week 12 pharm

Question 1

what are the three main approaches to treat cancer

Answer 1

surgery, radiation, and drug therapy

Question 2

what does a disseminated cancer mean

Answer 2

dissemination enables the spread of cancer from its original site,
a disseminated cancer is a cancer that has metasteseizesd

Question 3

what is the cell cycle of cancer

Answer 3

G1: growth
S: DNA synthesis
G2: prep for mitosis
M: actual mitosis and cell division

Question 4

what is growth fraction
what effect does it have on chemo

Answer 4

tissues will either have cells that actively proliferate or cells that rest in G0 phase.
tissues with active poliferation will have a high growth fraction

high growth fraction = more vulnerable to chemo

Question 5

which tissues have a high growth fraction

Answer 5

bone marrow, GI epithelium, Hair, sperm

Question 6

what are the 4 maim barriers to chemo successs

Answer 6

-it is impossible to tell if you’ve killed all the cancer
-cancers can develop resistance
-its impossible to kill every malignant cell
-you cannot target cancer cells so you have to also kill healthy cells

Question 7

what are the 4 main strategies for demo success

Answer 7

• intermittent periods of therapy
• combination therapy
• optimize dosing schedules
• regional drug therapyw

Question 8

what are the benefits to combination drug therapy for chemo

Answer 8

• reduces chance of resistance
• increases overall cell killing
• reduced toxicity to normal cells

Question 9

what is neutropenia

Answer 9

low white blood cells (v high risk for infection)

Question 10

what are three issues with bone marrow suppression

Answer 10

neutropenia, thrombocytopenia, anemia

Question 11

what are the three hematopoetic growth factors

Answer 11

erythropoietic growth factors
leukopoeitic growth factors (filgrastim)
thrombopoetic growth factors (oprelvekin)

Question 12

which hematopoetic growth factor should you only give to palliative patients

Answer 12

erythropoietin

Question 13

why cant you give PO erythropoietin

Answer 13

because it degrades digestive tract

Question 14

what is filgrastim

Answer 14

leukopoeitic growth factor that stimulates neutrophils

Question 15

which type of cancer can you not give filgrastim with

Answer 15

bone marrow cancer

Question 16

what is oprelvekin

Answer 16

thrombopoeitic growth factor

Question 17

which type of cancer should you never give with oprelvekin

Answer 17

myeloid cancer

Question 18

what are some adverse effects of erythropoietin

Answer 18

makes blood more coagulable which can increase his of stroke, MI, and DVT

Question 19

which hematopoetic growth factor can only be subcut

Answer 19

oprelvekin

Question 20

what are the 3 GI issues caused by chemo

Answer 20

stomatitis
diarrhea
N/V

Question 21

what is stomatitis

Answer 21

basically its inflammation of oral mucosa that can lead to infection and canker sores

Question 22

how long after chemo would you see stomatitis

Answer 22

2-3 days after

Question 23

why does chemo cause diarrhoea

Answer 23

due to destruction of epithelial lining of intestine

Question 24

why does chemo cause nausea and vomiting

Answer 24

because it directly stimulates the chemoreceptor trigger zone (remember vomiting pathways)

Question 25

what are the three types of nausea d/t chemo

Answer 25

• anticipatory
• acute
• delayed

Question 26

what drugs do patients usually take for chemo induced N/V and when do they take them

Answer 26

dexamethasone + ondansetron and they’ll take it 30 mins before chemo dose

Question 27

when will you see alopecia after first chemo dose

Answer 27

7-10 days after start of treatment

Question 28

when will alopecia usually peak d/t chemo

Answer 28

1-2 months after start of treatment

Question 29

when will hair grow back after chemo

Answer 29

1-2 months after treatment ends

Question 30

how does chemo affect reproduction in women

Answer 30

may cause amenorrhea and menopause symptoms

Question 31

what is extravasation

Answer 31

leakage of a drug from blood to surrounding tissues

Question 32

what is a vesicant

Answer 32

a cytotoxic drug that is very chemically reactive

Question 33

how can you reduce risk for injury from extravasation

Answer 33

using a central line

Question 34

what are some early signs and symptoms of extravasation with chemo

Answer 34

redness, swelling, and blisters around site

Question 35

why does chemo cause carcinogenesis

Answer 35

because they damage DNA which can promote cancer to develop

Question 36

which cytotoxic cancer drug is most likely to cause carcinogenesis

Answer 36

alkylating agents like cyclophosphamide