CPHON TEST - Principles of Chemo/Chemo
Drugs/Supportive Drugs
Cancer cells experience unchecked growth because:
3 reasons ✔️Ans - 1. do not have preset # divisions before death, thus
apoptosis is avoided.
2. do not appear to be inhibited by contact
3. do not require usual amount of growth factors, some ca cells even produce
their own growth factors.
multimodal therapy ✔️Ans - chemo with another type of therapy (surgery,
radiation)
adjuvant chemotherapy ✔️Ans - chem with surgery or radiation to address
residual disease or mets
combo chemotherapy ✔️Ans - multidrug regimine
Gancyclovir ✔️Ans - used to treat active cmv infection
neoadjuvant chemotherapy ✔️Ans - chemo preoperatively to debulk tumor
sanctuary or regional chemo ✔️Ans - chemo delivered to area where
malignant cells may not be reached with systemic chemo (intrathecal)
Procarbazine
dietary cautions ✔️Ans - avoid tyrosine rich foods
is an alkylating agent
Stages of cell cycle ✔️Ans - G0 : resting
G1: growth, accumulation of nutrients, RNA sythesis, protein synthesis, largest
part of cell life spent here
S: duplication of chromosomes
G2: growth, recheck for chromosomal errors
Mitosis: prophase, prometaphase (spindle fibers attach), metaphase,
anaphase, telephase, cytokinesis
Plant Alkaloids
,-largely impact which stages?
-drugs that impact s phase?
-drugs that impact G2 phase?
-drugs that impact M phase? ✔️Ans - largely impact any stage dealing with
spindle fibers
S phase drugs: irinotecan, topotecan ( initial unwind/unzip, topiosmerase I
inhibitor)
G2 phase drugs: etoposide, teniposide: can't rewind/rezip, topiosmerase
inhibitor
M phase (specifically prometaphase) drugs:
paclitaxel, docetaxel (taxoids): suspend/make
spindles sticky
vinblastine, vincristine, vinorelabine: "blast"
microtubules and inhibit spindle formation
anti metabolites
main mechanism of action?
what phase do they work on?
examples from each class? ✔️Ans - mechanism of action: work to mimic
nucleic acids and produce nonfunctional end products during s phase
- methotrexate: folate analog. folate becomes a precursor to purines
-purine analogs: 6MP (mercaptopurine), thioguanine, clofarabine, nelarabine
-pyrimidine analogs: cytarabine (ARA-C), gemcytabine
hydroxyurea: cystine analog
DNA nucleic acid pairings ✔️Ans - purines: a and g
pyrimidines: t and c
a pairs with t
g pairs with c
ETOPOSIDE/VP16 (Think Brian, Evie)
1. Cell cycle specific or not?
2. alkylating agent, antibiotic, anti-metabolites, plant products, hormones, or
miscellaneous?
3. route
4. side effects
5. special considerations
6. how exactly does it work? ✔️Ans - 1. CELL CYCLE SPECIFIC
2. PLANT ALKALOID
, 3. IV,PO
4. N/V, myelosuppresion
5. admin over 60 mins to avoid hypotension, BPq15mins
6. works during G2 - prevents DNA strands from condensing, re-zippering and
rewinding. topoisomerase inhibitor
MERCAPTOPURINE/6MP
1. Cell cycle specific or not?
2. alkylating agent, antibiotic, anti-metabolites, plant products, hormones, or
miscellaneous?
3. route
4. side effects
5. special considerations
6. how exactly does it work? ✔️Ans - 1. CELL CYCLE SPECIFIC
2. ANTIMETABOLITE
3. PO
4. myelosuppression (which is why there might be dose reduction if counts
too low) - Thiopurine testing needed if myelosupression is very low
5. take on empty stomach (1 hour before food or 2 hours after), usu at night
time
6. purine analog (AG) works during S phase
TENOPOSIDE
1. Cell cycle specific or not?
2. alkylating agent, antibiotic, anti-metabolites, plant products, hormones, or
miscellaneous?
3. route
4. side effects
5. special considerations
6. how exactly does it work? ✔️Ans - 1.CELL CYCLE SPECIFIC
2. PLANT ALKALOID
3. IV
4. N/V, myelosuppression
5. irrritant, heparin can precipitate (good flushes), hypotension with rapid
infusion
6. works during G2 - prevents DNA strands from condensing, re-zippering and
rewinding. topoisomerase inhibitor
PACLITAXEL/TAXOL
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