Chemotherapy Drugs in Oncology
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Questions and Answers

Which factor does NOT typically influence dose modification of cytotoxic drugs?

  • Hematological toxicity related to white blood count
  • Skin toxicity level (correct)
  • Renal impairment based on creatinine clearance
  • History of previous adverse effects
  • Which toxicity requires dose modification based on bilirubin levels?

  • Hepatic impairment (correct)
  • Stomatitis
  • Renal impairment
  • Hematological toxicity
  • What type of toxicity is primarily associated with immunotherapy?

  • Renal impairment
  • Stomatitis
  • Neurological complications (correct)
  • Hematological toxicity
  • Which of the following is considered an endocrinopathy related to immunotherapy?

    <p>Hypophysitis (B)</p> Signup and view all the answers

    What factor may cause differences in dosing when administering cytotoxic drugs?

    <p>Combination with other medications (C)</p> Signup and view all the answers

    What can reduce the duration and severity of neutropenia in selected patients?

    <p>Recombinant human granulocyte-colony stimulating factors (B)</p> Signup and view all the answers

    What is a primary consideration when dosing cytotoxic drugs?

    <p>Steep dose response relationship (A)</p> Signup and view all the answers

    Which of the following methods is NOT used to determine the doses of cytotoxic drugs?

    <p>Fixed dosing regardless of weight (D)</p> Signup and view all the answers

    Area under the curve-based dosing is primarily applicable for which type of drug clearance?

    <p>Glomerular filtration (A)</p> Signup and view all the answers

    Which algorithms are mentioned for calculating body surface area when dosing cytotoxic drugs?

    <p>Dubois and Dubois, Mosteller (D)</p> Signup and view all the answers

    Which type of antimetabolite is Methotrexate classified as?

    <p>Folic Acid Antagonist (A)</p> Signup and view all the answers

    What is the mechanism of action of antimetabolites?

    <p>They are cell-cycle specific. (D)</p> Signup and view all the answers

    Which of the following is a Pyrimidine Antagonist?

    <p>Fluorouracil (B)</p> Signup and view all the answers

    Which drug is NOT classified under the category of Antimetabolites?

    <p>Asparaginase (B)</p> Signup and view all the answers

    Which targeted therapy approach would focus on specific genes?

    <p>Focusing on genetic mutations (D)</p> Signup and view all the answers

    Which of the following is classified as an adrenocortical steroid inhibitor?

    <p>Mitotane (A)</p> Signup and view all the answers

    Which agent is a Ribonucleotide reductase inhibitor?

    <p>Hydroxyurea (C)</p> Signup and view all the answers

    What is a key feature of targeted therapy?

    <p>It targets cancer-specific genes. (C)</p> Signup and view all the answers

    Which class of targeted therapy specifically includes drugs like Trastuzumab and Rituximab?

    <p>Monoclonal antibodies (D)</p> Signup and view all the answers

    What is a primary mechanism of hormone therapy in cancer treatment?

    <p>Block hormone receptors or inhibit hormone production (C)</p> Signup and view all the answers

    Which of the following is NOT a common adverse effect of cytotoxic drugs?

    <p>Photosensitivity (B)</p> Signup and view all the answers

    Which drug is classified as an mTOR inhibitor?

    <p>Everolimus (B)</p> Signup and view all the answers

    What is a characteristic side-effect of chemotherapy highlighted in the content?

    <p>Hypertension (D)</p> Signup and view all the answers

    Which type of hormone therapy drug is used to inhibit adrenal steroid production?

    <p>Adrenal steroid inhibitors (B)</p> Signup and view all the answers

    What is the primary use of a drug like Tamoxifen in cancer treatment?

    <p>Act as an antiestrogen (D)</p> Signup and view all the answers

    Which of the following drugs is classified as an antiandrogen?

    <p>Flutamide (A)</p> Signup and view all the answers

    What condition may contraindicate the use of cytotoxic drugs?

    <p>Acute infection (C)</p> Signup and view all the answers

    Which of these treatments focuses on increasing the body’s own natural defense against tumors?

    <p>Angiogenesis inhibitors (A)</p> Signup and view all the answers

    Which class of drugs is most active during the resting phase of the cell cycle?

    <p>Alkylating agents (A)</p> Signup and view all the answers

    Which of the following are examples of Vinca alkaloids?

    <p>Vincristine (C)</p> Signup and view all the answers

    Which of the following drugs belongs to the class of alkylating agents?

    <p>Cisplatin (D)</p> Signup and view all the answers

    What type of inhibitors are Topoisomerase 1 inhibitors?

    <p>Cell cycle specific (A)</p> Signup and view all the answers

    Which antitumor antibiotic is derived from the soil fungus Streptomyces?

    <p>Bleomycin (A)</p> Signup and view all the answers

    What is the main action of alkylating agents in chemotherapy?

    <p>Damage DNA (A)</p> Signup and view all the answers

    Which of the following substances is a type of taxane?

    <p>Paclitaxel (A)</p> Signup and view all the answers

    Which chemotherapy class includes both antitumor antibiotics and does not fit into other classes?

    <p>Miscellaneous (A)</p> Signup and view all the answers

    Which of the following is a characteristic of plant-derived drugs in chemotherapy?

    <p>They are derived from plant substances (B)</p> Signup and view all the answers

    Which of the following drugs belong to the class of hydrazines & triazines?

    <p>Temozolomide (D)</p> Signup and view all the answers

    Flashcards

    Dose Modification

    Adjusting medication dosage based on factors like blood cell count, kidney or liver function, and previous reactions.

    Hematological Toxicity

    Side effects involving the blood, including low white blood cell count, neutrophils, or platelets.

    Dose Modification: Renal Impairment

    Dosage adjusted depending on how well the kidneys are filtering waste.

    Dose Modification: Hepatic Impairment

    Dosage adjusted based on how well the liver is working, using bilirubin and other liver function tests.

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    Immunotherapy Complications

    Complications of immunotherapy that affect various organs and systems, including skin irritation, gut inflammation, liver problems, hormonal issues, lung inflammation, kidney inflammation, neurological issues, and others.

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    Steep Dose Response Relationship

    A steep dose response relationship indicates that a small change in drug dose can result in a significant difference in its effect.

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    Narrow Therapeutic Index

    A narrow therapeutic index means that the difference between the effective dose and the toxic dose is small. A slightly higher dose could lead to serious side effects.

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    Body Surface Area (BSA)

    Body surface area (BSA) is a measurement used to calculate drug dosage based on the patient's size. It's calculated using height and weight.

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    AUC-based Dosing

    Dosage based on the area under the curve (AUC) is used for drugs that are eliminated through the kidneys.

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    Fixed Dose for Targeted Therapies

    Targeted therapies have a fixed dose, regardless of the patient's weight or BSA, or a fixed dose based on their weight.

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    Antimetabolites

    Drugs that resemble normal substances within cells, interfering with their function during specific phases of the cell cycle. They are cell-cycle specific, targeting cells at specific stages of growth and division.

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    Purine Antagonists - What do they target in the cell?

    These drugs block the synthesis of purine bases, which are essential building blocks for DNA and RNA.

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    Pyrimidine Antagonists - What do they target in the cell?

    These drugs interfere with the synthesis of pyrimidine bases, which are also essential for DNA and RNA production.

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    Folic Acid Antagonists -How do they disrupt cell function?

    Drugs that prevent the conversion of folate into its active form, disrupting DNA synthesis and cell division.

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    Adenosine Deaminase Inhibitors - How do they affect DNA/RNA production?

    These drugs target and inhibit enzymes essential for purine metabolism, disrupting DNA and RNA synthesis. They work by blocking the breakdown of adenosine, which is a building block for DNA, RNA, and ATP.

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    Ribonucleotide Reductase Inhibitors - How do these drugs work?

    They target enzymes involved in the production of nucleotides, which are the building blocks of DNA and RNA. This leads to a disruption in DNA and RNA synthesis, hindering cell growth and division.

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    Targeted Therapy - What is the main principle of this therapy?

    A type of targeted therapy that focuses on specific aspects of cancer cells, such as their genes, proteins, or the environment they thrive in.

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    Targeted Therapy - What is the goal of this therapy?

    By interfering with the growth and survival factors specific to cancer cells, targeted therapy aims to prevent further growth and spread of the cancer, while minimizing harm to healthy cells.

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    Chemotherapy

    Chemicals used to treat cancer by killing rapidly dividing cells. They work by targeting different stages of the cell cycle (growth and division).

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    Alkylating Agents

    A group of chemotherapy drugs that damage DNA by adding alkyl groups, preventing cell division.

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    Mustard Gas Derivatives

    A class of alkylating agents that are effective against various cancers, including leukemia, lymphomas, and solid tumors.

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    Nitrosoureas

    Another important class of alkylating agents, known for their ability to cross the blood-brain barrier, making them effective against brain tumors.

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    Plant Derivatives

    A family of chemotherapy drugs derived from plants like periwinkle and yew trees. They target the cell cycle specifically, disrupting cell division at different stages.

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    Vinca Alkaloids

    Plant-derived drugs that interfere with microtubule formation, essential for cell division, leading to cell death.

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    Topoisomerase Inhibitors

    Another class of plant derivatives that target the cell cycle, specifically inhibiting topoisomerase enzymes, which are key for DNA replication.

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    Antitumor Antibiotics

    Chemotherapy drugs that are natural products derived from various species of the soil fungus Streptomyces. They interfere with cell division at multiple stages.

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    Anthracyclines

    A type of antitumor antibiotic that works by inhibiting the formation of DNA and RNA, ultimately leading to cell death.

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    Miscellaneous Antineoplastics

    A diverse group of chemotherapy drugs that work by interfering with various aspects of cell function, including DNA synthesis, cell division, and DNA repair.

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    Targeted Therapy

    These drugs target specific molecules within cells to inhibit tumor growth and survival.

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    Monoclonal Antibodies

    Antibodies that bind to specific proteins on the surface of cancer cells, blocking their growth or signaling pathways.

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    Tyrosine Kinase Inhibitors

    A type of targeted therapy that blocks the activity of tyrosine kinases, enzymes involved in cell growth and survival.

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    Apoptosis-inducing Drugs

    These drugs induce programmed cell death in cancer cells.

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    Angiogenesis Inhibitors

    Drugs that inhibit the formation of new blood vessels that tumors need to grow and spread.

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    mTOR Inhibitors

    Drugs that block the mTOR pathway, a key signaling pathway involved in cell growth and proliferation.

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    Hormone Therapy

    A type of therapy that aims to modify the hormonal environment of a tumor, often by reducing or blocking the effects of specific hormones.

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    Cytotoxic Adverse Effects

    Common side effects of cytotoxic drugs such as nausea, vomiting, hair loss, and low blood cell counts.

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    Hormone Production Inhibitors

    Drugs that block the production of specific hormones that fuel tumor growth.

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    Hormone Receptor Blockers

    Drugs that bind to and block hormone receptors, preventing hormones from activating pathways that promote tumor growth.

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    Study Notes

    Chemotherapy Drugs in Oncology

    • Chemotherapy drugs are categorized into several main classes: alkylating agents, plant derivatives, topoisomerase inhibitors, antitumor antibiotics, antimetabolites, and miscellaneous antineoplastics.

    Alkylating Agents

    • These drugs are most effective during the resting phase of cell division.
    • They are non-specific, meaning they damage DNA throughout the cell cycle.
    • Examples include:
      • Mustard gas derivatives (e.g., cyclophosphamide, chlorambucil, melphalan, ifosfamide)
      • Nitrosoureas (e.g., carmustine, lomustine)
      • Alkyl sulfonates (e.g., busulfan)
      • Platinum compounds (e.g., cisplatin, carboplatin, oxaliplatin)
      • Ethylenimines (e.g., thiotepa)
      • Hydrazines & triazines (e.g., procarbazine)

    Plant Derivatives

    • Derived from plants, some synthesized artificially.
    • Cell cycle-specific, targeting cells at different phases of division.
    • Examples include:
      • Vinca alkaloids (e.g., vincristine, vinblastine, vinorelbine)
      • Taxanes (e.g., paclitaxel, docetaxel)
      • Podophyllotoxins (e.g., etoposide, teniposide)
      • Camptothecin analogs(e.g., Irinotecan)

    Topoisomerase Inhibitors

    • Inhibit topoisomerase enzymes, which are essential for DNA replication.
    • Divided into two classes:
      • Topoisomerase 1 inhibitors (e.g., irinotecan, topotecan)
      • Topoisomerase 2 inhibitors (e.g., etoposide, amsacrine)

    Antitumor Antibiotics

    • Naturally produced by Streptomyces species.
    • Cell cycle-specific, active during multiple phases of the cell cycle.
    • Examples include:
      • Anthracyclines (e.g., doxorubicin, daunorubicin)
      • Dactinomycin
    • Miscellaneous (e.g., plicamycin, mitomycin, bleomycin)

    Antimetabolites

    • Similar to normal cell substances, targeting specific cell cycle phases.
    • Examples include:
      • Folic acid antagonists (e.g., methotrexate, pemetrexed)
      • Pyrimidine antagonists (e.g., 5-fluorouracil, floxuridine, cytarabine)
      • Purine antagonists (e.g., 6-mercaptopurine, 6-thioguanine)

    Miscellaneous Antineoplastics

    • Drugs not fitting into other classes, still produced by the same organisms.
    • Includes:
      • Ribonucleotide reductase inhibitors
      • Adrenocortical steroid inhibitors
      • Antimicrotubule agents
      • Retinoids
      • Hydroxyurea
      • Asparaginase
      • Miscellaneous

    Targeted Therapy

    • Targets specific cancer genes, proteins, or the tissue environment.
    • Examples include:
      • Monoclonal antibodies
      • Tyrosine kinase inhibitors
      • Apoptosis-inducing drugs
      • Angiogenesis inhibitors
      • mTOR inhibitors

    Hormone Therapy

    • Stops hormone production, blocks hormone receptors, or substitutes hormones for targeted cancer cells.
      • Adrenal steroid inhibitors
      • Androgens
      • Antiandrogens
      • Antiestrogens
      • Aromatase inhibitors
      • Estrogens
      • Progestational agents
      • Selective estrogen receptor modulators (SERMs)

    Cytotoxic Drug Dosing

    • Dose response is steep, with narrow therapeutic index.

    • Dose determination methods include:

      • Mg of drug per BSA
      • Algorithms
      • Fixed dose
      • Area under the curve
    • Dose modification considerations include:

      • Hematological toxicity (blood count)
      • Renal impairment (creatinine clearance)
      • Hepatic impairment (liver function)
      • Other specific toxicities

    Complications of Immunotherapy

    • Side effects, such as:
      • Skin toxicity
      • Colitis
      • Hepatitis
      • Endocrinopathies
      • Neurologic complications

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    Description

    This quiz covers the various classes of chemotherapy drugs used in oncology, including alkylating agents and plant derivatives. It highlights key characteristics, examples, and mechanisms of actions for each class. Test your knowledge about these essential drugs used in cancer treatment.

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