ONS Chemotherapy Immunotherapy Certificate exam 2022/2023

3 major phases of cell division: Interphase Mitotic phase Cytokinesis 3 steps of interphase: First growth phase (G1) Synthesis phase (S phase) Second growth phase (G2) 4 phases of mitosis: Prophase Metaphase Anaphase Telophase Innate immunity: Non-specific response, either: 1. Barrier (skin, mucous membranes, flora of skin/gut) 2. Cellular components (phagocytes, natural killer cells, granulocytes, macrophages) Adaptive immunity: Follows innate immunity if unsuccessful. Memory immunity, including: 1. Humoral immunity (production of antibodies or immunoglobulins) 2. Cell mediated immunity (dependent upon T cells) 3. Regulatory T -cells (prevent autoimmune reactions and limit inflammatory responses) Define mutations Variations in the nucleotide sequence of a gene 3 main goals of treatment: Cure Control Palliation Define neoadjuvant therapy Treatment is given prior to surgery to shrink the tumor Define adjuvant therapy Additional cancer treatment given after the primary treatment to lower the risk that the cancer reoccur Define conditioning/preparative therapy Treatments used to prepare a patient for stem cell transplantation 2 types of conditioning therapies: Myeloablative Nonmyeloablative Define dose density Drug dose per unit of time Define dose intensity Amount of drug delivered over time How is relative dose intensity (RDI) calculated? By comparing the dose that the patient ACTUALLY received to the planned dose of the standard regimen How do alkylating agents work? By causing a break in the DNA helix strand, interfering with DNA replication and causing cell death 3 subcategories of alkylating agents: 1. Nitrogen mustards 2. Platinum-based agents (do not possess an alkyl group but still termed alkylating agents as they work similarly) 3. Nitrosoureas Most common subcategory of alkylating agents: Nitrogen mustards Common alkylating agents: Cyclophosphamide (Cytoxan) Ifosfamide (Ifex) Bendamustine (Treanda) Common platinum-based agents: Cisplatin (Platinol) Carboplatin (Paraplatin) What is unique about nitrosoureas agents? Able to cross the blood-brain barrier; can be effective in treating some brain tumors Common nitrosoureas agents: Carmustine (BiCNU) Lomustine (CeeNu) Streptozocin (Zanosar) Hypersensitivity can occur with late doses of: Carboplatin These agents are typically categorized as highly emetogenic: 1. Alkylating agents 2. Nitrosoureas Pre-administration labs for alkylating agents and nitrosoureas: BUN Creatinine CBC w/ diff What is the medication Mesna used for? Bladder protectant with administration of cyclophosphamide or ifosfamide Instruct pts receiving ________ to avoid exposure to cold air and consuming cold fluids for 3-4 days following treatment Oxaliplatin How do antimetabolites function? By blocking DNA and RNA growth by interfering with enzymes needed for normal cell metabolism Antimetabolites work in the ___ phase. S What types of cells are best affected by antimetabolites? Cells with high division rates Common side effects of antimetabolites: Myelosuppression GI toxicities Photosensitivity Hand-foot syndrome