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Flashcards in Exam 3 antineoplastic agents Deck (41):
1

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

Transformation

2

_____: inherited gene mutations that alter growth/repair, alterations in or loss of regulatory proteins

genetic damage

3

growth of transformed cells into a tumor, increase in # of cells

proliferation

4

What are the critical cell cycle events?

synthesis of DNA (S phase)
division of parent into daughter cells (M phase = mitosis)

5

results in ___ ___ ___: challenge is to give adequate dose to kill cancer without killing too many healthy cells

dose limiting toxicities

6

_____: cancer cells acquire ability to invade tissues throughout body, tumor cells mutate which allows them to invade into tissues, vessels, body cavities, spread through lymph or blood and grow in new location

Metastasis (as they gain mutations their response to chemo may change)

7

7 categories of antineoplastic agents

1. alkylating agents
2. antimetabolites
3. platinum complexes
4. vinca alkyloids
5. Hormonal agents
6. antibiotics
7. thalidomide

8

what drug is used to treat HIV associated kaposis sarcoma?

daunorubicin citrate (DaunoXome) (antibiotic)

9

What is Thalomid used to treat?

leprosy, investigational for multiple myeloma, chrons disease, graft vs host disease, AIDS related apthous lesions

10

Name the category of drug: interferes with DNA, RNA, and proteins to prevent cell metabolism and division - cell cycle non specific

Alkylating agents - transfers alkyl groups (alkylate DNA - probably at guanine as the primary mechanism for cell death)

11

Name the category of drug: interferes with growth of rapidly proliferating cells, S phase specific

Antimetabolites

12

what are the 3 classes of antimetabolites

1. folic acid antagonists
2. purine antagonists
3. pyrimidine antagonists

13

Which antimetabolite is S phase specific, inhibits DNA synthesis, and inhibits nucleic acid synthesis by blocking the enzyme dihydrofolate reducatese?

Folic acid antagonist (methotrexate)

14

What are the 2 drugs that inhibit pyrimidie synthesis?

1. fluorouracil
2. cytrarabine

15

What purine antagonist inhibits enzymes that convert hypoxanthine ribonucleotide to adenine and xanthine ribonucleotide? aka inhibits DNA and RNA synthesis

mercaptopurine

16

Which antinoplastic drugs inhibits DNA synthesis and repair and induces cell death via apoptosis or necrosis?

platinum complexes

17

Which antineoplastic drugs inhibits mitotic division by interfering with microtubular proteiins involved in the formation of mitotic spindles? (M and S phase cell cycle specific)

Vinca alkyloids

18

Which antineoplastic drugs interrupt cells in G phase and reduce amount of circulating hormones?

Hormonal agents

19

_____: antitumor effect may be related to inhibition of glucose transport, phosphorylation, or induction of cell death in immature lymphocytes

Glucocorticoids

20

_____: competiticely binds to estrogen receptors on tumors and other target tissues. It decreases DNA synthesis and inhibits estrogen effects in G0 and G1

tamoxifen (cytostatic)

21

Which antineoplastic drug's cytotoxins bind with DNA to inhibit cell division, both non cell specific and cell cycle specific. Inhibits DNA and RNA synthesis

Antibiotics

22

Name 5 antineoplastic antibiotics discussed in class

1. bleomycin - G2, M
2. docorubicin - S
3. dactinomycin
4. mitoantrone - affects entire cell cycle
5. mitomycin - G, S

23

which antineoplastic drugs are an angiogenesis inhibitors, immunosuppressant, and TNF blocking agent?

thalidomide (Thalomid)

24

Which antineoplastic drugs interfere with cell proliferation and are relatively selective against cancer cells?

Chemo - cancer cells are most sensitive to these drugs when the cells are actively going through cell cycle

25

___: DNA damage is sensed by molecules that arrest the cell cycle to allow time for the damage to be repaired

p53

26

transcription factor that regulates the cell cycle =

tumor suppressor, activates DNA repair proteins

27

How does tumor suppressor transcription factor work?

holds cell cycle at G1/S regulation point so that DNA repair proteins will fix damage, then cell is allowed to continue its cycle.
It can also initiate apoptosis if damage is irreparable

28

3 stresses that can induce tumor suppressor factor

1. UV
2. oncogenes
3. DNA damage

29

Name 3 cancers that express p53 therefore are highly responsive to chemo?

1. leukemias
2. lymphomas
3. testicular

30

Name 3 cancers that acquire a mutation in p53 therefore are minimally responsive or resistant to chemo

1. pancreatic
2. lung
3. liver

31

T/F multiple cycles of chemo must be give at the highest tolerable dose with the most frequent tolerable interval to achieve a cure

True

32

___ tumor site will respond better to chemo then ____ site.

Parent
Metastatic

33

_____: Current emphasis, acts on different molecular targets at different phases of the cell cycle with different dose limiting toxicities

combo chemo - reduces emergence of drug resistance, some regimens offer synergistic benefits, increases efficacy, and typically used intermittent dosing.

34

which antineoplastic drugs causes red urine as a side effect?

daunorubicin hydrochloride (antibiotic)

35

which antineoplastic drug causes nephrotoxicity, myelosuppression, neurotoxicity, ototoxicity, and nausea/vomiting?

platinum derived compounds

36

which antineoplastic drug increases susceptibility to infection?

alkylating agents

37

which antineoplastic drug's side effects include uterine cancer, stroke, pulmonary emboli, liver problems, osteoporosis?

tamoxifen (hormone)

38

which antineoplastic drug increases risk for pulmonary fibrosis/pneumonia?

bleomycin (antibiotic)

39

which antineoplastic drug causes oral mucosal lesions and diarrhea?

datinomycin (antibiotic)

40

Name 7 side effects of chemo

1. suppression of bone marrow (immunosuppression/fatigue)
2. GI problems
3. Dermatological (skin lesions/alopecia)
4. Hepatotoxicity (enzyme induction or inhibition of P450)
5. Neurotoxicity (paresthesias, hearing/vision/hormones)
6. Nephrotoxicity (hyperuricemia/altered drug clearance)
7. Infertility

41

Recommended management for oral complications of chemo

1. good plaque control
2. pain control (topical anesthetics)
3. salivary replacement for xerostomia
4. fluorides due to caries risk
5. antifungals
6. antivirals
7. antimicrobial mouth rinses