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Pharmacology drugs 3
Onco (chemotherapy)
| Question | Answer |
|---|---|
| What is a systemic chemotherapy drug? | Treatment aimed at micrometastases or system neoplastic disease |
| what is a localized chemotherapy drug? | Does not treat area beyond primar tumor site |
| what are two forms of localized chemotherapy? | surgery and external beam radiation |
| Why would you use radiation therapy over surgery? | if the tumor is too big to initially remove, shirnk it with radiation and then at least life is more comfortable for animal. then can possibly surgically remove |
| What is a primary chemotherapy drug? | main treatment for the disease Ex.) chemotherapy to treat lymphoma |
| what is an adjuvant chemotherapy drug? | a drug used on top of something else (secondary) Ex- treat bone cancer with something else then come back around with chemo |
| what is a neoadjuvant chemotherapy drug? | it's a seconday drug that is used first. Ex.) give chemotherapy before amputation surgery |
| what is induction in reference to chemo? | first treatment to induce remission |
| what is maintenance in reference to chemo? | continued therapy after remission is achieved |
| what is rescue in reference to chemo? | subsequent treatment aimed at re-inducing remission |
| what are the two FDA approved immunotherapy drugs? | acemanann canine melanoma vaccine |
| how does the canine melanoma vaccine work? | DOES NOT PREVENT!!! Just helps fight existing cancer Receptor that is species specific (tyrosinase); give a human receptor to dog in order to stimulate immune system to attack cancer cells |
| what was the first FDA approved chemotherapy drug for veterinary medicine? | Toceranib= palladia |
| what is toceranib/palladia? what type of tumors does toceranib/palladia target? | small molecule inhibitor drug targets mast cell tumors |
| what is another small molecule inhibitor drug? | Masitinib = Kinavet |
| what are the top three vitals to check before beginning a chemotherapy? | renal, bone marrow, cardiorespiratory |
| what complicating diseases should you keep in mind when evaluating a patient for chemotherapy? | endocrine disorders, infectious diseases (b/c dec immune sys), neurologic disorders, orthopaedic diseases |
| when administering a chemotherapy and the patient returns a week for a later for a checkup and the animal has severe anemia, what would you suspect? | GI bleeding, AIHA Anemia NOT due to chemo |
| What are some other possible causes for GI problems other than chemo? | pancreatitis, parvovirus |
| what is the equation for deteriming body surface area? | [(W^2/3)x k] / 100 k for 65# dogs= 1m^2 k for cats= 0.2-0.25m^2 |
| there are 4 basic concepts to consider when developing an approach to cancer therapy. what are they? | Gompertzian Growth Goldie-Coldman Hypothesis Skipper’s Log Kill Hypothesis Cell Cycle Kinetics |
| what are the basics of gompertzian crowth? | when a tumor begins to grow, gf is low and dt is short. by the time the tumor is detectable, mass has undergone 30 doublings and contains one billion cells. So, by time the tumor is noticable, it's pretty far progressed. Initiate chemotherapy early!!! |
| what are the basics of goldie-coldan hypothesis | tumor cells have a spontaneous mutation rate that could potentially confer resistance to treatment |
| which drugs are known to be affected by MDR? | actinomycin D, daunorubicin, doxorubicin, etoposide, mitomycin C, mitoxantrone, taxol, vinblastine, and vincristine |
| what are some mechanisms by which tumors employ MDR? | increased efflux (p-gp), decreased influx, increased detoxification of drug radicals (by glutathione), increased DNA repair |
| what are the basics of skippers log kill hypothesis? | a certain percentage of tumor cells are killed with each chemotherapy administration |
| what are the phases of the cell cycle? | G0= resting G1= RNA and protein synthesis (hrs-ds) S= DNA synthesis; 6-8hrs G2= RNA and protein synthesis; 2hrs M= mitosis 30-90min |
| which cell specific drug works during G1? | L-asparaginase |
| which cell specific drug(s)works during S? | Antimetabolites (5-FU, cytosine arabinoside, etc.) |
| which cell specific drug(s) work during G2? | Radiation and bleomycin |
| which cell specific drug(s) work during M? | vincristine, vinblastine, paclitaxel and bleomycin |
| which drugs work during G0 phase? | none; G0 is very chemotherapy resistant |
| which cell cycle phase is radio resistant? | S phase |
| what are the three most common side effects of chemotherapeutic drugs? | "BAG" Bone marrow suppression Alopecia GI effects |
| which hair coat type is most susceptible to alopecia and color changes in dogs? | curly haired coats |
| alkylating agents are cell cycle specific or non-specific? | cell cycle nonspecific |
| how do alkylating agents work? | cross-link DNA and prevent replication |
| what is the nitrogen mustard derivative chemotherapy drug? | mechlorethamine |
| what is mechlorethamine used to treat? | lymphoma |
| what is the trade name for chlorambucil? | leukeran |
| what is chlorambucil used as an alternative for? | cyclophosphamide |
| what is chlorambucil used to treat? | chronic lympocytic leukemia lymphoma |
| what is another name for cyclophosphamide? | cytoxan |
| T/F: the liver does not need to be functional in order for cyclophosphamide to work? | false; metabolized by liver so liver must be functional |
| what is the most common alkylating agent used for chemotherapy? | cyclophosphamide |
| what is a side effect of cyclophosphamide use that would require immediate stopage of this drug? | sterile hemorrhagic cystitis |
| what is another name for melphalan? | alkeran |
| what is melphalan used to treat? | multiple myeloma |
| what is another name of lomustine? | CCNU |
| what type of drug is lomustine? | nitrosurease |
| T/F: lomustine can be given orally or by IV? | false; oral only |
| what are the two major concerns of using lomustine? | thrombocytopenia and hepatotoxicity |
| What type of cancer can lomustine treat? | Brain tumors b/c crosses BBB |
| what are the alkylating agents? | Mechlorethamine Chlorambucil Cyclophosphamide Melphalan Lomustine |
| what are the antimetabolite drugs? | Cytosine arabinoside 5-Fluorouracil Gemcitabine Methotrexate Azathioprine |
| what are other names for cytosine arabinoside? | Cytosar-U or Ara-C |
| what type of cancer does cytosine arabinoside treat? | lymphoma, primarily renal |
| what is another name for 5-fluorouracil? | 5-FU |
| why can't you use 5-fluorouracil in cats? | nephrotoxicity |
| what is 5-FU used to treat and how? | Intracavitary or IV use for carcinomas |
| what is another name for Gemcitabine ? | Gemzar |
| Gemcitabine is hopeful to treat? | carcinomas |
| Methotrexate, use? | lymphoma and possibly oral SCC in cats |
| what are the contraindications of gemcitabine? | thrombocytopenia and retinal hemorrhage |
| what is another name for azathioprine? | imuran |
| what is imuran used for? | immunosuppressive |
| what are the antitumor drugs? | Doxorubicin Mitoxantrone Actinomycin D Bleomycin Idarubicin Epirubicin |
| what is 5-FU used to treat and how? | Intracavitary or IV use for carcinomas |
| what is another name for Gemcitabine ? | Gemzar |
| Gemcitabine is hopeful to treat? | carcinomas |
| Methotrexate, use? | lymphoma and possibly oral SCC in cats |
| what are the contraindications of gemcitabine? | thrombocytopenia and retinal hemorrhage |
| what is another name for azathioprine? | imuran |
| what is imuran used for? | immunosuppressive |
| what are the antitumor drugs? | Doxorubicin Mitoxantrone Actinomycin D Bleomycin Idarubicin Epirubicin |
| what is one of the most versitile chemotherapy drugs available to treat lymphoma and osteosarcoma? | Doxorubicin aka adriamycin |
| This chemotherapy drug is a terrible vesicant. | doxorubicin |
| chemotherapy drug found to be cardiotoxic in dogs and nephrotoxic in cats. | doxorubicin |
| this chemotherapy drug has similar action to doxorubicin, but has decreased cardiotoxicity, decreased tissue irritation and is more myelosuppressive | mitoxatrone aka novantrone |
| Vinca alkaloids used for chemotherapy act on which cell cycle phase? | M phase |
| which vinca alkaloids Inhibit microtubule formation | vincristine,vinblastine, VP-16 |
| which vinca alkaloids disrupt microtubule disassembly | taxol, paclitaxel |
| what is another name for vincristine? | oncovin |
| this vinca alkaloid causes peripheral neuropathy, Constipation, Increases platelet count (CBC >1,000,000) and is a vesicant | vincristine/oncovin |
| what is another name for vinblastin? | velban |
| this vinca alkaloid is myelosuppressive a vesicant, and used primarily to treat mast cell tumor in dogs. | vinblastin/velban |
| this newer vinca alkaloid may treat lung cancer | vinorelbine |
| what are the vinca alkaloid related drugs? | Etoposide (VP-16 (VePesid)) Taxol (paclitaxel) |
| the drug vehicle of this drug causes anaphylaxis | Etoposide (VP-16 (VePesid)) polysorbate 80 is the drug vehicle |
| the drug vehicle of this drug causes hypersensitivity reactions | Taxol (paclitaxel) Cremophor EL is the drug vehicle |
| which hormones are commonly used as chemotherapy agents? | prednisone, estrogen, testosterone, progesterone |
| L-Asparaginase (Elspar)is cell cycle specific for which phase? | G1 phase |
| how does L asparaginase work? | cleaves arginine, nucelic acid needed for protein synthesis |
| what is L-asparaginase derived from? | E. coli |
| what are some adverse reactions seen with L-asparaginase use? | hypersensitivity, pancreatitis |
| what forms of cancer is L-asparaginase most commonly used to treat | lymphoma, esp if bone marrow invovled |
| what is Dacarbazine (DTIC) used to treat? | melanoma |
| T/F: cisplatin is cell cycle non-specific? | True |
| what is another name for cisplatin? | platinol |
| what is cisplatin most commonly used to treat? | osteosarcoma |
| why must cisplatin be given with large amount of saline? | to prevent acute proximal tubular necrosis. |
| can cisplatin be given to cats? why/why not? | NO! causes fatal pulmonary edema |
| what other toxicities are associated with cisplatin? | of nephrotoxicity, acute emesis, ototoxicity, or myelosuppression |
| cisplatin can be given intracavitary to treat what? | carcinomatosis |
| carboplatin is also called? | paraplatin |
| what are the benefits of using carboplatin over cisplatin? | less nephrotoxic; can be used in cats; no diuresis required with admin; |
| what is the down side to using carboplatin over cisplatin? | more myelosuppressive |
| life span of neutrophils? | 4-8hrs |
| life span of platelets? | 6d |
| life span of dog RBC's? cat RBC's? | 110d; 70d |
| when administering chemotherapy and you notice the dog has GI upset (stool changes/vomiting) what are your top 3 differentials other than drug effects? | parasites; parvo; pancreatitis |
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clcxrf
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