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Oral Medicine- Cancer > Pharmacology > Flashcards

Pharmacology Flashcards

(76 cards)

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1
Q

Chemo: Name two indications

A
  1. Used primarily for organ preservation in advanced disease
  2. May be used for palliative treatment or in combination with radiation therapy for post-operative high-risk cases
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2
Q

Chemo: Name three approaches to treatment

A
  1. Neoadjuvant therapy
  2. Adjuvant therapy
  3. Concurrent chemo+ radiation
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3
Q

Chemo: Define neoadjuvant therapy

A

Induction; chemo given before surgery or radiation

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4
Q

Chemo: Define Adjuvant Therapy

A

Chemo+ radiation simultaneously after surgery

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5
Q

Chemo: Adjuvant therapy is used when?

A

In high-risk patients to reduce metastatic burden

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6
Q

Chemo: Concurrent chemo + radiation if used for

A

Cure or organ preservation

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7
Q

What type of chemo is the standard of care for tumors in oropharynx

A

Concurrent chemo + radiation

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8
Q

Define Radiosensitizing effect

A

Chemo makes radiation more effective

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9
Q

Chemo: Three MOA

A
  1. Interfere with cell proliferation
  2. Relative selectivity against cancer cells
  3. Cancer cells are most sensitive to these drugs when the cells are actively going through the cell cycle
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10
Q

Chemo: Which types of cells are more susceptible to drugs that interfere with cell growth and division?

A

Metabolically active cells

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11
Q

Cancer: A single malignant cell can expand clonally to give rise to what?

A

A tumor

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12
Q

Cancer: What needs to happen to “cure” cancer?

A

Every malignant cell must be destroyed

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13
Q

Cancer: How is chemotherapy administered?

A

Multiple cycles of chemotherapy must be given at the highest tolerable dose with the most frequent tolerable interval to achieve a cure.

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14
Q

Cancer: Describe how chemo works with first-order kinetics

A

A constant fraction of tumor cells are killed with each cycle of chemo

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15
Q

What types of tumors do not respond well to chemo? Why?

A

Solid tumors; because they have slower growth/division of these cells

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16
Q

Solid Tumors: What do solid tumors often require in treatment?

A

Often require radiation and/or surgery as well

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17
Q

Solid Tumors: What is the justification for using combination drug therapy?

A

Resistance to chemotherapy drugs may develop

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18
Q

Combo Chemotherapy includes drugs that act on what?

A

Different molecular targets, at different phases of the cell cycle and with different dose-limiting toxicities

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19
Q

Combo Chemotherapy reduce the emergence of what?

A

Drug resistance

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20
Q

Combo Chemotherapy allows each individual drug to be given at its _____ tolerable dose

A

Highest

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21
Q

Combo Chemotherapy offers what types of benefits?

A

Synergistic benefits

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22
Q

Combo Chemotherapy is typically used as _____ dosing

A

Intermittent

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23
Q

What types of cancers require combo chemotherapy?

A 
Hodgkin's Disease
Testicular Cancer
Breast Cancer
Ovarian Cancer
Cervical Cancer
Bladder Cancer
Lung Cancer
Cancer of the head and neck
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24
Q

Drugs used to Treat Head and Neck Cancer:

Alkylating Agents Mechanism

A

Alkylate DNA, probably at guanine, as the primary mechanism for cell death.
Interfere with DNA, RNA and proteins to prevent cell metabolism and division.

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25
Drugs used to Treat Head and Neck Cancer: | Three types of alkylating agents
- Cisplatin - Carboplatin - Cyclophophamide
26
Drugs used to Treat Head and Neck Cancer: Cylophosphamide is an ____ agent and is used to treat what?
Alkylating agent | Multiple cancers, bone marrow transplants
27
Drugs used to Treat Head and Neck Cancer: Function of antimetabolites
Serve as fraudulent substrates for biochemical interactions; interfere with growth of rapidly prolferating cells
28
Drugs used to Treat Head and Neck Cancer: What are two examples of antimetabolites
Methotrexate and 5-fluorouracil
29
Drugs used to Treat Head and Neck Cancer: Methotrexiate is used to treat ____
Autoimmune diseases and multiple cancers
30
Drugs used to Treat Head and Neck Cancer: 5-fluorouracil is what type of analog
Pyrimidine analog
31
Drugs used to Treat Head and Neck Cancer: Alkyloids (Vinca) are derived from what?
Periwinkle plant (Vinca rosea)
32
Drugs used to Treat Head and Neck Cancer: Alkyloids MOA
Inhibit mitotic division by interfering with microtubular proteins involved in the formation of mitotic spindles
33
Drugs used to Treat Head and Neck Cancer: Alkyloids (Vinca) examples (2)
Vinblastine and vincristine
34
Drugs used to Treat Head and Neck Cancer: Alkyloids (Vinca) treat what two cancers
Hodgkin's Lymphoma and other lymphomas
35
Drugs used to Treat Head and Neck Cancer: What is a major side effect of Alkyloids that may cause hearing loss (ototoxic)
Neurotoxicity
36
Drugs used to Treat Head and Neck Cancer: Taxanes MOA
Inhibit DNA, RNA and protein synthesis; inteferes with mitotic phase (G2), inhibiting cell replication
37
Drugs used to Treat Head and Neck Cancer: Two examples of taxanes
Docetaxel and paclitaxel
38
Drugs used to Treat Head and Neck Cancer: Antibiotics are derivatives from
Streptomyces
39
Drugs used to Treat Head and Neck Cancer: Antibiotic MOA
Inhibits DNA, RNA and protein synthesis
40
Drugs used to Treat Head and Neck Cancer: Antibiotics are most effective for
Solid mass tumors
41
Drugs used to Treat Head and Neck Cancer: Antibiotics Examples (3)
Bleomycin Doxorubicin Mitomycin
42
Chemo: Define Biological therapy
Uses substances made from living organisms to treat cancer
43
Chemo: What does it mean when Tumor-infiltrating lymphocytes are found in and around tumors?
It is a sign that the immune system is responding to the tumor
44
Chemo: How does a patient's tumor respond when it has TILs around it?
Better than peole whose tumors don't contain them
45
Chemo: Monoclonal antibodies is a type of targeted therapy, which is a type of ______
Immunotherapy
46
Chemo: Monoclonal antibodies are ___ ____ proteins created in a lab
Immune system
47
Chemo: What do monoclonal antibodies do?
Mark cancer cells so that the immune system will better recognize and destroy them.
48
Chemo: What are two examples of monoclonal antibodies?
Rituximab and cetuximab
49
Chemo: What does rituximab do?
Binds to a protein called CD20 on B cells and some types of cancer cells
50
Chemo: Cetuximab is what type of inhibitor? What is it used for?
Epidermal Growth Factor Receptor Inhibitor; advanced or metastatic head and neck cancer
51
Chemo: How do monoclonal antibodies work for leukemia and lymphoma tx?
Bring t cells close to cancer cells, helping the immune cells kill the cancer cells
52
Chemo: Immune system modulators are a type of _______
Immunotherapy
53
Chemo: Immune system modulators are used to treat what types of cancers?
Advanced cancers
54
Chemo: What are two examples of immune system modulators?
Cytokines and hematopoietic growrth factors
55
Chemo: What are three examples of cytokines?
Interferons and interleukins
56
Chemo: Interferons activate
Natural killer cells
57
Chemo: Interleukin function
T cell growth factor; boosts the number of WBCs
58
Chemo: Hematopoietic growth factors function
Cytokines that are used to reduce side effects from cancer treatment
59
Chemo: What are three examples of Hematopoietic growth factors
Erythropoietin, IL-11 and GM-CSF/G-CSF
60
Chemo: Erythropoietin function
Increases production of red blood cells
61
Chemo: IL-11 function
Increases the production of platelets
62
Chemo: Immunomodulatory drugs are ____ ____ modifiers
Biological response
63
Chemo: Immunomodulatory drugs stimulate the immune system by doing what two things
1. Cause cells to release IL-2 | 2. Angiogenesis inhibitors
64
Chemo: Angiogenesis inhibitors function
Stop growth of blood vessels; cuts of blood supply to tumors
65
Chemo: Immunomodulatory drugs example
Thalidomide
66
Describe why chemo drugs have a low therapeutic index
Lack of specificity -> affect malignant cells as well as rapid but normally proliferating cells
67
What types of healthy tissues does chemo affect?
Bone marrow, skin and intestinal mucosa
68
Where do signs of chemo toxicity appear?
Blood dyscrasias Ulcerations of oral mucosa and other sites in GI tract Nausea/vomiting
69
Symptoms of chemo toxicity: | Supression of bone marrow (blood dyscrasias) symtpoms
Fatigue, immunosupression, infection susceptibility, thrombocytopenia
70
Symptoms of chemo toxicity: GI disturbances symptoms
Nausea, vomiting, diarrhea Dehydration and electrolyte imbalances Changes in gut flora
71
Symptoms of chemo toxicity: Dermatological reaction symptoms
Skin lesions, ulcerations | Hair loss
72
Symptoms of chemo toxicity: Hepatoxocity symptoms
Enzymatic induction or inhibition via P450 en zymes
73
Systemic Effects of Chemo: Describe neurotoxicity symptoms
Parasthesia, reduced gastric motility alteration in hormone release, hearing/vestibular disorders
74
Symptoms of chemo toxicity: Nephrotoxicity symptoms
Hyperurecemia from excess cell destruction and byproducts | Altered drug renal clearance
75
Oral Mucositis develops how quickly after tx? When does it subside?
7 to 14 days after chemo and when lowest WBC. | Subsides 1-2 weeks after chemo ends
76
Chemo: Secondary infections occur when WBC is below
2000

Oral Medicine- Cancer (8 decks)

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