E3: Cancer Drugs Flashcards by Austin Shackelford

What are the 3 main steps of cancer growth?

1.Transformation 2.Proliferation 3.Metastasis

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________: When a cell with normal growth changes into a cell with dysregulated growth (malignancy)

Transformation

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Transformation is mainly attributed to ______ damage: inherited, gene mutations, alterations/loss in regulatory proteins

GENETIC damage

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________: Growth of transformed cells into a tumor

Proliferation

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Proliferation of a tumor is an increase in the ______ of cells

NUMBER of cells (not their size)

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Proliferation: Critical cell cycle events include the synthesis of DNA (__ phase) and the division of the parent cell into 2 daughter cells (__ phase = ______)

synthesis (S phase)….M phase mitosis

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Most antineoplastic drugs target _______ cells

DIVIDING

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Original tumor may respond well to chemotherapy, but _______ lesions may be less responsive = poor prognosis

metastatic

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Most chemotherapy agents interfere with cell _______

proliferation

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What is the critical gene that can asses of a cell can be repaired or not? If the damage can not be repaired what happens in a normal situation?

p53 gene….apoptosis

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The p53 gene is a _______ that functions as a tumor _______

transcription factor…tumor supressor

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p53 is _______ after many different stressors: UV radiation, oncogenes, DNA damaging drugs

INDUCED

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If _____ gene is damaged, tumor suppression is severely reduced

p53

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Cancers that express p53 (leukemias, lymphomas, testicular cancer) = highly _______ to chemotherapy

RESPONSIVE

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Cancers that acquire a mutation in p53 are _______ responsive or resistant to DNA- damaging chemotherapy drugs

minimally

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Chemo drugs act under ______ kinetics.

First-order

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______ tumors DO NOT respond well to chemotherapy and often require _______ and/or ______ as well

SOLID… radiation… surgery

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Current emphasis on cancer chemotherapy is use of drug _________ therapy

combination

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G0 = ______ phase

resting

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G1 = ____ phase; occurs after ______; genes for replication are activated

gap…mitosis

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S = DNA _______

synthesis

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G2 = second gap phase; “_______”; DNA REPAIR progresses

premitosis

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Which phase does DNA repair progress?

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Cell-cycle ______ (drugs affects one phase)….Cell-cycle ________ (drug affects any/all phases)

specific…non-specific

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Which cycles are considered interphase?

G0/G1-->S-->G2 (M is only one not in interphase)

Perspective: What are the 7 classes of Chemo Drugs?

1.Alkylating Agents 2.AntiMetabolites 3.Platinum Complexes 4.Vinca Alkyloids 5.Hormonal Agents 6.Antibiotics 7.Thalomide

Oral Manifestations of Chemo: Concern is that complications pose __________ risk and/or may dictate the need to temporarily discontinue treatment

econdary infection

Oral complications of Chemo pose great ________ to the patient

discomfort

Mgmt of Oral Complications during Chemo: Good _____ control...Pain control with ________

plaque...topical anesthetics

Mgmt of Oral Complications during Chemo: Salivary replacement for _________

xerostomia

Mgmt of Oral Complications during Chemo: _____ due to caries risk...Antifungals... Antivirals... Antimicrobial _______ or dentifrices

Fluorides... mouthrinses

What is the extremely painful oral condition when on chemo that is best treated with ICE CHIPS?

Oral Mucositis

What are the 4 major oral manifestations of Chemo tx?

1.Oral Mucositis 2.Candidiasis 3.Black Hairy Tongue (antibiotics) 4.Viral Lesions

All chemo drugs have a ___ therapeutic index.

LOW

What are 3 major areas/ signs of the toxicity of chemo drugs?

1.BLOOD dyscrasias 2.Ulcerations of ORAL mucosa/GI tract 3.Nausea/Vomiting

Alkylating agents transfer alkyl groups to important cell constituents. When alkylating DNA, which nucleotide is it most likely alkylating to start cell death?

GUANINE

DO alkylating agents target a specific part of the cell cycle?

NO, Alkylating agents are cell-cycle NON-specific (drugs combine with cells in any phase of the cycle)

For Alkylating agents, __________ is common outcome of treatment

Susceptibility to infection

What is the most common example of an alkylating agent?

Cyclo-phosph-AMIDE

Antimetabolites are __ phase specific

S phase

Nitrogen mustard is a class of _________

alkylating agents

The 3 classes of antimetabolites are all antagonists, which antagonists are they?

1.Folic Acid Antagonists 2.Purine Antagonists 3.Pyrimidine Antagonists

What is an example of a folic acid antagonist?

meth-o-trex-ATE

Folic Acid antagonists inhibit DNA/Nucleic acid synthesis by blocking the enzyme ____________.

Di-Hydro-Folate Reductase

______ antagonists inhibit enzymes that convert hypoxanthine ribonucleotide to adenine and xanthine ribonucleotide

Purine

What is an example of a PURINE Antagoinist? Inhibits ____ AND ____ synthesis.

MER-CAP-TO-PURINE

What are the two Pyrimidine antagonists that "really kick people's buts"?

Fluoro-Uracil "5-FU" and CYT-ARA-BINE "Ara-C"

Which cell cycle phase do Pyrimidine antagonists target?

Since they are antimetabolites- they target S phase

In Platinum complex drugs they inhibit ____ synthesis and repair, which induces cell death.

DNA

Platinum complex drugs are platinum ions surrounded by _______ ions.

chloride

What is an example of a Platinum Complex drug? (Hint what do they all have in their name?)

they all have "Plat" in their name...CARBO-PLATIN

What is ALMOST always a toxicity associated with Platinum derived meds?

OTOTOXICITY---Hearing loss

VINCA alkyloids-is this a cell cycle-specific drug? If so, what cycle(s) does this affect?

Yes, M and S phases

VINCA alkyloids-Inhibit mitotic division by interfering with ________ proteins involved in the formation of mitotic spindles.

microtubular

What are the two examples of Vinca Alkyloids? (you better not get this wrong)

VIN-BLAST-INE and VIN-CRIST-INE

What is a common side effect of the Vinca Alkyloids?

NeuroToxicty---Hearing loss specifically

Melissa is on Vinca Alkyloids for lymphoma, but what is the one indication Dr. S pointed out in lecture?

Kaposi's Sarcoma

Which cell cycle phase do Hormonal Agents interfere with?

Hormones interrupt cells in G phase

What are the 5 hormonal agents used in Chemo therapy?

1.Estrogens 2.Androgens 3.Progestins 4.Glucocorticoids 5.TAM-OX-IF-EN

What are the two main Cancers indicated for the use of Estrogens? What is the form of Estrogen administered?

1.PROSTATE!!!! 2.Mammary...Ethinyl EstraDiol

Who would you give ANDROGENS to for Cancer therapy?

POSTmenopausal women with Mammary Cancer

Testosterone propionate and FLU-OXY-mesterone are drugs in the ______ family. What are they used for?

ANDROGEN....POSTmenopausal women with Mammary Cancer

What are the two main indications for Progestin chemotheraputics?

1.RENAL 2.Endometrial cancers

What are the two Progestin drugs?

1.MED-ROXY-PROGESTERONE 2.MEG-ES-TROL

What is the hormone of choice for these indications? hematologic; lymphomas; bone metastases; immunosuppression for organ transplantation

GLucoCorticoids

What is the only drug Dr. S gave us for the Glucocorticoid family?

PRED-NIS-ONE

The anti tumor effects of PRED-NIS-ONE may be related to inhibition of _______ transport, phosphorylation, or induction of cell death in immature ________

glucose.... lymphocytes

What is the hormonal agent that competitively binds to ESTROGEN receptors on tumors and other target tissues?...What cancer is it indicated for?

TAM-OX-IFEN...breast cancer

TAM-OX-IFEN Decreases ______ synthesis and inhibits _______ effects

DNA... estrogen

Which phases of the cell cycle does TAM-OX-IFEN act on? Is this cytostatic or cytosidal?

G0 and G1...cytostatic

uterine cancer, stroke, pulmonary emboli, liver problems, osteoporosis are the adverse effects of what hormonal drug?

TAM-OX-IFEN

Mech of Action for Antibiotics: ________ bind with DNA to inhibit cell division

Cytotoxins

What phase do antibiotics attack cells?

haha TRICK question...non-cell cycle specific AND Cell cycle specific!!

What type of tumors are ANTIBIOTICS most effective for?

Solid mass tumors

What is the ONE Antibiotic drug Dr. S said TO KNOW?! What is is indicated for?

DAUN-O-RUB-ICIN CITRATE (DaunoXome)....HIV-assoc Kaposi's sarcoma

What do MOST, if not all the Antibiotic Chemo Agents end in?

"-CIN"

What is the Angiogenesis inhibitor, immunosuppressant, TNF blocking agent used in multiple myeloma, AIDS-related pathos ulcers?

THAL-ID-O-MIDE

What drug did we talk about that is the CLASSIC model drug for Teratogens?

THAL-ID-O-MIDE

WHAT ARE THE 8, yes 8 Systmemic Effects of Chemotherapy?

1.Bone Marrow Suppression 2.GI Disturbances 3.Dermatological Reactions 4.HepatoToxicity 5.NeuroToxicity 6.NephroToxicity 7.Immune Deficiency 8.Infertility

What are 2 signs of bone marrow suppression in systemic effects of Chemo?

1.Fatigue 2.ImmunoSuppression

What are two major signs of GI disturbances in Chemo effects?

1.Nausea/Vomiting/Diarrhea 2.Change in Gut Flora

What are 2 examples of Dermatological reactions to Chemo therapy?

1. Skin lesions/ ulcerations 2.AloPecia

What is the systemic effect of Chemo tx on Hepatotoxicity?

Enzymatic INDUCTION or INHIBITION via P450 enzymes

What is the main NeuroToxicity from Chemo Therapy that we discussed?

Hearing Disorders

In the Nephrotoxicity assoc with Chemo, there is _________ from excess cell destruction and byproducts. This is Treated with _________ to inhibit Uric Acid production and resultant Urema.

HYPERuremia...ALLOpurINOL

In the immune deficiency consequence of Chemo, what are the two possible outcomes?

1.Susceptible to infection 2.Secondary Malignancy

Chemo can cause infertility because it inhibits _________ and ________

spermatogenesis and oogenesis

E3: Cancer Drugs Flashcards

(87 cards)