Term
|
Definition
childhood leukemia
peds solid tumors (wilms)
rhabdomyosarcoma
ewings sarcoma
osteosarcoma
testicular cancer
chorioarcinoma
hodgkins lymphoma
some breast cancer |
|
|
Term
| 4 cancers that are malignant and difficult to cure |
|
Definition
| colon, lung, pancreas, late stage breast |
|
|
Term
| what are 4 characteristics of a tumor that show it will respond well to chemo |
|
Definition
fast growth
smaller
in growth stage (current proliferation)
areas of metastasis die easier |
|
|
Term
| how can you perdict the size of a tumor |
|
Definition
mass doubling is inversley proportional to growth fraction
tumors >1cm cause symptoms |
|
|
Term
| why do we do multiple rounds of chemo 2 |
|
Definition
to prevent resistance
pt may appear in remission because tumor decreased in size but it isn't gone |
|
|
Term
| why do we follow cancer surgery with chemo |
|
Definition
| chemo has a hard time penetrating large tumors, if there was tissue left it should be easily penetrated |
|
|
Term
| why do some tumors have necrosis and some dont |
|
Definition
diffusion of blood only goes 150um
some tumors are in steady state with a diffusion distance where rate of death equals rate of new cells
some outgrow their distance from the vessel and undergo necrosis
some make VEGF and produce their own vessels to avoid this problem |
|
|
Term
| explain the pattern in which cancer cells die |
|
Definition
killing is 1st order
prportion of cells die not a number |
|
|
Term
| how can you minimize cancer resistance to chemo |
|
Definition
| short term, intensive, intermittent, combination therapy |
|
|
Term
| what are some mechanisms of chemo resistance 3 |
|
Definition
change of target
drug penetration
drug efflux |
|
|
Term
| explain how chemo is effluxed, how can this be avoided |
|
Definition
P-glycoprotein Ca dependent ATPase pumps drug out
verapmil Ca channel blocker inhibits efflux |
|
|
Term
| what are commone side effects or toxicities of most cancer drugs 6 |
|
Definition
low theraputic index
vomiting
nausea
diarrhea
aloplecia
myelosupression |
|
|
Term
| what are 2 tumors caused by cancer treatment, how are they formed |
|
Definition
radiation often causes solid tumors
alkylating agents damage DNA in S phase leading to cancer in 10y, usually AML |
|
|
Term
| what are some patient criteria before they can begin cancer treatment 4 |
|
Definition
WBC > 3000
platelets > 100,000
assessment of renal and liver function |
|
|
Term
| explain the MOA of alkylation cancer drugs |
|
Definition
positive ion and carbonium ion covalently bind DNA/RNA on N7 and 2 guanine
cytotoxic effect stops DNA polymerase
(note: often mutagenic to DNA causing more cancer and not cell cycle specific) |
|
|
Term
| what are the alkylating agents |
|
Definition
low loved his mustangs, his car was a mustang. he declaired it's amazing, this is plastic, this is carbon plated, this is oxylate plated. Temara was so amazed. If only his family wasn't cyco all the time"
lowmustiing
carmusting
decarbazing
cysplastin
carboplastin
oxaloplastin
temaozolamide
ifosfamide
cyclophosphamide |
|
|
Term
| loumustine and carmustine: use |
|
Definition
| lipid soluble so good in brain |
|
|
Term
| loumustine and carmustine: SE |
|
Definition
| delayed marrow supression 4-6wk |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| cysplastin, carboplastin, oxaloplastin: how is the MOA different from the other alkylating agents |
|
Definition
| no carbonium ion, involves platinum |
|
|
Term
|
Definition
peripheral neuropathy
nephrotoxicity
ototoxicity
severe vomiting after 1h lasting 5d |
|
|
Term
|
Definition
marrow toxicity
peripheral neuropathi
ototoxicity
severe vomiting after 1h lasting 5d |
|
|
Term
|
Definition
peripheral neuropathy
nephrotoxicity
ototoxicity
marrow toxicity
severe vomiting after 1h lasting 5d |
|
|
Term
| what alkylating cancer drugs have a unique major limiting side effect, how is it avoided |
|
Definition
cysplastin, carboplastin, oxaloplastin: nephrotoxicity
TX: 1-2 L saline |
|
|
Term
|
Definition
|
|
Term
| ifosfamide and cyclophosphamide; how is the MOA different from other alkylating agents |
|
Definition
| P450 activations to carbonium which is converted to arcolem which can cause cystitis |
|
|
Term
| ifosfamide and cyclophosphamide SE and antidote |
|
Definition
hemorrhagic cystitis leads to fibrosis and blood in urine
MENSA: stops acrolein |
|
|
Term
| what do all the anti-metabolite cancer drug MOAs have in common |
|
Definition
| stops purine or primidine synthesis in S phase |
|
|
Term
| what are the anti-metabolite cancer drugs 6 |
|
Definition
he did his meth and trecked around, he put on his cap and sat behind the floral, carocel, and cirtus. he was in a bind, thio was only nine, in merca the pure
methotrexate
capeticapine
5-florouracil
citrabine
thioguanine
metacptopurine |
|
|
Term
| explain how thymine is made |
|
Definition
| dUMP + thymidine synthase -> dTMP -> thyamine |
|
|
Term
| explain how glycine is made |
|
Definition
methyl FH4 + (reaction to make thyamine) -> dihydrofolate
dihydrofolate + DHFR + folate -> tetrahydrofolate
tetrahydrofolate + serine -> glycine + methyl FH4 |
|
|
Term
|
Definition
| same a 5-FU but its a pro drug |
|
|
Term
|
Definition
| converted to 5-FdUMP which competes with dUMP for thymidine synthase inactivating it so dTMP isn't made and thymine isn't made |
|
|
Term
|
Definition
stops folate incorporation into DHFR so dihydrofolate cant be turned into tetrahydrofolate and glycine cannot be made
because this reaction stops so does the conversion of dUMP to dTMP ith thymidine synthase |
|
|
Term
| explain how uracial is made |
|
Definition
|
|
Term
|
Definition
| first converted to nucleotide, replaces with D-arabinose antagonizing |
|
|
Term
| explain how guanine and adenosine are made (non-salvage) |
|
Definition
ribose-1-P + PRPP synthase --> PRPP
PRPP + glutamite --> glutamate + IMP
IMP + GTP --> guanine
IMP + ATP --> adenosine |
|
|
Term
| explain how guanine and adenosine are made (salvage) |
|
Definition
| PRPP + HPRT --> IMP OR guanine |
|
|
Term
| MOA 6-mecaptopurine and 6-thioguanine |
|
Definition
stop denovo synthesis of purine ring by stopping HPRT in salvage pathway of guanine and adenosine synthesis
similar to AMP/GMP/IMP negative feedback |
|
|
Term
|
Definition
hepatic fibrosis
marrow toxicity |
|
|
Term
|
Definition
marrow toxicity
hand and foot disease: red desqumation of palms and soles |
|
|
Term
|
Definition
marrow toxicity
hand and foot disease: red desqumation of palms and soles |
|
|
Term
|
Definition
|
|
Term
| SE 6-mercaptopurine and 6-thioguanine |
|
Definition
| hyperuricemia: uric acid released from cells are they are lysed (esp in leukemia and lymphoma) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| methotrexate antidote: converted to methyl FH4 to restore DNA |
|
|
Term
|
Definition
| with combine wtih 5-FU is toxic |
|
|
Term
| what is the best way to administer 5-FU and why |
|
Definition
| with folate because it is more stable |
|
|
Term
| 6-mercaptopurine and 6-thioguanine drug interaction and why, what if they need to take it |
|
Definition
allopurinol: blocks xanthine oxidase which decreases metabolism of drug and causes chemo drug toxicity
if they have to take it reduce chemo by 75% strength |
|
|
Term
|
Definition
do the ox and Dan's ruby believe my sins? when i die i'll act on my sins
doxorubicin
danrubicin
bleomycin
diactinomycin |
|
|
Term
|
Definition
| most widley used and most important cancer drug |
|
|
Term
| what type of antitiobic are doxorubicin and danrubicin |
|
Definition
|
|
Term
|
Definition
inhibit topoisomerase II uncoiling and stopping DNA synthesis
P450 turns anthromycin to semiquinine (Fe ROS). it turns to superoxide and peroxide and breaks DNA
(Note: tissue is protected via superoxide dismutase and glutathione peroxidase except the heart |
|
|
Term
|
Definition
marrow toxicity
dose dependent cardiotoxicity (arrhythmia, edema, reduced EF and CO, cardiomyopathy) |
|
|
Term
|
Definition
antidote for anthrocycline
blocks Fe from drug
antidote for cardiac damage |
|
|
Term
|
Definition
| IN G2 forms ROS (Fe++ -> Fe+++ -> superoxide + hydroxide) which cause strand breaks |
|
|
Term
|
Definition
pulmonary fibrosis
mucocutaneous reaction |
|
|
Term
|
Definition
intercalator: inserts into DNA and complexes with G-C stopping RNA (and sometimes DNA) polymerase
also causes strand breaks |
|
|
Term
|
Definition
marrow toxicity
extravasion when injected (local toxicity) |
|
|
Term
| what phase do microtubule inhibitors work |
|
Definition
|
|
Term
|
Definition
vin was really blind but he blasted cristine's pack of taxes while she was doing her taxes
vinorelbine
vinblastin
vincristine
paclitaxel
docetaxel |
|
|
Term
| what are the 3 vinca alkaloids |
|
Definition
vinorelbine
vinblastin
vincristine |
|
|
Term
|
Definition
| blocks tubulin which blocks microtubule proliferation |
|
|
Term
|
Definition
marrow toxicity
aloplecia rare |
|
|
Term
|
Definition
SIADH
marrow toxicity
aloplecia rare |
|
|
Term
|
Definition
SIADH
peripheral neuropathy |
|
|
Term
|
Definition
|
|
Term
|
Definition
| reversibly bind tubulin, promote polymerization and stabilization and microtubules can't depolymerize so cell is stuck in M phase |
|
|
Term
|
Definition
hypersensitivity: chemophor EL has casteroil and absolute ethanol
marrow toxicity (esp neutropenia)
peripheral neuropathy |
|
|
Term
| how can you prevent taxane hypersensitivity |
|
Definition
dexamethasone
diphrenhydramine
cimetidine |
|
|
Term
|
Definition
he hand an episode with ten popsicles and asparagus. he wasnt hydrated and peed urea. so i treated trent's inion so he could go to Camp Tothecin where i ran to the top of the tecan mountain
etoposide
tenposide
L-asparaginase
hydroxyurea
trentinoin (ATRA)
irinotecan
Topotecan |
|
|
Term
| etoposide and tenposide MOA |
|
Definition
| blocks S-G2 by blocking topoisomerase II breaking DNA strands |
|
|
Term
| etoposide and tenposide SE 1 |
|
Definition
|
|
Term
|
Definition
| deaminates asparagine to asparatic acid and ammonia |
|
|
Term
|
Definition
hypersensitivity
marrow toxicity
hydroxylizes blood asparagine too |
|
|
Term
|
Definition
| ribonucleotide reductase inhibitor |
|
|
Term
|
Definition
|
|
Term
|
Definition
| binds RARa and promotes cell differentiation |
|
|
Term
|
Definition
retinoic acid syndrome: fever, respiratory distress, pleural effusions
marrow toxicity |
|
|
Term
| how to avoid retinoic acid syndrome |
|
Definition
| pretreat with dexamethasone before trentinoin use |
|
|
Term
| ininotecan and topotecan MOA |
|
Definition
|
|
Term
| ininotecan and topotecan SE |
|
Definition
|
|
Term
| what is the least toxic form of cancer therapy |
|
Definition
|
|
Term
| what is a clinical indication for steroid hormone cancer therapy |
|
Definition
| pallative unless a lymphoma |
|
|
Term
| what are 7 steroid hormone cancer drugs |
|
Definition
ana stared at leu who had a proglide. he was dexterous and handsome. she player her flute full of restraint as he tampered with the ox in the pan preoccupied with gettin some
anastrazole
leuprolide
dexamethazone
flutamide
fulvestrant
tamoxifen
prednisone |
|
|
Term
|
Definition
blocks aromatase which stops esterone conversion to estradiol
competitive inhibitor |
|
|
Term
|
Definition
| GNRH analog binds LHRH receptor in pituitary and desensitizes it which decreases FSH and LH and thus estrogen |
|
|
Term
|
Definition
| binds glucacorticoid receptors increasing apoptosis and lymphocytes |
|
|
Term
|
Definition
| competitive inhibitor of androgen receptors |
|
|
Term
|
Definition
| inhibits estrogen binding, targets receptor for protesomal degradation |
|
|
Term
|
Definition
| competitive inhibitor of estrogen receptors |
|
|
Term
|
Definition
| binds glucacorticoid receptors increasing apoptosis and lymphocytes |
|
|
Term
|
Definition
| estrogen dependent cancer |
|
|
Term
|
Definition
| prostate cancer: with antiandeogen because it takes 1wk for receptors to down regulate and testosterone decreases so their could be a flare |
|
|
Term
|
Definition
|
|
Term
|
Definition
| prostate cancer with GNRH agonist |
|
|
Term
|
Definition
| estrogen positive breast cancer |
|
|
Term
|
Definition
| estrogen positive breast cancer |
|
|
Term
|
Definition
| leukemia and lymphoma (curative) |
|
|
Term
| general MOA of targeted anticancer drugs |
|
Definition
| target GF receptors disregulating cell signals causing defective DNA repair, apoptisis, tumor agenesis |
|
|
Term
| 6 targeted anticancer drugs |
|
Definition
im a tiny bored zombie, you bettwe be vaccinated for zombies because in thiland i reside. i see you tuck and hide. its a travesty, those zombies
imatinib
bortezomib
beavacizumab
thalidomide
cetuximab
trastuzumab |
|
|
Term
|
Definition
protein kinase inhibitor
stops BCR-ABL TK |
|
|
Term
|
Definition
| reversible chymotrypsin inhibitor in proteasome stopping apoptosis |
|
|
Term
|
Definition
| antibody to VEGFa blocks receptor stopping proliferation of endothelial cells and vessels |
|
|
Term
|
Definition
| inhibits IL6 and TNFa decreasing angiogenesis |
|
|
Term
|
Definition
| antibody to HER2 decreases TK which decreases angiogenesis, apoptosis, and metastasis |
|
|
Term
|
Definition
CML (>90% remission)
TK tumors: GI, C-KIT |
|
|
Term
|
Definition
|
|
Term
|
Definition
renal cell cancer
lung cancer
colorectal cancer
breast cancer |
|
|
Term
|
Definition
head SCC
neck SCC
colon cancer |
|
|
Term
|
Definition
| metastastic breast cancer |
|
|
Term
| what are 4 hematopoietic agents and what do they do |
|
Definition
erythropoetin: increases RBC
thrombopoietin: increases megakaryocytes which increases platelets
GM-CSF: increases neutrophils and monocytes
G-CSF: increases neutrophils |
|
|
Term
| what is GM-CSF synergistic with 6 |
|
Definition
| SCR, IL1, IL3, IL6, CFU-GM, CFU-MEG |
|
|
Term
|
Definition
my cousin was late, she cycles for sport and takes glucocorticoids. she likes tacos within limits. i asked siri what the limits were
mycophenolate mofentil
cyclosporine
glucacorticoids
tacrolimus
sirolimus |
|
|
Term
| MOA mycophenolate mofetil |
|
Definition
non competitive inhibitor of inosme monophosphate DH of de novo guanine neculotide synthesis
prevents T and B cell proliferation |
|
|
Term
|
Definition
| binds cyclophilin and inhibits caleineruin (cytoplasmic phosphatase) stopping NFAT movement to mucleus and IL2 activation |
|
|
Term
|
Definition
inhibit NG-kG causing apoptosis
decrease IL1 and IL6
decrease T cell production of IL2 |
|
|
Term
|
Definition
| binds FKB-12 and inhibits calcineurin stopping NFAT movement to the nucleus and IL2 activation |
|
|
Term
|
Definition
binds FKB-12 and inhibits mTOR TK decreasing cell progression from G1-S
usually given with calcineurin inhibitor and steroid |
|
|
Term
| contraindications to sirolimus and why |
|
Definition
| never use in liver and lung transplant, can cause hepatic artery thrombosis and bronchial anastamotic dishiscence |
|
|
Term
| use mycophenolate mofetil |
|
Definition
|
|
Term
|
Definition
| transplant prophylaxis, RA, psoriases |
|
|
Term
|
Definition
| transplant prophylaxis, SLE, psoriasis, IBD, asthma, allergies |
|
|
Term
|
Definition
| transplant prophylaxis, RA, psorisis |
|
|
Term
|
Definition
transplant prophylaxis
other use in patients with renal issues |
|
|
Term
| SE mycopheolate mofetil 2 |
|
Definition
|
|
Term
|
Definition
nephrotoxicity
hyperlipidemia
gingival hyperplasia |
|
|
Term
|
Definition
nephrotoxicity
hyperlipidemia |
|
|
Term
|
Definition
hyperlipidemia
hepatic artery thrombosis
bronchial anastamotic dishiscence |
|
|
Term
| what cancer drugs do not cause marrow supression 5 |
|
Definition
hormones
asparaginase
bleomycin
vincristine
cisplastin |
|
|
Term
| what cancer drugs cause renal toxicity 3 |
|
Definition
cisplastin
nitrosureas
methotrexate |
|
|
Term
| what cancer drugs cause cardiotoxicity 2 |
|
Definition
|
|
Term
| what cancer drugs cause pulmonary toxicity 4 |
|
Definition
bleomycin
nitrosureas
methotrexate
busulfan |
|
|
Term
| what cancer drugs cause extravastion 2 |
|
Definition
|
|
Term
| what cancer drugs cause hypersensitivity 4 |
|
Definition
taxanes
asparaginase
etoposide
teniposide |
|
|
Term
| what cancer drugs cause peripheral neuropathy 3 |
|
Definition
vincristine
oxaloplatin
taxanes |
|
|
Term
| what cancer drugs cause hemorrhagic cystitis |
|
Definition
|
|
Term
| what cancer drugs cause liver toxicity |
|
Definition
|
|
