40 Questions
What is the second leading cause of death in America, after cardiovascular disease?
Cancer
What are the two types of chemotherapy mentioned as advances in cancer treatment over the last 100 years?
Cytotoxic chemotherapy and targeted chemotherapy
How can cancer screening impact society?
It can lead to overdiagnosis in certain types of cancers
What is the main function of the RB checkpoint in the normal cell cycle progression?
To prevent cell cycle progression
What happens if the Rb gene does not work properly in the cell cycle progression?
The cell will progress to the S-phase even if it should not
What impact do errors in DNA replication have on the activation of the P53 protein?
Errors in DNA replication enhance the activation of P53 protein
What is a key characteristic that differentiates malignant cells from non-malignant cells?
Uncontrolled and abnormal growth
What is the function of telomerase in cancer cells?
Adds back telomeres to allow for infinite replication
Which protein is upregulated in many cancer cells and causes the growth of new blood vessels?
VEGF
What is a common feature of tumor genetic changes in cancer cells?
Invasion and metastasis
Which gene mutation is found at the interphase between G1 and S phases and increases the chance of mutation during cell proliferation?
Rb
What serves as a protective function against potentially dangerous cellular abnormalities?
Programmed cell death (apoptosis)
Which characteristic of cancer cells is associated with the inability to repair DNA?
Genomic instability
Which gene encodes for proteins that make cells grow and divide, and when mutated, can lead to increased cellular activity?
EGFR
What is the primary mechanism of action of alkylating agents in disrupting DNA synthesis and replication?
Formation of DNA adducts
Which toxic effect is unique to cyclophosphamide and ifosfamide among alkylating agents?
Hemorrhagic cystitis
What type of gene is TP53 in the context of cancer development?
Tumor suppressor gene
Which hallmark characteristic of cancer may develop without mutational changes?
Nonmutational epigenetic reprogramming
What is the main metabolite responsible for the development of cyclo-/ifosfamide-induced hemorrhagic cystitis?
Acrolein
Which drug can be used to mitigate acrolein-induced toxicity by mimicking glutathione?
Mesna
What is the main strategy for preventing cisplatin-induced nephrotoxicity?
Administering IV fluids with normal saline pre- and post-cisplatin
What is the mechanism of action of methotrexate?
Inhibition of key enzyme in the folate pathway
What is the role of leucovorin as it pertains to high dose methotrexate?
Rescuing healthy cells without rescuing cancer cells
What is a unique toxicity associated with platinum (Cisplatin) agents?
Gonadal toxicity
What is the primary role of Leucovorin in the presence of high-dose methotrexate (MTX)?
Bypassing the inhibited DHFR enzyme
Which enzyme is primarily responsible for the bio-activation of capecitabine?
Carboxylesterases
What is the pharmacogenetic determinant of 5-FU/capecitabine toxicity that leads to life-threatening toxicity in individuals with deficiency?
Dihydropyrimidine dehydrogenase (DPD)
What are the hallmark toxicities of cytarabine and gemcitabine, respectively?
Mucositis; Alopecia
What is the mechanism of action of purine analogs in inhibiting DNA synthesis?
Interfering with purine biosynthesis
What is the primary reason why purine analogs increase the risk of opportunistic infections?
Inhibiting purine biosynthesis
Which purine analog requires prophylactic antimicrobials?
Fludarabine
Which drug interaction is associated with purine analogs?
Allopurinol increases myelosuppression of 6MP
Which microtubule inhibitor causes hypersensitivity reactions related to its diluent?
Docetaxel (Taxotere)
What unique toxicity is associated with vincristine?
Constipation
What is the unique step required to prepare and administer paclitaxel (Taxol)?
Use of a special tubing
What is the brand name for docetaxel?
Taxotere
What is the conventional maximum dose of vincristine?
2mg/dose
What are the unique toxicities of topoisomerase I inhibitors?
'Cholinergic storm', bone marrow suppression
How can toxicities from topoisomerase I inhibitors be limited or treated?
[[Atropine 0.25 to 1mg IV, loperamide 4mg initially]]
What are the pharmacokinetic predictors of effect to topoisomerase I inhibitors?
[[Metabolized by CYP3A4 into two inactive metabolites]]
Test your knowledge about the use of Mesna as a chemoprotectant to prevent ifosfamide-induced hemorrhagic cystitis and its role in mitigating acrolein-induced toxicity. This quiz covers the dosage, administration, and considerations for using Mesna with ifosfamide.
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