Pharm > Week 5 > Flashcards

Week 5 Flashcards

(51 cards)

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1
Q

Cancer Risks

A

Lifestyle, age, epigenetics, environment, UV radiation, alcohol consumption

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2
Q

Alcohol

A

risk factor for oral, pharynx, larynx, esoph, liver, colorectum, breast cancer, genetic factors also involved

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3
Q

TNF-A

A

Pro-inflammatory cytokine in epidermis that plays role in cancer

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4
Q

Reproductive and Infection Cancer

A

HPY, H Pylori (75-89% of stomach cancers) Hep B HPV and Hep C HCV (Liver cancers)

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5
Q

Benign Tumors vs. Malignant Tumors

A

Grow slowly, well-defined capsule, not invasive, well differentiated, low mitotic index, do not metastasize

grow rapidly, not encapsulated, invasive, poorly differentiated, high mitotic index (cell proliferation), metastisizes

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6
Q

Adenoma

A

Gland benign tumor

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7
Q

Fibroma

A

Fiber benign tumor

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8
Q

Hemanginoma

A

Blood benign tumor

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9
Q

Lipoma

A

Fatty benign tumor

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10
Q

Carcinoma

A

Epithelial Malignant tumor

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11
Q

Adenocarcinoma

A

Ductal malignant tumor

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12
Q

Sarcoma

A

Mesenchymal (connective tissue) malignant tumor

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13
Q

Lymphoma

A

Lymphatic malignant tumor

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14
Q

Leukemia

A

Blood-forming cell malignant tumor

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15
Q

Telomeres

A

Protective cap at end of chromosomes in germ cells, maintained by telomerase - found in tumors to keep them replicating

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16
Q

Tumor Associated Macrophage (TAM)

A

Help tumors survive, correlated with worse prognosis, diminished cytotoxic response, block T-cytotoxic and NK cell, produce advantageous cytokines

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17
Q

Carcinoma in SITU (CIS)

A

Preinvasive epithelial malignant tumors that have not broken through basement membrane or invaded surrounding stroma

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18
Q

Invasion (cancer)

A

Cellular multiplication, release of lytic enzymes to kill normal cells, decreased cell-cell adhesion, increased motility

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19
Q

Metastasis

A

Spread of cancer from primary site to distant site, invasion of contiguous organs through local spread, metastases to distant organs through lympatics and blood, usually occurs late

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20
Q

Clinical Manifestations of Cancer

A

Syndrome of Cachexia - malnutrition, anorexia, early satiety, weight loss, anemia, taste alterations, altered metabolism

Anemia - decrease of blood hemoglobin,

CAUSED BY: chronic bleeding from iron deficiency, malnutrition, medical therapies, malignancy in blood-forming organs

Leukopenia and Thrombocytopenia - tumor invasion of bone marrow and chemotherapy drugs toxic to bone marrow

Infection - risk increases when neutrophil and lymphocyte counts fall

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21
Q

Cancer Staging

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A

Metastasis
Stage 1 - none
Stage 2 - local invasion
Stage 3 - spread to regional structures
Stage 4 - distant metastasis

22
Q

TNM System

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A

T - tumor spread/size

N - nodes

M - metastasis

23
Q

Tumor Markers

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A

Biological markers produced by cancer cells found in or on tumor cells in blood CSF or urine

screens and identify high risk indiv, diagnose type of tumor, observe clinical course of cancer

Problem: false positives and negatives

24
Q

Common Tumor Marker

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A

PSA which indicates prostate cancer

Note: AFP could mean cancer or pregnant

25
Cancer Treatment
Surgery - prevent cancer, biopsy, lymph node sampling, palliative surgery (focusing on comfort) Radiation - eradicate cancer without excessive toxicity, avoid damage to normal structures
26
Non Small Cell Lung Cancer
85% of primary lung cancer diagnoses - EGFR mutation causes this, helps us target treatment and prevention
27
Malignant Lymphomas
Proliferation of malignant lymphocytes Primary - thymus, bone marrow Secondary - Lymph nodes, spleen, tonsils, intestinal lymphoid tissue
28
Hodgkin Lymphoma
Reed-Sternberg cells in the lymph nodes (necessary but specific), derived from malignant B cells, stages 1-4 Enlarged, painless neck lymph nodes, lymphadenopathy, mediastinal mass, fever, weight loss, night sweats, pruritis (itching), fatigue Tests: chest X-rays, lymphangiography, biopsy (most indicative)
29
Non-hodgkin Lymphoma
B cell neoplasms and includes T cell and NK, linked to chromosome translocations lymphadenopathy, nodal enlargement over months or years PAINLESS, retroperitoneal and abdominal masses with symptoms of abdominal fullness and back pain, ascites (fluid in peritoneal cavity) and leg swelling, biopsy (primary means)
30
Hodgkin vs Non Hodgkin
Localized nodes vs multiple Orderly spread vs non contiguous Fever night sweats weight loss vs none Reed Sternberg Cells vs not localized vs not
31
Acute Myeloid Leukemia
bone marrow, blood cells, platelets, wbcs, malignancies of immature wbcs
32
Acute Lymphoid Leukemia
bone marrow, too many lymphoblasts
33
Chronic Lymphatic Leukemia
slower progressing, lymphocytes, often asymptomatic, lymphadenopathy, WBCs non functional
33
Chronic Myeloid Leukemia
slower leukemia, increased granulocytic precursors, eosinophils, more WBCs but less functional
34
Leukemia Pathophys Symptoms
Anemia, bleeding, unintended weight loss, bone pain, liver or spleen enlargement, increased uric acid, more susceptible to infection
35
Solid Tumor Relation to Chemo
Have low growth fraction, so less sensitive to chemo
36
High Growth Fraction
Leukemias and lymphomas - chemo more effective against because they target rapidly dividing cells - hair follicles, bone marrow, GI tissue also targeted which explains side effects
37
Cell Cycle
G0 phase - resting G1 phase - synthesize material needed to duplicate DNA S phase - duplicate DNA G2 phase - premitotic phase M phase - mitosis occurs
38
Glioma
cancer of glial (interstitial cells) in CNS
39
Cancer Regimens
Surgery, radiation, cytotoxic drugs, hormonal agents
40
Multiple Drug Strategy
Different classes - affect diff stages in cell cycle and diff mechanisms of action allows for lower doses to reduce toxicity and slow development of resistance
41
Hyperuricemia
Caused by chemo as a result of DNA degradation renal injury can be minimized by giving IV fluids and med - prophylactic allopurinol to block uric acid formation
42
Nitrogen Mustards
Cyclophosphamide Alkylating Agents - prevents cell division and disrupts DNA replication, LYMPHOMAS Bone marrow suppression, alopecia, thrombocytopenia, hemorrhagic cystitis (unique, bleeding in bladder) NC - use contraception bc of repro complications, monitor CBC and LFTs, adequate hydration
43
Platinum Compounds
Cisplatin (Platinol) IV Alkylating Agent - platinum analog that binds to nucleotides to prevent replication nausea, vomiting, ototoxicity, nephrotoxicity, neuropathy, bone marrow suppression monitor renal function, hydration, assess hearing for ototoxicity, and LFTs
44
Methotrexate (MTX) (Otrexup, Trexall)
Antimetabolite (antifolate) - block synthesis of folic acid bone marrow suppression, rare alopecia, thrombosis, thrombocytopenia NC: teratogen so no use during pregnancy, monitor CBC and LFT, limit ETOH intake, monitor for bleeding
45
5 Fluorouracil (5-FU) (Adrucil)
Antimetabolite (Pyrimidine Analog) - inhibit thymidylate synthetase needed to make DNA mainly for solid tumors immune system suppression, lack of appetite, hair loss, nausea, vomiting no pregnancy, CBC and LFTs
46
Anti-Tumor Antibiotics
doxorubicin (Doxil, Adriamycin), daunorubicin (Cerubidine) Anthracyclines - inhibit cell growth through cytotoxicity and trigger apoptosis bone marrow suppression, nausea, vomiting, cardiotoxicity caution with heart failure, CBC and LFT and cardiac function, red discoloration (not bleeding) of bodily fluids
47
Anti Microtubule Agents
Vincristine (Oncovin), vinblastine (Velban) Vinca alkaloid - disrupt M-phase leading to cell arrest and apoptosis neurotoxicity and periph neuropathy, bone marrow suppression, alopecia muscle weakness, no bone marrow depression, monitor for peripheral neuropathy, need central line because it is caustic
48
Antiestrogens
Tamoxifen (Soltamox) Estrogen receptor antagonist - stops growth of estrogen dependent tumors (breast cancer) thrombocytopenia, hot flashes, hyperglacemia, GI upset, risk of uterine cancer and pulmonary embolism (risk of clots) Should use contraception, monitor for DVT (leg swelling, tenderness) or PE (shortness of breath), avoid grapefruit juice, administer with food or fluids to decrease GI irritation
49
Androgen Deprivation Med
Leuprolide (Lupron) Gonadotropin releasing hormone agonist - blocks effects of adrenal androgens on prostate cells by decreasing testosterone (Prostate cancer) decreased libido, gynecomastia (breast tissue), hot flashes, low blood sugar no pregnancy, monitor glucose for hypoglacemia
50
Handling Antineoplastic drugs
Need special qualifications to administer double flush bodily fluid, special hampers, PPE, special concerns for chemo liquid spills
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