Chapter 32 and 37

Question 1

Cause of 75% of cancers

Answer 1

smoking, poor diet

and lack of exercise

Question 2

Palliation

Answer 2

decrease size of tumor or control side effects to make person feel better, but the cancer continues

Question 3

Cell Cycle Specific tx: M phase

Answer 3

Plant Alkaloids (Vincristine), Taxanes (Paclitaxel)

Question 4

Cell Cycle Specific tx: G2 phase

Answer 4

Topoisomerase inhibitors (Irinotecan)

Question 5

Cell Cycle Specific tx: S phase

Answer 5

Antifolates (methotrexate); Antipurine (hydroxyurea)

Question 6

Cell Cycle Non-Specific tx

Answer 6

Alkylating agents cyclophosphamide (Cytoxan)
Anthracycline antibiotics (Doxorubicin)
Nitrosureas (Carmustine)
Miscellaenous (Cisplatin, Dacarbazine)

Question 7

Agents Used in the Treatment of Cancer

Answer 7

Antimetabolites
Alkylating agents
Plant Alkaloids
Antibiotic Antineoplastics
Hormones Therapy
Monoclonal Antibodies
Radioactive Isotopes
Biological Response Modifiers

Question 8

Antineoplastic Agents effect

Answer 8

affect all cells, both healthy and sick

Question 9

Antineoplastic Agents dose limiting effects

Answer 9

death of GI cells causing N+V

***Myelosuppression (bone marrow suppression): too low a cell count may result in death

Question 10

Alkylating Agents

Answer 10

Cell cycle non specific

Kills cancer cells by directly attacking DNA

Question 11

Alkylating Agents uses

Answer 11

treatment of chronic leukemias, Hodgkin’s, lymphomas

Certain lung, breast, prostate, and ovary

Question 12

Alkylating Agents examples

Answer 12

Cyclophosphamide, nitrogen mustard

Question 13

Antimetabolites

Answer 13

Interferes with DNA synthesis
stop development and reproduction of cell
cell cycle specific

Question 14

Antimetabolites examples

Answer 14

mercaptopurine and 5-fluorouracil (5FU)

Question 15

Antitumor Antibiotics

Answer 15

Bind with DNA and preventing RNA synthesis

Used in a wide variety of cancers

Question 16

Antitumor Antibiotics examples

Answer 16

Doxorubicin, Mitomycin C and Bleomycin

Question 17

Plant (Vinca) Alkaloids

Answer 17

Derived from plants

Block cell division during mitosis

Question 18

Plant (Vinca) Alkaloids uses

Answer 18

ALL, Hodgkin’s and non Hodgkin’s lymphomas, neuroblastomas, cancers of the lung, breast and testes

Question 19

Plant (Vinca) Alkaloids examples

Answer 19

Vincristine and Vinblastine

Question 20

Steroid Hormones

Answer 20

Includes adrenocorticosteroids, estrogens, antiestrogens, progesterones and androgens

Question 21

Steroid Hormones action

Answer 21

unclear- modify the growth of hormone-dependent cancers

Question 22

Steroid Hormones example

Answer 22

tamoxifen

Question 23

Combination chemotherapy

Answer 23

only partially effective used together
decreases drug resistance
attacks cancer on several fronts
kills more healthy tissue

Question 24

Drugs used to treat side effects

Answer 24

Antiemetics (anti-nausea)

Blood-forming agents

Question 25

Growth Factors

Answer 25

stimulate the bone marrow to produce more red, white and platelet cells

Question 26

Growth Factors examples

Answer 26

erythropoietin (Epogen) for RBC, Filgrastim (Neupogen) and Pegfilgrastim (Neulasta) for WBC and oprelvekin (Neumega) for platelets

Question 27

Growth Factors side effects

Answer 27

**bone pain** | edema, fever, headache, nausea and vomiting, rash and diarrhea, hypertension, dysrhythmias

Question 28

Rescue Agents

Answer 28

help prevent severe side effects from Ca treatment | given at the same time or just after chemotherapy

Question 29

Limitations of chemotherapy

Answer 29

``` Lack of effective drug Tumor outgrows blood supply Patient tolerance Myelosuppression Drug resistance ```

Question 30

Antineoplastic drug adverse reactions

Answer 30

``` bone marrow suppression N+V Anorexia GI disturbances Alopecia Avoid pregnancy ```

Question 31

Bone Marrow Suppression considerations

Answer 31

Assess for signs of infection | Monitor for S/S of bleeding

Question 32

Bone Marrow Suppression interventions

Answer 32

``` Administer antibiotics Administer colony stimulating factors such as Epogen Private room Avoid others with infections or crowds Check labs avoid injury ```

Question 33

Mucositis interventions

Answer 33

Swish and spit with anti-fungal medication for thrush Rinse with NS and Hydrogen Peroxide Use topical anesthetics swish and swallow before meals

Question 34

Biologic Response Modifiers

Answer 34

Alter body defenses to kill cancer cells | Immunostimulants

Question 35

Cytokines

Answer 35

Biotherapy Agents broad class of protein cell regulators produced by the immune system have multiple effects

Question 36

Cytokines examples

Answer 36

Interferons Interleukins Hematopoietic growth factors

Question 37

Interferons (IFNs)

Answer 37

have antiviral, anti-cancer and anti-inflammatory properties

Question 38

Interferons (IFNs) uses

Answer 38

hairy cell leukemia, non-Hodgkin’s lymphoma, chronic hepatitis B & C, Kaposi sarcoma found in patients with AIDS

Question 39

Interleukins (ILs)

Answer 39

Secreted by macrophages, lymphocytes and monocytes

Question 40

Interleukins (ILs) effects

Answer 40

stimulates cytotoxic T cell activity against tumor cells, increase B cell and plasma cell production and promotes inflammation

Question 41

Monoclonal Antibodies

Answer 41

any drug ending in MAB | recognize and bind to only one tumor associated antigen

Question 42

Monoclonal Antibodies side effects

Answer 42

fevers, rigors, N/V, headache) to more severe urticaria, dyspnea, hypotension, myelosuppression bronchospasm, anaphylaxis