Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
dental pharm
antineoplastic drugs & cancer therapy
| Question | Answer |
|---|---|
| what is cancer? | the rapid, abnormal division of atypical cells into neoplasms, tumors that take over an area and are capable of relocating, metastasizing, and growing into a remote location |
| apoptosis | programmed, natural cell death (good) |
| angiogenesis | creation of new blood vessels=spread tumor cells (bad) |
| chemotherapy | goal=to kill every viable tumor cell. directed at rapidly multiplying cells-not tumor specific so they kill ALL rapidly dividing cells-bone marrow, hair follicles, oral & intestinal mucosal cells (literally=controlled poisoning of pt) |
| cell cycle: | S(DNA synthesis)-->G2 (premitotic)--> M(pro,meta,ana,telo)-->G1 (preparing for cell divison)-->G0 (resting phase) |
| when is chemotherapy most effective? | in actively and rapidly dividing tumors-not so efficacious in slow growing (most cells in G0 phase)like lung,colon cancer |
| alkylating agents | react with DNA,RNA,and proteins essential for cell divison.Cause cell death only when cell tries to divide.Leads to suppression of bone marrow,immune suppression,increased infections common |
| Nitrogen Mustard | Alkylating agent-among 1st agents used |
| Busulfan | Alkylating agent-anti-leukemia agent |
| Nitrosureas | Alkylating agent-brain and GI neoplasms |
| antimetabolites | resemble folic acid (essential vit. critical to formation of purines, & nucleic acids),purine and pyrimidine bases, and certain coenzymes |
| Folic acid analogue | Methotrexate-widely used anticancer, rheumatoid arthritis, debilitating psoriasis. Can induce severe mucositis, bone marrow depression, extreme GI discomfort, bleeding. Points to newer uses in autoimmune diseases |
| vinka alkaloids | Found to limit cell divison and cure lymphomas. Although natural cause, same side effects (from the vinca rosa shrub) |
| antibiotics | products of strep bacteria-inhibit cell division by binding with DNA |
| what are interferons and interleukins effective in? | certain cancers by augmenting the immune,antuproliferative response, and actions of nautral defense cells in the body |
| what are interferon alpha and interleukin 2 used? | in melanomas, some leukemias, and Kaposi's sarcoma |
| oral complications due to cancer therapy: | oral mucositis, salivary gland dysfunction, neurotoxicity, and infection |
| oral mucositis | =most frequent complaint-inflammation and breakdown of oral mucosa:erythema w/ or w/o ulcerations |
| causes of oral mucositis: | direct damage of chemo drug; emesis (throw-up) induces harmful acid to mucosa; normal physical trauma may be too much for compromised surface; abnormal and slow healing |
| management of oral mucositis: | -bland rinses(Saline soln-q 15min to 4h)-topical anesthetics(viscous lidocaine sprays,benzocaine sprays/gels, diphenhydramine rinses)-mucosal coating agents (kaopectate soln; zilactin=lidocaine+film forming agent)-systemic agents(opiods, NOT NSAID) |
| salivary gland dysfunction | irreversible w/ radiation, reversible w/ chemo |
| management of salivary gland dysfunction | frequent rinses w/ saline, saliva substitutes, sugarless gum/candy, "supping" on H2O continuously, bethanecol, cevimeline, pilocarpine |
| neuroroxicity | leads to severe, deep-seated throbbing pain that mimics dental pathology; dysguesia=taste change; TMJ disorders nay present due to sleep disruption, stress of tx |
| management of neurotoxicity | must eliminate possiblilty of actual dental problem; palliative |
| infection | immunosuppression & compromised mucosa leads to easier/more infections from normal flora and frequent candidal infections |
| management of infections | Oral hygiene practices, antibacterial rinses, prechemotherapy preps |
| radiation therapy complications | same complaints-more extensive and lasting problems; loss of salivary leads to change in flora (more S.mutans, lactobacillus) and higher caries incidence; topical fl; soft tissue and osteoradionecrosis |
| what are the tx strategies for immunotherapy? | augmentation (vaccines) or suppression (useful in oragn transplants,grafts, or autoimmune diseases) |
| immune stimulation-cell mediated immunity | in absence or deficiency of the thymus could implant immature fetal thymus to take over function in generalized cell mediated response; thymic extracts of calf thymus for specific disease states; levamisole (Ergamisol)-used for colorectal cancers, crohns |
| levamisole | Ergamisol-used for colorectal cancers, crohn's disease |
| immune stimulation-humoral immunity | (PASSIVE)due to congenital or aquired lack of certain immunoglobins.One means of tx=regular replacement therapy(passive immunity); antitoxins or antivenoms from active immunity in horses against snake bites or diphtheria |
| immunosupression | (ACTIVE)most often used and most successful in organ or tissue transplants; cyclosporin (Restasis) |
| cyclosporin | Restasis-used in organ transplants. bLocks interleukins and stops macrophages to prevent immune effect. Side effects=renal toxicity or hypertension. ALso useful vs. oral lichen planus (immunosupression) |
| tacrolimus | Prograf-macrolide antibiotic that works like cyclosporin, except 100x stronger (immunosuppression) |
| glucorticoids | Prednisone or Dexamethasone (immunosuppression) |
| cytotoxic drugs | kills lymphocytes and interferes w/ cell proliferation (immunosuppression) |
| cyclophosphamide | Cytoxan-developed for cancer therapy. Used now for autoimmune disease (immunosuppression) |
| interferon beta 1b | Betaseron-used in tx of relapsing/remitting cases of multiple sclerosis.Most effective during pds of acute breakdown.Many side effects. Most commonly flu-like symptoms w/ start of therapy (immunosuppression) |
Created by:
kendall7
Popular Pharmacology sets