on what premise about cells?

A

Chemo is poison that is most effective when given to cells that are dividing. Since cancer cells divide rapidly and chaotically, chemo hopefully kills off more cancer cells than healthy cells.

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6
Q

3 Groups of Chemo Drugs

A

Cytotoxic drugs
Hormonal agents
Signal transduction inhibitors

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7
Q

Cytotoxic drugs include…

A
Alkylating agents
Antimetabolites
Antibiotics
Antibodies
Others
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8
Q

How do cytotoxic drugs work?

A

Kill cells when they are dividing

Via first order kinetics: each time a dose is given, the same % of cancer cells are killed

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9
Q

Cell cycle: S phase

A

DNA synthesis occurs

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10
Q

Cell cycle: M Phase

A

Cellular division occurs

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11
Q

Since cancer cells can become resistant to chemo, how do we combat it?

A

Give multiple chemotherapeutic agents

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12
Q

Adverse effects of cancer drugs are most pronounced where?

A

on cells that divide the fastest

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13
Q

Chemo adverse effects on bone marrow

A

Bone marrow:
—low WBC —> risk for severe infection
—low RBC —> anemia; possibly need transfusion
—low PLT —> risk for bleeding

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14
Q

Chemo adverse effects on GI tract

A

causes Nausea & Vomiting; sometimes patients show up in the ER with intractable nausea and vomiting

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15
Q

Chemo adverse effects on hair

A

Hair loss

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16
Q

Methotrexate can have toxic effects on what organ?

A

Kidneys

17
Q

Cardiac toxicity is common with what drugs? Name 2 of these drugs.

A

Anthracyclines like doxorubicin and danorubicin

18
Q

What cancer drug can cause pulmonary fibrosis?

A

Bleomycin

19
Q

What cancer drug can cause nervous system toxicity?

A

Vincristine

20
Q

How do the alkylating agents work?

A

Add an alkyl group to DNA —> prone to cause local tissue damage and necrosis and hopefully results in apoptosis

21
Q

How do the antimetabolites work?

A

Compete with binding sites on enzymes
OR
Can be incorporated into DNA or RNA

ESPECIALLY HELPFUL if they bind to an enzyme that affects cell replication pathways

22
Q

What kind of drug is methotrexate?

A

Antimetabolite

23
Q

What is methotrexate used to treat?

A

Psoriasis
rheumatoid arthritis
Variety of cancers

24
Q

How do antibiotics treat cancer?

A

Interrupt cell DNA function

25
Q

What two groups of antibiotics treat cancer?

A

Anthracyclines and others

26
Q

What is plicamycin used to treat? How does it work?

A

Life-threatening hypercalcemia associated with malignancy. It inhibits resorption of bone by osteoblasts, and lowers serum calcium.

27
Q

What do vinca alkaloids do?

A

bind to tubulin and disrupt spindle apparatus during cell division

28
Q

Name 3 vinca alkaloids

A

Vincristine
Vinblastine
Vinorelbine

29
Q

Antibodies often end in …?

A

-mab

30
Q

What is hydroxyurea used for?

A

Prevention of sickle cell crises

31
Q

Tamoxifen is used for…

A

Hormonal therapy for up to 5 years after breast cancer treatment

32
Q

What kind of sensitivity should breast cancer cells have in order for the patient to receive tamoxifen?

A

Estrogen

33
Q

GnRH stands for…

What releases GnRH?

A

Gonadotripin-releasing hormone (released by the hypothalamus)

34
Q

What do GnRH drugs often end with?

A

-relin

35
Q

What are GnRH analogues and antagonists used to treat?

A

Breast cancer and prostate cancer

36
Q

Many signal transduction inhibitors end with …?

A

-nib