NSG 511 EXAM 1 Questions and Correct Answers
Cancer characteristics
-proliferative
-invasive
-metastatic
-immortal
Growth fraction
ratio of dividing cells (G1+S+G2+M) to resting cells (G0)
Blood cancers primary treatment
cytotoxic therapy d/t high growth fraction
Solid tumor cancers primary treatment
surgery or radiation to lower tumor burden and get more cells dividing so cytotoxic therapy is
more effective
Obstacles to chemotherapy (7)
1. toxicity to normal cells
2. 100% cell kill requirement (remnants may refresh disease)
3. early vs. late detection
4. solid tumors and low growth fraction
5. Drug resistance
6. Heterogeneity of cancer cells
7. limited access depending on location (BBB)
First order kinetics
,a constant percentage of cancer cells are killed with each dose, no matter how many overall
cells there are
lethal tumor burden
1 kg cancer cells
cancer drug resistance (concept)
cytotoxic agents create selection pressure and cells with random mutations that resist therapy
proliferate
Strategies for successful chemotherapy (3)
1. intermittent therapy (allows normal tissues to repopulate more quickly)
2. combination chemotherapy
3. Correct route of administration
Key points of combination chemotherapy (3)
1. less resistance, increased cell kill d/t different MOAs
2. reduce injury by selecting drugs without overlapping toxicities
3. dosing schedules vital
Major chemotherapy toxicities (6)
1. bone marrow (neutropenia, anemia, thrombocytopenia)
2. GI tract symptoms (stomatitis, mucositis, NVD)
3. Alopecia
4. Reproductive toxicities
5. Hyperuricemia from cell death
6. *Damage from vesicant drugs
, Nadir
lowest point in WBC count after chemo
WBC lifespan
7 days
RBC lifespan
3 months
platelet lifespan
14 days
Allopurinol
drug used with MTX to clear uric acid from bloodstream to prevent crystallization and
subsequent kidney damage
Goals of chemotherapy (3)
1. Cure
2. Control/Palliation
3. Prolonging life
Cyclophosphamide (CYP) MOA
Alkylates DNA, "locking" DNA strands together so they cannot separate and divide
Cyclophosphamide (CYP) SE
Myelosuppression
hemorrhagic cystitis
Cancer characteristics
-proliferative
-invasive
-metastatic
-immortal
Growth fraction
ratio of dividing cells (G1+S+G2+M) to resting cells (G0)
Blood cancers primary treatment
cytotoxic therapy d/t high growth fraction
Solid tumor cancers primary treatment
surgery or radiation to lower tumor burden and get more cells dividing so cytotoxic therapy is
more effective
Obstacles to chemotherapy (7)
1. toxicity to normal cells
2. 100% cell kill requirement (remnants may refresh disease)
3. early vs. late detection
4. solid tumors and low growth fraction
5. Drug resistance
6. Heterogeneity of cancer cells
7. limited access depending on location (BBB)
First order kinetics
,a constant percentage of cancer cells are killed with each dose, no matter how many overall
cells there are
lethal tumor burden
1 kg cancer cells
cancer drug resistance (concept)
cytotoxic agents create selection pressure and cells with random mutations that resist therapy
proliferate
Strategies for successful chemotherapy (3)
1. intermittent therapy (allows normal tissues to repopulate more quickly)
2. combination chemotherapy
3. Correct route of administration
Key points of combination chemotherapy (3)
1. less resistance, increased cell kill d/t different MOAs
2. reduce injury by selecting drugs without overlapping toxicities
3. dosing schedules vital
Major chemotherapy toxicities (6)
1. bone marrow (neutropenia, anemia, thrombocytopenia)
2. GI tract symptoms (stomatitis, mucositis, NVD)
3. Alopecia
4. Reproductive toxicities
5. Hyperuricemia from cell death
6. *Damage from vesicant drugs
, Nadir
lowest point in WBC count after chemo
WBC lifespan
7 days
RBC lifespan
3 months
platelet lifespan
14 days
Allopurinol
drug used with MTX to clear uric acid from bloodstream to prevent crystallization and
subsequent kidney damage
Goals of chemotherapy (3)
1. Cure
2. Control/Palliation
3. Prolonging life
Cyclophosphamide (CYP) MOA
Alkylates DNA, "locking" DNA strands together so they cannot separate and divide
Cyclophosphamide (CYP) SE
Myelosuppression
hemorrhagic cystitis
