Mer Scott
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PHCY320 (Oncology) Quiz sobre ON4 Pharmacology of Anti-Cancer Drugs , criado por Mer Scott em 05-10-2019.

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ON4 Pharmacology of Anti-Cancer Drugs

Questão 1 de 16

1

Cytotoxic drugs damage the reproductive potential of cells by acting on DNA . Selectivity depends on of synthesis/division:
dividing cells more likely to respond to Tx
cancer cells resistant

Cell-cycle phase drugs: schedule dependent (time dependent)
Cell-cycle phase- drugs: dose dependent

Arraste e solte para completar o texto.

    synthesis
    rate
    Rapidly
    Resting
    -specific
    nonspecific

Explicação

Questão 2 de 16

1

Growth fraction is number of cells in over the total number of cells. This is normally %. It changes in cancers eg Burkitt’s lymphoma: 100% GF, Colon carcinoma: <5%.
Greater growth fraction means a chance of cell death.
The is the proportion of cells a cytotoxic dose kills. Note that drugs kill a proportion of cells, not a given number of cells. Intermittent therapy tumour cell killing and allows of healthy cells.

Arraste e solte para completar o texto.

    cell cycle
    20
    better
    proportional cell kill
    maximizes
    recovery

Explicação

Questão 3 de 16

1

Toxicity related to cytotoxic drugs:
The therapeutic index is a measurement of the relative of a drug, usually around 1(below one is less safe). It is a comparison of the amount of a therapeutic agent that causes the therapeutic , to the amount that causes .
In cancer a therapeutic dose is a dose.
The drug action is to the growth rate; meaning a greater effect in growth fraction & vice versa.
The drug with affect dividing (cancerous AND non-malignant) tissue.

Arraste e solte para completar o texto.

    safety
    effect
    toxicity
    toxic
    proportional
    high
    rapidly

Explicação

Questão 4 de 16

1

Match the tissues to their types of proliferation.

Continuous rapid proliferation - marrow, mucosa, follicles, germ cells
Continuous slow proliferation - epithelium, endothelium
Cyclical proliferation - Glandular female tissue, lining of uterus
Capacity to proliferate after injury -
Non proliferating - Cartilage

Arraste e solte para completar o texto.

    Bone
    Gastrointestinal
    Hair
    Testicular
    Tracheobronchial
    Vascular
    breast
    Endometrial
    Liver, Bone
    Skeletal muscle, Cardiac muscle,

Explicação

Questão 5 de 16

1

Hematopoietic system toxicity:
Bone marrow suppression occurs when cell pool is damaged by chemotherapy. Clinically we see a in circulating cells. Platelets gone within weeks. Granulocytes within 14 days. Fall in white cell count by days. No change in RBCs for weeks. Then, bone marrow occurs.

(Erythrocyte life span: days. Platelet: days. WBCs: days.)

Arraste e solte para completar o texto.

    stem
    fall
    1-2
    3-7
    6-8
    recovery
    120
    9-10
    4-5

Explicação

Questão 6 de 16

1

Infection, bruising and anaemia are signs of hematopoietic system toxicity.

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 7 de 16

1

Nearly all cytotoxics cause BM suppression at therapeutic doses but severity and duration . Why?
1. Different effects on stem cells (pluripotent vs unipotent)
2. Kinetics of cell types in peripheral blood ( of cells)
3. Cycle nonspecific drugs: greater than phase specific

Low BMS with .
Cancer cells have [hydrolase], BM cells have [hydrolase].

Arraste e solte para completar o texto.

    varies
    precursor
    life span and turnover
    duration of BMS
    bleomycin
    low
    high

Explicação

Questão 8 de 16

1

Nausea and vomiting as a SE has a complex mechanism, only partly due to action of drugs on GIT. It can affect the nerve which affects the centre. Anticipatory nausea is common and the pathway uses .

Arraste e solte para completar o texto.

    direct
    vagus
    emetic
    catecholamines/DA

Explicação

Questão 9 de 16

1

GI Tract toxicity:
Observed as oesophagitis, diffuse ileitis, colitis, oral .
• Mucosal cells have turnover (4-7 days)
after cytotoxic administration: Pain, tingling, dryness, loss of taste - - -
• Consider the combo of trauma/low count/pathogen environment
• Severity: dose related, schedule of administration
• Worse in people.

Arraste e solte para completar o texto.

    mucositis
    high
    3-4 days
    ulceration
    local
    WBC
    rich
    younger

Explicação

Questão 10 de 16

1

Dermatological toxicity:
1. Alopecia
hair follicles actively dividing, 24h doubling time

2. Specific skin toxicity (uncommon)
: Palmar-plantar syndrome (redness, swelling, and on palms and soles). Affects growth of skin cells, capillaries
3. Extravasation

Arraste e solte para completar o texto.

    60-90%
    Reversible
    Capecitabine
    pain

Explicação

Questão 11 de 16

1

Match the cytotoxics to the cell phase they act in.
G1 -
S phase -
G2 -
Mitosis -
Phase non-specific - agents, Cytotoxic , -based drugs

Arraste e solte para completar o texto.

    Steroids, asparaginase
    Antimetabolites
    Bleomycin
    Vinca alkaloids, taxanes
    Alkylating
    antibiotics
    Platinum

Explicação

Questão 12 de 16

1

Alkylating agents:
binding to 1) DNA - blocks DNA/RNA and 2) proteins - blocks DNA .
Cell-cycle .
Causes suppression, hair loss, GI disturbances.
PK depends on structure.

e.g. for breast and bronchi cancer. Hydroxylation in liver makes the active . Risks: Haemorrhagic cystitis (stay ), damage (with high dose).

Arraste e solte para completar o texto.

    Covalent
    synthesis
    repair
    nonspecific
    BM
    Cyclophosphamide
    metabolites
    hydrated
    Cardiac

Explicação

Questão 13 de 16

1

Cytotoxic antibiotics:
Anthracyclines (Streptomyces): e.g. Daunorubicin, , epirubicin
In general - cell cycle specific.
• DNA intercalation
• Inhibits
• Blocks , disrupt normal replication = cell death
Poor gut absorbtion so given .
Toxicitity:
– dose dependent and cumulative
Maximum dose recommended to prevent heart failure.

Special case: Bleomycin. Non-anthracycline cytotoxic AB for tumours, Hodgkin’s .
Mode: DNA intercalation, free radical-induced (cell cycle ).
Pulmonary and dermatological toxicity, low BM suppression: pulmonary (partially reversible), (50% of patients).

Arraste e solte para completar o texto.

    doxorubicin
    non
    topoisomerase II
    transcription
    IV
    Cardiotoxicity
    cumulative
    germ cell
    Lymphoma
    strand breaks
    specific
    fibrosis
    erythema, hyperkeratosis, pigmentation

Explicação

Questão 14 de 16

1

Platinum compounds e.g. cisplatin, carboplatin, oxaliplatin. AKA ‘Non-classical alkylating agents’.
MoA: interact with - INTRA strand -linking.
infusion, excreted by . Long t1/2: h, due to protein binding.
◦ BM suppression and GI toxiciity - requires support
◦ Renal toxicity ()
, tinnitus, hearing loss
◦ Peripheral neuropathy

Arraste e solte para completar o texto.

    Clions
    N-7 of guanine
    cross
    IV
    kidney
    24-60
    anti-emetic
    reversible
    Ototoxicity

Explicação

Questão 15 de 16

1

Antimetabolites:
• Structural similarity to of normal metabolism
• Incorporation into nucleic acids e.g. (prodrug)
• Enzyme substrates that inhibit RNA and DNA
• Good absorption, also IV, intrathecal
excretion

e.g. Methotrexate (MTX) for leukaemias (breast, head, lung and neck).
analogue, stops synthesis
Toxicity: BM (leukocytes) – infection, GI (mucosa)

Arraste e solte para completar o texto.

    intermediates
    5-FU, capecitabine
    synthesis
    gut
    Renal
    Folate
    purine

Explicação

Questão 16 de 16

1

Mitotic inhibitors which are derivatives are cell cycle-specific.

1. Vinca alkaloids
e.g. Vincristine, vinblastine, vindesine, vinorelbine
Bind to , inhibits polymerisation (mitosis). Eliminated via metabolism. Given usually. Toxicity: constipation, BMS usually dose limiting (absent for ), dose-limiting for vincristine, neuropathy (mixed motor/sensory), paraesthesia, loss of deep reflexes (axonal transport).

2. Taxanes
e.g. Docetaxel, paclitaxel
Stabilise structure, prevent cell division. Poor absorbtion. Hepatic metabolism. Toxicity: Dose-limiting , arthralgia/myalgia syndrome (mechanism unknown)
Paclitaxel: neuropathy (motor at higher dose)
Docetaxel: leg (fluid retention – peripheral effect)

Arraste e solte para completar o texto.

    plant
    tubulin
    IV
    vincristine
    neurotoxicity
    microtubule
    oral
    neutropaenia
    sensory
    oedema

Explicação