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OCN ONS Bundle > Cancer Treatment Modalities: Chemotherapy > Flashcards

Cancer Treatment Modalities: Chemotherapy Flashcards

(72 cards)

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1
Q

Neoadjuvant chemotherapy =

A

Preop chemo, sometimes used to shrink a cancer tumor before surgery so that it is easier to remove

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2
Q

Adjuvant chemotherapy =

A

Postop chemo, where surgery is the main treatment but chemo is given after with intent to cure or control disease

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3
Q

Multi-modal therapy =

A

chemo can be given in combo with other therapies such as radiation

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4
Q

The 5 phases of the cell cycle

A 
GO phase (resting phase) 
G1 phase 
S phase 
G2 phase 
M phase
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5
Q

G0 phase (resting stage) =

A

The cell has not yet started to divide

G0 can last from a few hours to a few years. When the cell gets a signal to reproduce , it moves to G1 phase

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6
Q

G1 phase =

A

Cell starts making more proteins and growing larger, so the new cells will be of normal size

~18-30 hours

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7
Q

S phase =

A

Chromosomes containing the genetic code (DNA) or copied, so both of the new cells formed will have matching strands of DNA

~18-20 hours

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8
Q

G2 phase =

A

The cell checks the DNA and gets ready to start splitting into two cells

~2-10 hours

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9
Q

M phase =

A

Mitosis phase, cell splits into two new cells

~30-60 minutes

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10
Q

Chemotherapy classifications (6)

A 
Alkylating Agents 
Antimetabolites 
Antitumor Antibiotics 
Plant Alkaloids 
Glucocorticoids 
Hormonal Agents
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11
Q

Alkylating agents treat which types of cancer?

A 
Leukemia 
Lymphoma 
Hodgkin disease 
Multiple myeloma 
sarcoma 
Cancers of lung, breast, ovary
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12
Q

How do Alkylating agents work?

What part of the cell cycle do they work in?

A

Interferes with DNA replication, RNA transcription, and nucleic acid function

Cell cycle nonspecific, works in all phases of the cycle

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13
Q

What is a potential downfall of receiving alkylating agents? (2)

A

Can eventually lead to acute leukemia bc it damages DNA causing long term damage to bone marrow (dose dependent)

Also a significant threat to future fertility in adolescents and young adults of child bearing age (discuss egg retrieval, sperm banking, etc)

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14
Q

Alkylating agents

2 types

A

Non-platins

Platinum analogs

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15
Q

Alkylating agents

Non-platins (5)

A

1) Nitrogen mustards (mechlorethamine, chlorambucil, cyclophosphamide, ifosfamide, melphalan)
2) Nitrosoureas (Streptozocin, carmustin BCNU, lomustine)
3) Alkyl sulfonates (Busulfan)
4) Triazines (Dacarbazine DTIC and temozolomide)
5) Ethylenimines (Thiotepa and altretamine (hexmethylmelamine) )

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16
Q

Alkylating agents

Platinum analogs (3)

A

Carboplatin
Cisplatin
Oxaliplatin

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17
Q

How do Antimetabolites work?

What part of the cell cycle do they work in?

A

Inhibits protein synthesis, substitute erroneous substances needed for DNA/RNA replication, and inhibit DNA synthesis

S phase

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18
Q

Examples of Antimetabolites

A

5FU
6-MP
Capecitabine, Cladribine, Clofarabine, Cytarabine
Floxuridine, Fludarabine, Gemcitabine
Hydroxurea
Methotrexate, Pemetrexed, Pentoastatin, Thioguanine

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19
Q

How do antitumor antibiotics work =

Interfered with enzymes required for ->

Are cell cycle _______

A

Used to treat hematologist and various types of solid tumors

DNA replication

Nonspecific (all phases)

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20
Q

Antitumor Antibiotics (2)

A

Anthracyclines

Liposomal formulations

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21
Q

Major consideration for Anthracyclines

A

Can permanently damage heart if given in high doses

-> Lifetime dose limits

Baseline cardiac function (ECG, MUGA scans)

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22
Q

Examples of Anthracyclines (5)

A 
Daunorubicin 
Doxorubicin 
Epirubicin 
Idaraubicin 
Valrubicin
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23
Q

Liposomal Formulations (2)

A

Doxorubicin hydrochloride liposome

Daunorubicin citrate liposomal

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24
Q

What are Plant Alkaloids?

Cell Cycle _____

A

Derived from certain types of plants and have varying mechanisms of action

Specific

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25
Types of Plant Alkaloids (3)
Vinca Alkaloids Epipodophyllotoxins Taxanes
26
Vinca Alkaloids come from?
From Madagascar Periwinkle plant, naturally extracted from pink periwinkle plant
27
Vinca Alkaloids Have hy____ and cy____ effects, therefore have been used to treat (2)
Hypoglycemic Cytotoxic Diabetes, HTN, as a disinectant
28
What part of the cell cycle do Vinca Alkaloids work on?
M Phase
29
Vinca Alkaloids significant SE (3)
Myelosuppression Peripheral Neuropathy N/V
30
Examples of Vinca Alkaloids (3)
Vinblastine Vincristine Vinorelbine
31
Types of Epipodophyllotoxins Categories (2)
Camptothecans | Podophyllotoxins
32
Campothecans come from the?
Asian “happy tree” plant
33
Podophyllotoxins come from the?
May apple plant
34
How do Epipodophyllotoxins work on the cell cycle? What enzyme?
Forms a complex with topoisomerase and DNA resulting in inhibition and function of topoisomerase enzyme (required for DNA synthesis)
35
What part of the cell cycle do Epipodos work on?
Late S, G2 phases
36
Types of Cancer Epipodos are used to treat (2)
Leukemia’s GI Cancers
37
Common SE of Epipodos (2)
Diarrhea Neutropenia
38
Types of Epipodophyllotoxins (4)
Etoposide Teniposide Camptothecan Topotecan hydrochloride
39
What are Taxanes? Where are they derived from?
Mitotic inhibitors (stops mitosis) Pacific Yew Tree
40
What part of the cell cycle do taxanes work on?
M phase | Also active in G1 and S transition phase a last checkpoint where cell division can be stopped
41
What types of cancers do taxanes treat?
Breast, Lung | Myelomas, Lymphomas, Leukemia’s
42
What side effect are taxanes known for causing? Therefore ->
Peripheral nerve damage Dose limiting
43
Types of Taxanes (4)
Paclitaxel Docetaxel Cabazitaxel Paclitaxel protein bound
44
What are Glucocorticoids?
Steroids, naturally occurring hormones, hormone like drugs
45
How do glucocorticoids work on the cell cycle?
They modify transcription and protein synthesis within the cell -> reversal of increased capillary permeability, inhibits glucose transport and phosphorylation to induce cell death
46
Glucocorticoids treat what types of cancers?
L/L | MM
47
Glucorticoids can also be used for what?
Before, after, during tx - antiemetics - allergic reactions - SVC, SCC
48
Types of Glucocorticoids (4)
Prednisone Hydrocortisone Methylprednisone Dexamethasone
49
Hormonal Agents =
Effects sex hormones, change the action of production of female or male hormones
50
Hormonal agents treat what types of cancers?
Breast Prostate Endometrial
51
How do hormonal agents work on cancer?
They prevent the cancer cell from using the hormone it needs to grow to prevent body from making hormones
52
Categories of Homronal Agents (2)
Estrogen receptor (ER) modulators Aromatase inhibitors
53
Types of Estrogen Receptor (ER) modulators (3)
Tamoxifen Toremifene Raloxifine
54
Types of Aromatase inhibitors
``` Anastrozole, Letrozole Exemestane Fulvestrant Leuoprolide Glutamine Bicatulamide Nilutamide Fluoxymesterone Estradiol Octreotide Megestrol Medroxyprogesterone acetate ```
55
Chemotherapy effects normal rapidly dividing cells as well such as?
Blood cells formin in bone marrow Digestive tract Reproductive system Hair follicles
56
Chemo side effects present as ->
Myleosuppression Mucositis N/V Alopecia
57
Most common SE of chemo
1) Myleosuppression (anemia, neutropenia, thrombo) 2) GI (anorexia, n/v, constipation, diarrhea, mucositis 3) Fatigue 4) Cognitive/ Neuro changes 5) Sexual and reproductive dysfunction (hot flashes, decreased libido, infertility) 6) Organ dysfunction (renal, hepatic, cardiac, pulmonary)
58
Hazardous drugs are those that exhibit one or more of what types of toxicities?
``` Carcinogenicity Teratogenicity/other developmental toxicity Reproductive toxicity Organ toxicity in low doses Genotoxicity ```
59
Adverse health effects of occupational exposure to hazardous drugs include 1) Integumentary/mucosal (3) 2) Neuro (2) 3) Respiratory (1) 4) GI (2) 5) Hypersensitivity (2) 6) Reproductive 6)
1) Skin irritation or contact dermatitis, mouth and nasal sores, partial alopecia, hair thinning 2) HA, dizziness 3) Dyspnea 4) N/V, abdominal pain 5) Allergic asthma, eye irritation 6) Infertility, prolonged time to conception, premature delivery/low birth weight, ectopic pregnancy, spontaneous abortions/miscarriages, stillbirths, learning disabilities in offspring
60
Risk levels for Hazardous drugs 1) Chronic low-level exposure to HD's can lead to a______ 2) Chronic low level absorption may cause significant long term ___ ___ 3) Acute exposure may cause ___ symptoms 4) Use of _ _ _ reduces risk of absorption
1) absorption 2) side effects 3) acute 4) PPE
61
Ways you can be exposed to Hazardous drugs (4)
1) Absorption (through skin, eyes, mucous membranes) 2) Injection (accidental needle sticks) 3) Ingestion 4) Inhalation (sprays, aerosolization, drug dust, spills)
62
What do you wear for PPE when administering hazardous drugs?
1) Gloves (two pairs) 2) Gown 3) Face shield 4) Respirator mask (only if required by specific drug)
63
Postadmin considerations for body fluids and linen handling Body fluids 1) HDs are found in? 2) Consider all bodily fluids contaminated for at least __ hours after completion of drug admin 3) ____ toilets without a lid before flushing to avoid spray contamination. Encourage use of toilets instead of urinal/bed pan to decrease exposure 4) Protect the skin of ____ patients 5) Remember: D____ can be contaminated too 6) Wear _ _ _ when emptying foley catheters and urinals or bed pans
1) Urine, feces, sweat, vomit, breast milk, seminal fluid 2) 48 3) Cover 4) incontinent 5) Diapers 6) PPE
64
Postadmin considerations for linen handling 1) Prevent exposure: use ___ backed disposable pads under incontinent patients 2) Use v___/p____ pillow covers 3) If linen becomes contaminated with any body fluid within 48 post admin, what do you do?
1) plastic 2) vinyl/plastic 3) don PPE, bas as contaminated, double wash, if home double wash separately from other linen
65
CAM stands for
Complementary, Alternative, and Integrative medicine A broad category of approaches to health care with origins outside of mainstream western medicine
66
A non-mainstream therapy combined with conventional medicine =
Complementary
67
A non-mainstream therapy used instead of conventional medicine =
Alternative
68
Therapies that have had widespread use in western medicine =
Conventional
69
Unproven therapy
Any therapy that has not been scientifically tested and approved, therapies under investigation
70
Disproven therapy
One for which evidence exists but not in support a therapy
71
The following are all examples of? Vitamin or mineral supplements Intercessory or self prayer Chiropractic or osteopathic care Herbal therapies
CAM therapies
72
Acupuncture, Animal assisted activity, Aromatherapy, art therapy, ayurveda, chiropractic medicine, naturopathy, osteopathy, reflexology, reiki, yoga are all examples of CAM therapy that require?
Licensure, certification, training

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