45 Questions
What is one of the general toxicities of anticancer drugs on rapidly dividing normal cells?
Myelosuppression
What is a side effect of anticancer drugs on the gut mucosa?
GI ulcers
What is a side effect of anticancer drugs on the skin and hair?
Alopecia
What is a side effect of anticancer drugs on the gonads?
Infertility
What is a side effect of anticancer drugs on the fetus?
All of the above
What is a result of Tumor Lysis Syndrome?
Hyperuricemia
What is the learning outcome for listing drugs belonging to specific groups?
Anticancer 1
What is the learning outcome for explaining the general toxicities of anticancer drugs?
Anticancer 2
Which anticancer drug is known to cause cardiotoxicity?
Doxorubicin
What is the learning outcome for listing the specific toxicities of certain anticancer agents?
Anticancer 2
What is a common symptom of hypersensitivity reactions to anticancer drugs?
All of the above
What is the learning outcome for explaining the role of drug combinations in cancer therapy?
Anticancer 2
What is the primary cause of nausea and vomiting in patients taking anticancer drugs?
All of the above
Which of the following anticancer drugs is associated with pulmonary fibrosis?
Bleomycin
What is a primary use of Ondansetron in cancer treatment?
Controlling cytotoxic drug-induced vomiting
What is a benefit of recombinant colony stimulating factor in cancer treatment?
Hastening recovery from myelosuppression
What is Amifostine used for in cancer treatment?
Preventing nephrotoxicity caused by Cisplatin
What is a common complication of Tumor Lysis Syndrome?
Acute kidney injury
What is the method to reduce nephrotoxicity in patients receiving cisplatin infusion?
Vigorous hydration
What is the purpose of administering mesna before chemotherapy?
To reduce hemorrhagic cystitis
What is the benefit of dexrazoxane in doxorubicin administration?
Reduces cardiotoxicity
What is the purpose of leucovorin (folinic acid) in methotrexate toxicity?
To reverse methotrexate toxicity
How can urate nephropathy be reduced?
By alkalinization of urine and plenty of fluids
What is the mechanism of mesna in preventing hemorrhagic cystitis?
By interacting with acrolein
What is the consequence of doxorubicin's cardiotoxicity?
Impacts patient prognosis and reduces survival
How does folinic acid reverse methotrexate toxicity?
By forming THFA and bypassing dihydrofolate reductase enzyme pathway
What is the purpose of vigorously hydrating patients before, during, and after cisplatin infusion?
To reduce nephrotoxicity
What is the role of allopurinol in cancer treatment?
To block the conversion of xanthine to uric acid
What is the purpose of administering normal saline solution in cancer treatment?
To flush out the remnants of uric acid through the kidneys
What is the main purpose of adjuvant chemotherapy?
To prevent relapse after surgery or radiotherapy
What is xerostomia, and how is it treated in cancer patients?
A side effect of chemotherapy, treated with artificial saliva
What is the combination of drugs used in the induction phase of Acute Myeloid Leukemia treatment?
Cytarabine + Daunorubicin
Why are drugs given in pulses with 2-3 week intervals in cancer treatment?
To allow normal cells to recover
What is the purpose of giving several cycles of chemotherapy?
To achieve eradication of cancer cells
What is the regimen used to treat Hodgkin's lymphoma?
ABVD regimen
What is the main advantage of using drug combinations in cancer therapy?
All of the above
What is a principle of drug combinations for cancer chemotherapy?
Combine drugs with different mechanisms of action
What is the regimen used to treat non-Hodgkin's lymphoma?
CHOP regimen
What is the purpose of using drug combinations in cancer chemotherapy?
To eradicate cancer cells
What is the purpose of using intermittent schedule of drug treatment in cancer therapy?
To reduce the toxicity of individual drugs
Why is it important to avoid combining drugs with significant toxicity overlap in cancer therapy?
To minimize the risk of adverse effects
Why is drug X given to a patient with choriocarcinoma treated with high doses of methotrexate?
To overcome hematological toxicity
What is the purpose of maintenance therapy in cancer treatment?
To recover from acute toxic effects of drugs
What is a requirement for a drug to be used in combination with other drugs in cancer therapy?
The drug must be active as a single agent against the tumor
What is the regimen used to treat Acute Myeloid Leukemia in the maintenance phase?
Cytarabine + Daunorubicin/Etoposide
Study Notes
General Toxicities of Anticancer Drugs
- Toxic to rapidly dividing normal cells, including bone marrow cells, gut mucosa, skin, hair, gonads, and fetuses
- Myelosuppression, thrombocytopenia, leukopenia, and suppression of lymphoreticular system leading to increased bleeding, immunosuppression, and opportunistic infections
- Tumor Lysis Syndrome, causing hyperuricemia, urate nephropathy, and acute kidney injury
- Hypersensitivity reactions, including rashes, chills, fever, and anaphylaxis
- Nausea and vomiting due to activation of dopamine, 5-HT3, serotonin, neurokinin-1, and cholecystokinin
Specific Toxicities of Anticancer Drugs
- Cyclophosphamide: hemorrhagic cystitis
- Doxorubicin: cardiotoxicity
- Bleomycin: pulmonary fibrosis
- Vincristine: neuropathy, syndrome of inappropriate antidiuretic hormone secretion
- Cisplatin: nephrotoxicity and ototoxicity
- Methotrexate: hepatotoxicity, nephrotoxicity, and megaloblastic anemia
Minimizing Toxicities of Anticancer Drugs
- Use of ondansetron to control cytotoxic drug-induced vomiting
- Platelet and/or granulocyte transfusion after treatment to prevent bleeding or infection
- Bone marrow transplantation
- Recombinant colony-stimulating factor to hasten recovery from cytotoxic drug-induced myelosuppression
- Amifostine to prevent cisplatin-induced nephrotoxicity
- Vigorous hydration before, during, and after cisplatin infusion to reduce nephrotoxicity
- Mesna to prevent hemorrhagic cystitis caused by cyclophosphamide and ifosfamide
- Dexrazoxane to prevent doxorubicin-induced cardiotoxicity
- Leucovorin to reverse methotrexate toxicity
- Allopurinol, alkalinization of urine, and plenty of fluids to reduce urate nephropathy
Role of Drug Combinations in Cancer Therapy
- Enhanced effect by achieving maximal cell killing
- Broader range of attack on heterogeneous cells
- Reduced resistance by early/rapid cell kill
- Reduced toxicity of individual drugs
Principles of Drug Combinations for Cancer Chemotherapy
- Drug must be active as a single agent against the tumor being treated
- Combine drugs with different mechanisms of action
- Avoid combinations with significant toxicity overlap
- Use intermittent schedule of drug treatment
- Several cycles of chemotherapy should be given to achieve eradication
- Adjuvant chemotherapy is given to prevent relapse after surgery or radiotherapy
Drug Combinations for Specific Cancers
- Acute Myeloid Leukemia: Cytarabine + Daunorubicin (induction), Cytarabine + Daunorubicin/Etoposide (maintenance)
- Hodgkin’s lymphoma: ABVD regimen (Doxorubicin, Vinblastine, and Dacarbazine), MOPP regimen (Mechlorethamine, Vincristine, Procarbazine, and Prednisone)
- Non-Hodgkin’s lymphoma: CHOP regimen (Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone)
This quiz covers the classification and mechanisms of anticancer drugs, including alkylating agents, antimetabolites, and protein tyrosine kinase inhibitors.
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