Chemotherapeutic

Question 1

Define:

1. Cure
2. Complete Response
3. Partial Response
4. Stable Disease
5. Progression

Answer 1

1. No evidence of disease
2. No evidence of disease for 1 month
3. 50% ↓ in tumor size
4. Tumor neither grows/shrinks more than 25%
5. ↑ 25% tumor size

Question 2

Cell cycle specific agents work during

Answer 2

Mitosis

Question 3

Chemos that cause extravasation (3)

Answer 3

1. Anthracyclines
2. Vinca Alkaloids
3. Taxanes

Question 4

Alkylating Agents

1. MOA
2. Examples
3. SE

Answer 4

1. Alkyl groups form covalent bonds with nucleotide bases in DNA, cannot uncoil, cell goes into apoptosis
2. Cyclophosphamide, Carmustine, Cisplatin, Carboplatin
3. Bone marrow suppression/infection, SIADH, impaired BChE (caution w/ Suxx)

Question 5

Platinum Compounds

1. Examples/SE

Answer 5

1. Subgroup of alkylating agents (Cisplatin, Carboplatin)
2. Cisplatin - Nephrotoxic! Dose limiting, watch for hypomagnesemia
3. Carboplatin - dose limiting peripheral neuropathy; avoid cold

Question 6

Antimetabolites

1. MOA
2. Examples

Answer 6

1. Structural analogues of natural metabolites; either directly inhibits DNA enzymes or incorporates into DNA
2. Methotrexate, 5FU

Question 7

Methotrexate

1. MOA
2. SE
3. CI

Answer 7

1. Antimetabolite; folic acid analog that prevents has a higher afinity for dihydrofolate reductase
2. Pulmonary fibrosis, renal/hepatotoxicity
3. No N2O administration (can worsen PF)

Question 8

5-FU

1. MOA
2. SE

Answer 8

1. Inhibits thymidylate synthetase, which inhibits Nucelotide production
2. ↑ MI risk one week; Hand/Foot syndrome

Question 9

Topoisomerase Inhibitors

1. MOA
2. Examples
3. SE

Answer 9

1. Inhibition of Topoisomerase I and II; prevents relaxation and re-assembly of DNA double helix
2. Doxorubicin, Daunorubicin, Bleomycin
3. Free radical generation

Question 10

Anthracyclines (Doxo-, Daunorubicin)

Answer 10

1. Type of TI
2. Very significant bone marrow supression/thrombocytopenia
3. Cardio toxicity can be acute (transient/rare within 2 mos) or chronic (fatal, can occur at anytime after treatment)

Question 11

Bleomycin (3)

Answer 11

1. Type of TI that also chelates iron
2. High pulmonary toxicity
3. Keep FiO2 low

Question 12

Vinka Alkaloids

1. MOA
2. Examples

Answer 12

1. Binds to tubulin to block microtubles assembly; arrests cell division
2. Vincristine, Vinblastine
3. Vincristine has little BM supression; others do

Question 13

Vincristine

Answer 13

1. Vinka Alkaloid
2. Very little bone marrow supression
3. High incidince of peripheral neuropathy
4. ANS dysfunction, sensory loss, laryngeal dysfunction
5. Regional anesthesia safety concerns (↓dose, admin time, no epi)

Question 14

Taxanes

1. MOA
2. Examples
3. SE

Answer 14

1. Allows tubules to form but then prevent disassembly
2. Paclitaxel, Docetaxel
3. Peripheral nephropathy (hands/feet); hypersensitivity reactions