Exam 3: Antineoplastic agents pt. 2

Question 1

Explain what Platinum complexes are and their action

Answer 1

• Platinum ions surrounded by chloride ions
• (B) Inhibit DNA synthesis and repair
  
  • Induces cell death via apoptosis or necrosis

Question 2

Name the drugs considered Platinum complexes and what cancers they treat

Answer 2

1. (B) carboplatin (Paraplatin)
   a. Small-cell lung cancer, ovarian cancer, head and neck cancer
2. (B) cisplatin (Platinol)
   a. Bladder, testicular, ovarian, head and neck cancer
3. Oxaliplatin (Eloxatin)
   a. Advanced colon and advanced rectal cancer

Question 3

Platinum based chemotherapy is widely used for the treatment of what cancers?

Answer 3

1. Gynecologic
2. Bladder
3. Testicular (metastatic disease)
4. Lung
5. Central nervous system
6. Head and Neck cancers (Squamous cell)

Question 4

List the Platinum-derived compound toxicities

Answer 4

• Myelosuppression
• Nephrotoxicity
• Neurotoxicity
• Ototoxicity
• Nausea/vomiting

Question 5

Which chemotherapy drug is derived from periwinkle plant?

Answer 5

Vinca Alkyloids

Question 6

Action of Vinca Alkyloids

Answer 6

(B) Inhibit mitotic division by interfering with microtubular proteins involved in the formation of mitotic spindles

Question 7

Are Vinca Alkyloids cell-cycle specific or non-specific?

Answer 7

• Cell Cycle Specific

- (B) **M and S phases

Question 8

Name the drugs considered Vinca Alkyloids

Answer 8

1. (B) Vinblastine (Valban)

2. (B) Vincristine (Oncovin)

Question 9

What cancers are treated with vinca alkyloids?

Answer 9

• Hodgkin’s lymphoma, other lymphomas
• Breast cancer
• Testicular cancer
• Kaposi’s sarcoma

Question 10

Are there side effects with vinca alkyloids?

Answer 10

• Yes, high incidence of side effects

- Neurotoxicity = may cause hearing loss (ototoxic)

Question 11

Are Hormonal Agents cell-cycle specific or non-specific?

Answer 11

• Cell-cycle specific

- **G phase interruption

Question 12

Name the hormonal agents used for chemotherapy?

Answer 12

1. Estrogens
2. Androgens
3. Progestins
4. Glucocorticoids
5. antiestrogens

Question 13

What cancers do Estrogens treat?

Answer 13

Prostate and mammary CA

Question 14

Name the estrogen preparations used in chemotherapy

Answer 14

ethinyl estradiol (Estinyl, Feminone)

Question 15

What cancers do Androgens treat

Answer 15

Mammary CA in premenopausal women

Question 16

Name the Androgen preparations used in chemotherapy

Answer 16

1. testosterone proprionate (Testrx)

2. fluoxymesterone (Halotestin)

Question 17

What cancers do Progestins treat

Answer 17

renal and endometrial CA

Question 18

Name the Progestin preparations used in chemotherapy

Answer 18

1. medroxyprogesterone (Depo-Provera)

2. megestrol (Megace)

Question 19

What cancers do Glucocorticoids treat?

Answer 19

hematologic
lymphomas
bone metastases
immunosuppression for organ transplantation

Question 20

Name the glucocorticoid preparations used in chemotherapy

Answer 20

Prednisone (Prednisone Intensol, Sterapred)

Question 21

Explain the anti tumor effects of glucocorticoids

Answer 21

These effects may be related to inhibition of glucose transport, phosphorylation, or induction of cell death in immature lymphocytes

Question 22

What cancers does tamoxifen (Nolvadex) treat

Answer 22

(It is an anti estrogen)

- Breast CA treatment and prevention

Question 23

Describe the mechanism of action of tamoxifen (Nolvadex)

Answer 23

• Competitively binds to estrogen receptors on tumors and other target tissues
• Decreases DNA synthesis and inhibits estrogen effects

Question 24

Is tamoxifen cell-cycle specific or non-specific?

Answer 24

Cell-cycle specific

- **G0 and G1 phases

Question 25

Is tamoxifen cytocidal or cytostatic?

Answer 25

Cytostatic

Question 26

Name the adverse effects of tamoxifen

Answer 26

``` Uterine cancer stroke pulmonary emboli liver problems osteoporosis ```

Question 27

Describe the function of Antibiotics in chemotherapy

Answer 27

Cytotoxins bind with DNA to inhibit cell division

Question 28

Are antibiotics cell-cycle specific or non-specific

Answer 28

Attack cells in different phases - Non-cell cycle specific - Cell cycle specific

Question 29

Antibiotics are most effective for what cancers?

Answer 29

Solid mass tumors

Question 30

Name the selected agents used to treat chemotherapy classified as antibiotics

Answer 30

1. bleomycin (Blenoxane) 2. doxorubicin (Adriamycin) 3. daunorubicin citrate (DaunoXome)

Question 31

What cancers does bleomycin treat?

Answer 31

Squamous cell CA Testicular tumor Lymphomas

Question 32

Is bleomycin cell-cycle specific or non-specific

Answer 32

Cell cycle specific | - *** G2, M phases

Question 33

doxorubican treats what cancers?

Answer 33

Kaposi's sarcoma, advanced breast and ovarian CA

Question 34

mechanism of action for doxorubicin (Adriamycin)

Answer 34

inhibit DNA and RNA synthesis

Question 35

Is doxorubicin (Adriamycin) cell-cycle specific or non-specific

Answer 35

Cell cycle specific | - S phase

Question 36

daunorubicin citrate (DaunoXome) treats what cancers?

Answer 36

*** (B) HIV-associated Kaposi's Sarcoma

Question 37

Action of thalidomide (Thalomid)

Answer 37

Angiogenesis inhibitor Immunosuppresant TNF blocking agent (multiple mechanisms of action)

Question 38

Indications for thalidomide

Answer 38

- Leprosy - Investigational for: - (B) Multiple myeloma - Crohn's disease - graft versus host disease - (B) AIDS-related aphthous lesions

Question 39

thalidomide is famous for what fact from it's history?

Answer 39

Drug from 1950's for morning sickness, sedation | = All first generation offspring had major limb defects

Question 40

thalidomide is the classic model drug for what?

Answer 40

teratogenesis

Question 41

Systemic effects of chemotherapy

Answer 41

1. Suppression of bone marrow 2. GI disturbances 3. Dermatological reactions 4. Hepatotoxicity 5. Neurotoxicity 6. Nephrotoxicity 7. Immune deficiencies 8. Infertility

Question 42

Name the oral manifestations of Chemotherapy

Answer 42

1. Oral complications cause great discomfort 2. Interfere with eating, drinking, swallowing, talking, etc. 3. Painful 4. Secondary infection risk concern