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pharm final

cancer drugs

QuestionAnswer
what is cancer large group of diseases characterized by the uncontrolled cellular growth
define neoplasm new growth of tissue that serves no physiological function
define tumor clumping of neoplasmic cells
define malignant cancerous
define benign noncancerous
external factors causing cancer chemicals, radiation, viruses, lifestyle
internal factors causing cacner hormones, immune conditions, inherited mutations
how gene mutations cause cancer disruption of RNA/DNA within normal cells; produce cells that differ in form, quality and function
2 physiologic events that cause cancer abnormal activation of genes that regulate cell growth; lack of tumor-suppressor gene
reproduce in response to need for tissue growth/repair normal cells
stop reproduction when need is met normal cells
apoptosis normal cells
well differentiated in appearance and function normal cells
have characteristic lifespan normal cells
persistent proliferation (endless division) neoplastic cells
decreased cellular differentiation neoplastic cells
invasive growth neoplastic cells
formation of metastases neoplastic cells
neoplasms classification hematologic malignancies, solid neoplasms
What neoplasm classification is liquid hematologic malignancies
What tissues do hematologic malignancies invade bone marrow and lymphoid tissue
3 cancers that are hematologic malignancies leukemias, lymphomas, multiple myeloma
leukemia hematologic malignancies
lymphoma hematologic malignancies
multiple myeloma hematologic malignancies
carcinomas solid neoplasms
what tissue do carcinomas affect epithelial tissue
what tissue do sarcomas affect connective tissue
sarcoma solid neoplasm
define chemotherapy use of medications to treat cancer rather than surgery/radiation
purpose of chemotherapy kill, damage, or slow growth of cancer cells and prevent/treat adverse effects
problem with chemotherapy kills normal cells also
Most chemotherapy regimens involve... combination of drugs with differing cellular action
What is a major problem with chemotherapy drugs drug resistance
adjuvant chemotherapy treatment strategy short course of high-dose after radiation or surgery to destroy residual cell; prevent recurrence
neoadjuvant chemotherapy treatment strategies prior to surgery, radiation to shrink tumor and improve outcome
palliative chemotherapy treatment strategies control symptoms, comfort, improve quality of life if cure is not achieveable
salvage chemotherapy treatment strategies potentially curative high dose for recurrence or treatment failure
induction chemotherapy treatment strategies high-dose give to induce complete response or cure (1st part = early on)
consolidation chemotherapy treatment strategies after remission, increase probability of cure or survival "moping things up"
intensification chemotherapy treatment strategies after remission, high doses or different drug to improve chances of cure or remission "just in case"
maintenance treatment strategy low dose in remission
What chemotherapy strategy occurs most often combination chemotherapy
combination chemotherapy suppress drug resistance, increase cancer kill, reduce injury to normal cells
delivery of chemotherapy IV; intra-arterial; intrathecal; oral
what treatment would liquid cancer be given more likely have chemo
what treatment would solid cancer be given radiation
What to consider before giving antineoplastic drugs age, functional status, nutritional status, blood count, kidney and liver function
What doses of antineoplastic drugs are usually most effective high doses
antineoplastic drug doses are usually calculated according to.. body surface area
Why would antineoplastic drugs be reduced? for impairments that reduce the ability to eliminate medicaitons
2 factors contributing to responsiveness to chemotherapy cell cycle, growth fraction
another name for growth fraction proliferating
What tissues are chemotherapeutic drugs more toxic to tissues that have high growth fraction
What tissues in the body have high growth fractions lining of intestine, hair, skin
Why is chemo not effective for solid tumors low growth fraction
What cancers have high growth fractions and respond well to chemo disseminated cancers
obstacles to successful chemotherapy toxicity to normal cells; absence of truly early detection; solid tumors respond poorly; heterogeneity of tumor cells; drug resistance
why is toxicity to normal cells an obstacle to successful chemotherpy cure requires 100% cell kill; not sure when to stop medicaitons = not sure when you get down to 1-cell tumor
Why is there an absence of truly early detection of cancer? symptoms do not appear until tumors grow larger
Why are solid tumors poor responders to chemotherapy low growth fraction; blood vessels carrying drugs can not reach tumor
3 adjectives to describe cytotoxic antineoplastic medications carcinogenic, mutagenic, teratogenic
Parenteral solutions of cytotoxic antineoplastics have what effect on the skin irritating to skin/mucous membranes;
What should you avoid with cytotoxic antineoplasctics direct contact with skin or respiratory tract
Will you administer cytotoxic antineoplastics as a student? no; only monitor patients receiving antineoplastics
define vesicants damage subcutaneous area by infiltration, causes "blisters"
4 groups of cancer chemotherapy drugs cell cycle specific and non-specific agents; biologic targeted therapies (cytotoxic); hormone inhibitors (noncytotoxic); medicaitons that reduce adverse effects of cytotoxic medications
What do cell cycle specific S phase antimetabolites minimic purines, pyrimidines, and folates
What happens at the S phase of the cell cycle where DNA synthesis occurs
cell cycle specific: S phase antimetabolite prototype methotrexate (MTX)
What kind of antimetabolite is methotrexate (MTX) folate antimetabolite
What does methotrexate do works on RNA/DNA; need B12 to make RNA (folate)
What kind of antimetabolite is 5-fluouracil (5FU) pyrimidine antagonist
What medication is the rescue for S phase antimetabolites Leucovorin rescue (folic acid supply)
What does Leucovorin do? rescues cells and goes back to normal (folic acid supply)
What do cell cycle specific: G2 phase medications do inhibit cell division
What cancer drugs act where DNA synthesis occurs cell cycle specific: S phase antimetabolites
What cancer drugs inhibit cell division cell cycle specific: G2 phase
Cell cycle specific: G2 phase prototype paclitaxel (Taxol)
paclitaxel (Taxol) cell cycle specific: G2 phase
What cancer drugs work where spindles occur/cell division cell cycle specific: M phase mitotic inhibitors
What do cell cycle specific: M phase drugs do? interfere with mitotic spindles, causing metaphase arrest
Vincristine (Oncovin) cell cycle specific: M phase mitotic inhibitor
vinblastine (Velban) cell cycle specific: M phase mitotic inhibitor
Why are cell cycle specific: m phase mitotic inhibitors dose limiting they are neurotoxic
symtpoms of neurotoxicity seen in cell cycle specific: m phase mitotic inhibitors numbness, loss of reflexes, weakness
vinca alkaloids cell cycle specific: m phase mitotic inhibitors from periwinkle flower
how do cell cycle nonspecific: alkylating agents work attack cell in any cycle phase: transfer alkyl group to cell nucleotides - cannot replicate
adjective describing cell cycle nonspecific: alkylating agents radiomimetic
define radiomimetic mimic action of radiation on cells
what cancer drugs are radiomimetic cell cycle nonspecific: alkylating agents
cell cycle nonspecific: alkylating agent prototype cyclophosphamide (Cytoxin)
cyclophosphamide (Cytoxin) cell cycle nonspecific: alkylating agent
What major role do cell cycle nonspecific: alkylating agents have in cancer treatment hematologic: Hodgkin's myeloma, acute and chronic leukemia
drugs to treat Hodgkin's myeloma cell cycle nonspecific: alkylating agents
drugs to treat acute and chronic leukemia cell cycle nonspecific: alkylating agents
Why are cell cycle nonspecific: alkylating agents dose limiting leukopenia
2 adjectives descriging cell cycle nonspecific: nitrosoureas alkalyting and cyctotoxic
distribution of cell cycle nonspecific: nitrosoureas crosses blood-brain barrier
What cancers are cell cycle nonspecific: nitrosoureas used for cancers of the CNS
cell cycle nonspecific: nitrosoureas prototype carmustine (BCNU)
Kinetics of carmustine (BCNU) - cell cycle nonspecific: nitrosoureas soft discs contain medications are placed in body and dissolve over time
physiologic effect of cell cycle nonspecific: nitrosoureas delayed bone marrow suppression (6 weeks)
What cancers are cell cycle nonspecific: platinum compounds used for testicular cancer
cell cycle nonspecific: platinum compounds prototype cisplantin (Platinol-AZ)
cisplantin (Platinol-AZ) cell cycle nonspecific: platinum compound
adjective of cell cycle nonspecific: platinum compounds highly emetogenic; vomiting withing 1 hour
What medication is given before the administration of cell cycle nonspecific: platinum compounds phenergan due to vomiting
What are cell cycle nonspecific: antitumor antibiotics derived from various streptomyces
How do cell cycle nonspecific: antitumor antibiotics fight cancer interfere with DNA directed RNA; prevent normal duplication and separation
"Red devil" doxorubicin hcl (Adriamycin)
cell cycle nonspecific: antitumor antibiotic prototype doxorubicin hcl (Adriamycin)
doxorubicin hcl (Adriamycin) cell cycle nonspecific: antitumor antibiotic
2 side effects from cell cycle nonspecific: antitumor antibiotics cardiotoxicity; vesicants
How do cell nonspecific: hormones and hormone antagonists fight cancer block or antagonize the naturally occurring substances that stimulate tumor growth
cell nonspecific: hormones and hormone antagonist prototype Tomoxifen (Nolvadex)
Tomoxifen (Nolvadex) cell nonspecific: hormones and hormone antagonist selective estrogen receptor
What medication is used with breast cancer tomoxifen (Nolvadex)
gonadotropin-releasing hormone analogue leuprolide (Lupron)
what medication is used with prostate cancer leuprolide (Lupron)
What is a result of bone marrow suppression from cancer drug toxicities decreased RBCs, neutropenia thrombocytopenia
illness occurring with decreased RBCs anemia, fatigue
illness occurring with neutropenia infection
illness occurring with thrombocytopenia bleeding
Treatment of anemia from bone marrow suppression with cancer drugs transfusion or epoetin
role of epogen in cancer treatment recombinant human erythropoien that stimulates RBC production
Kinetics of epogen subcutaneous 2-3 times per week
What must you use along with epogen to treat anemia from bone marrow suppression with cancer drugs supplemental iron
Most serious complication of bone marrow suppression with cancer drugs neutropenia
Onset of neutropenia after administration of cancer drugs 10-14 days
How long does it take a patient to recover from neutropenia after administration of cancer drugs 3-4 weeks
define nadir when WBC are lowest in body = don't have defense against infection
When is nadir reached 10-14 days after administration
Nursing implications during nadir period monitor for fever, culture and sensitivity
teaching for nadir period avoid direct contact with people; avoid salads
what is given during the nadir period granulocyte colong-stimulating factor (GCSF-filgrastim)
reason for giving Neupogen increase neutrophils during nadir
when is the most critical point during chemo administration 2 weeks after given chemo
When can a second round of chemo be administered not until WBC are at a safe level
oral side effects of chemo teeth diminish; ulcers are in mouth
Thrombocytopenia is a disorder of what cell platelets
Teaching with thrombocytopenia soft tooth brush; avoid aspirin/anticoagulants; acetaminophen; caution with BP cuff
What is administered to patients with thrombocytopenia from cancer drugs Neumega (platelet oprelevkin interleukin-11)
role of Neumega (platelet oprelevkin interleukin-11) stimulate platelet production; response 5-7 days
digestive tract injuries from cancer medication stomatitis; diarrhea; nausea; vomiting; premedicate with antiemetic
When is maximal hair loss seen with cancer medication administration 1-2 months
when does alopecia begin with cancer medication administration 7-10 days after receiving chemo
Do all chemotherapies cause alopecia no
why do cancer patients do sperm banking/egg preservation reproductive toxicity
Why would cancer patients need Allopurinol hyperuricemia - uric acid in blood - breakdown of DNA - injury to kidneys - crystal formation
Why must chemo patients push fluids flush uric acid out
Created by: 1818554924