Podcast
Questions and Answers
What is one of the general toxicities of anticancer drugs on rapidly dividing normal cells?
What is one of the general toxicities of anticancer drugs on rapidly dividing normal cells?
- Myelosuppression (correct)
- Alopecia
- Hypertension
- Immunosuppression
What is a side effect of anticancer drugs on the gut mucosa?
What is a side effect of anticancer drugs on the gut mucosa?
- Kidney failure
- GI ulcers (correct)
- Liver damage
- Heart failure
What is a side effect of anticancer drugs on the skin and hair?
What is a side effect of anticancer drugs on the skin and hair?
- Vitiligo
- Alopecia (correct)
- Hirsutism
- Psoriasis
What is a side effect of anticancer drugs on the gonads?
What is a side effect of anticancer drugs on the gonads?
What is a side effect of anticancer drugs on the fetus?
What is a side effect of anticancer drugs on the fetus?
What is a result of Tumor Lysis Syndrome?
What is a result of Tumor Lysis Syndrome?
What is the learning outcome for listing drugs belonging to specific groups?
What is the learning outcome for listing drugs belonging to specific groups?
What is the learning outcome for explaining the general toxicities of anticancer drugs?
What is the learning outcome for explaining the general toxicities of anticancer drugs?
Which anticancer drug is known to cause cardiotoxicity?
Which anticancer drug is known to cause cardiotoxicity?
What is the learning outcome for listing the specific toxicities of certain anticancer agents?
What is the learning outcome for listing the specific toxicities of certain anticancer agents?
What is a common symptom of hypersensitivity reactions to anticancer drugs?
What is a common symptom of hypersensitivity reactions to anticancer drugs?
What is the learning outcome for explaining the role of drug combinations in cancer therapy?
What is the learning outcome for explaining the role of drug combinations in cancer therapy?
What is the primary cause of nausea and vomiting in patients taking anticancer drugs?
What is the primary cause of nausea and vomiting in patients taking anticancer drugs?
Which of the following anticancer drugs is associated with pulmonary fibrosis?
Which of the following anticancer drugs is associated with pulmonary fibrosis?
What is a primary use of Ondansetron in cancer treatment?
What is a primary use of Ondansetron in cancer treatment?
What is a benefit of recombinant colony stimulating factor in cancer treatment?
What is a benefit of recombinant colony stimulating factor in cancer treatment?
What is Amifostine used for in cancer treatment?
What is Amifostine used for in cancer treatment?
What is a common complication of Tumor Lysis Syndrome?
What is a common complication of Tumor Lysis Syndrome?
What is the method to reduce nephrotoxicity in patients receiving cisplatin infusion?
What is the method to reduce nephrotoxicity in patients receiving cisplatin infusion?
What is the purpose of administering mesna before chemotherapy?
What is the purpose of administering mesna before chemotherapy?
What is the benefit of dexrazoxane in doxorubicin administration?
What is the benefit of dexrazoxane in doxorubicin administration?
What is the purpose of leucovorin (folinic acid) in methotrexate toxicity?
What is the purpose of leucovorin (folinic acid) in methotrexate toxicity?
How can urate nephropathy be reduced?
How can urate nephropathy be reduced?
What is the mechanism of mesna in preventing hemorrhagic cystitis?
What is the mechanism of mesna in preventing hemorrhagic cystitis?
What is the consequence of doxorubicin's cardiotoxicity?
What is the consequence of doxorubicin's cardiotoxicity?
How does folinic acid reverse methotrexate toxicity?
How does folinic acid reverse methotrexate toxicity?
What is the purpose of vigorously hydrating patients before, during, and after cisplatin infusion?
What is the purpose of vigorously hydrating patients before, during, and after cisplatin infusion?
What is the role of allopurinol in cancer treatment?
What is the role of allopurinol in cancer treatment?
What is the purpose of administering normal saline solution in cancer treatment?
What is the purpose of administering normal saline solution in cancer treatment?
What is the main purpose of adjuvant chemotherapy?
What is the main purpose of adjuvant chemotherapy?
What is xerostomia, and how is it treated in cancer patients?
What is xerostomia, and how is it treated in cancer patients?
What is the combination of drugs used in the induction phase of Acute Myeloid Leukemia treatment?
What is the combination of drugs used in the induction phase of Acute Myeloid Leukemia treatment?
Why are drugs given in pulses with 2-3 week intervals in cancer treatment?
Why are drugs given in pulses with 2-3 week intervals in cancer treatment?
What is the purpose of giving several cycles of chemotherapy?
What is the purpose of giving several cycles of chemotherapy?
What is the regimen used to treat Hodgkin's lymphoma?
What is the regimen used to treat Hodgkin's lymphoma?
What is the main advantage of using drug combinations in cancer therapy?
What is the main advantage of using drug combinations in cancer therapy?
What is a principle of drug combinations for cancer chemotherapy?
What is a principle of drug combinations for cancer chemotherapy?
What is the regimen used to treat non-Hodgkin's lymphoma?
What is the regimen used to treat non-Hodgkin's lymphoma?
What is the purpose of using drug combinations in cancer chemotherapy?
What is the purpose of using drug combinations in cancer chemotherapy?
What is the purpose of using intermittent schedule of drug treatment in cancer therapy?
What is the purpose of using intermittent schedule of drug treatment in cancer therapy?
Why is it important to avoid combining drugs with significant toxicity overlap in cancer therapy?
Why is it important to avoid combining drugs with significant toxicity overlap in cancer therapy?
Why is drug X given to a patient with choriocarcinoma treated with high doses of methotrexate?
Why is drug X given to a patient with choriocarcinoma treated with high doses of methotrexate?
What is the purpose of maintenance therapy in cancer treatment?
What is the purpose of maintenance therapy in cancer treatment?
What is a requirement for a drug to be used in combination with other drugs in cancer therapy?
What is a requirement for a drug to be used in combination with other drugs in cancer therapy?
What is the regimen used to treat Acute Myeloid Leukemia in the maintenance phase?
What is the regimen used to treat Acute Myeloid Leukemia in the maintenance phase?
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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)
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