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PPP 2 > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

Characteristics of a Cancer Cell

A
  1. Uncontrolled growth and survival
  2. Angiogenesis
  3. Invasion and metastasis

1-2 = benign
1-3 = malignant (breaks through basement membrane)

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2
Q

Non-Targeted Chemotherapies

A

Not cancer-cell specific

MOA: Induce damage to cells that are proliferating (cells in cell cycle)
-Inhibit DNA formation, structural DNA damage, target mitosis

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3
Q

Targeted Chemotherapies

A

Cancer-cell specific

MOA: Target a specific mutant protein that thrives the proliferation of cancer cells

Target: typically in growth factor receptor signaling pathway that thrives proliferation (EGFR/BCR-ABL) or angiogenesis (VEGFR)

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4
Q

EGFR (MOA)

A

CEG

mAB: Cetuximab
TKI: Erlotinib, Gefitinib

Activates cell proliferation through proteins that activate RAS

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5
Q

BCR-ABL (MOA)

A

NDI

TKIs: Imatinib, Dasatinib, Nilotinib

Unique constitutively active tyrosine kinase that promotes proliferation and prevents apoptosis

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6
Q

VEGR (MOA)

A

BSS

mAB: Bevacizumab
TKI: Sarafenib, Sunitinib

Initiates signal cascades that stimulate angiogenesis

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7
Q

General Adverse Effects of Non-targeted Chemotherapy

A

-GI: diarrhea, mucositis, nausea, vomiting
-BM: decrease WBC (leukopenia, increase infection risk), decrease platelets (thromebocytopenia, increase bleeding), decrease RBCs (anemia, increase fatigue)
-Hair: alopecia

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8
Q

Vincristine

A

MT NEC “Cristine is from Mt. Nec”

Vinca-alkaloid
MOA: inhibit microtubule polymerization

AE:
-Neurotoxic (peripheral neuropathy)
-Extravasation (monitor for pain/swell/poor blood return)
-Constipation (given with lax/stool softener)

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9
Q

Vinblastine

A

MT HEN “Blast off to Mt. Hen”

Vinca-alkaloid
MOA: inhibit microtubule polymerization

AE:
-Neurotoxic (peripheral neuropathy)
-Extravasation (monitor for pain/swell/poor blood return)
-Hyelotoxic (decreases blasts)

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10
Q

Paclitaxel

A

Pac went to Mt DNA

Taxan
MOA: inhibit microtubule depolymerization

AE:
-Neurotoxic (peripheral neuropathy)
-Anaphylaxis (premed. with steroid and anti-his)

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11
Q

Docetaxel

A

Doc is a MT FAN

Taxan
MOA: inhibit microtubule depolymerization

AE:
-Neurotoxic (peripheral neuropathy)
-Anaphylaxis (premed. with steroid and anti-his)
-Fluid retention (premed. with steroid)

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12
Q

6-Mercaptopurine

A

F HAND

MOA: inhibits de novo purine synthesis

AE: Hepatotoxicity (check LFT)

DDI: Allopurinol, Febuxostat

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13
Q

Methotrexate

A

HB PL

MOA: inhibits de novo purine synthesis and inhibits DHF-reductase / thymidylate synthase

AE:
-Hepatotoxicity (BBW)
-Bone marrow suppression (BBW)

CI: Pregnancy (BBW) - used with misoprostal to end pregnancy

*Leucovorin rescue therapy to limit toxicity

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14
Q

5-Fluoruracil (5-FU)

A

MOA: inhibits thymidylate synthase (prodrug)

AE: hand-foot syndrome (skin toxicity)

Oral prodrug of 5FU = Capecitabine

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15
Q

Hydroxyurea

A

MOA: inhibits ribonucleotide reductase

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16
Q

Doxorubicin, Daunorubicin, Dactinomycin

A

DNA intercalators

MOA: intercalate into DNA, disrupt replication fork/helix

AE:
-Cardiomyopathy (prevention: Dexrazoxane)
-Urine discoloration (red)
-Vesicant = skin necrosis

17
Q

Cytarabine (Ara-C)

A

MOA: incorporates into DNA, blocks elongation

AE:
-Hepatotoxicity (BBW)
-BM suppression (BBW)
-Cerebellar toxicity (ataxia, slurred speech)

18
Q

Irinotecan, Topotecan, Etoposide

A

MOA: inhibit topoisomerase = DNA strand breaks

AE:
-Severe diarrhea (premed with atropine)

19
Q

Bleomycin

A

MOA: produces ss/ds DNA breaks

AE:
-Pulmonary fibrosis (major limitation)
-Hypersensitivity (anaphylactic rxn)

20
Q

Cyclophosphamide

A

MOA: alkylate DNA - cross links - strand breaks - apoptosis

AE:
-Hemorrhagic cystitis
-Secondary malignancies
-Gonadotoxic

21
Q

Cisplatin

A

MOA: forms platinum adduct to cross link guanines, apoptosis

AE:
-Nephrotoxicity (monitor Mg/K/SCr) - hypomg
-Ototoxicity (tinnitus, hearing loss)

22
Q

Oxaliplatin

A

MOA: forms platinum adduct to cross link guanines, apoptosis

AE:
-Less nephrotoxicity and ototoxicity
-Neurotoxicity (exposure to cold temps - pharyngolaryngeal dysesthesia)

23
Q

Erlotinib, Gefitinib, Brigatinib

A

EGFR TKIs (oral)

MOA: blocks EGFR TK

AE: Rash, Diarrhea, Steven-John syndrome

24
Q

Lapatinib

A

HER 2 / EGFR TKI

MOA: blocks HER2 / EGFR TKI

AE: Cardiotoxic, hepatotoxic

25
Q

Imatinib, dasatinib, nilotinib

A

BCR Ab1 TKI

MOA: blocks BCR Ab1 TK

AE: GI, Hepatoxicity, QT prolongation (nilo - BBW)

26
Q

Sunitinib

A

VEGFR TKI

MOA: block VEGR TK

AE: Hepatoxicity (BBW)
-HTN, Thromboembolism
(stimulates NO)

27
Q

Cetuximab

A

MOA: MAB to EGFR

AE: Rash, GI, Hypomg

28
Q

Trastuzumab

A

MOA: MAB to HER2

AE: Cardiotoxic

29
Q

Bevacizumab

A

MOA: MAB to VEGFR

AE: HTN, Thromboembolism, Poor wound healing

PPP 2 (16 decks)

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