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Exam 2
Neoplastic Drug Theory
46
Nursing
Graduate
10/18/2016

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Term
Cushing's disease
Definition
overstimulation of adrenal corticoids
Term
Addison's disease
Definition
adrenal corticoids insufficiency
Term
cancer
Definition
a term for diseases in which abnormal cells divide without control and are able to invade other tissues
--Named for organ or type of cell where they start
Term
Cancers that result in most deaths
Definition
1--Lung cancer
2--Gender specific cancers
3--Colon
Term
Staging of Cancer
Definition
IDs extent of disease
TNM system: Tumor size; Nodes; Metastases
Term
Grading of Cancer
Definition
Determines how closely tumor cells resemble normal cells
-Higher grade = more aggressive
G1 = very well differentiated
G4 = undifferentiated
Term
Treatment Modalities
Definition
1-Surgery; 2-Radiation Therapy; 3-Chemotherapy; 4-Biotherapy
Term
Characteristics of Neoplastic Cells
Definition
1-persistent proliferation
2-angiogenesis
3-invasive growth
4-formation of metastases
5-immortality
Term
Senescence
Definition
the process of deterioration with age
--each cell has only so many divisions before apoptosis
Term
cyclin-dependent kinase (CDK) complexes
Definition
inactive cell cycle regulators
--activate when bound to cyclin to turn on a phase of the cell cycle
Term
Phases of Cell Cycle
Definition
Gap 0 (G0)
Gap 1 (G1)
Synthesis
Gap 2 (G2)
Mitosis
Term
G0
Definition
resting or dormant phase of cell cycle
--cancer cells can hide here
--no cellular division here
Term
G1
Definition
cell cycle phase of protein synthesis
Term
cell cycle synthesis
Definition
DNA replication in cell cycle
Term
G2
Definition
premitotic or post-synthetic phase of cell cycle
-prepares for mitotic spindle formation
Term
mitosis
Definition
cellular division
--shortest but most active phase of cell cycle
Term
growth fraction in chemotherapy
Definition
GF is the ratio of proliferating cells to the total number of cells
-higher GF = increased response to chemo but more destruction
Term
Parts of body with high growth fraction
Definition
1-bone marrow; 2-skin; 3-hair follicles; 4-sperm; 5-GI tract
Term
Normal function of oncogenes
Definition
cell growth and gene transcription
--In cancer, oncogenes are agonized = allows uncontrolled growth
Term
Normal function of tumor suppressor genes
Definition
DNA repair, cell cycle control and cell death
--In cancer, TSG are inactivated
Term
Strategies for achieving maximal benefits from chemotherapy through combo therapy
Definition
1-suppression of drug resistance
2-increased cancer cell kill--more drugs, but less of each
3-reduced injury to normal cells
Term
Strategies for achieving maximal benefits from chemotherapy through optimizing dosing schedules
Definition
1-consistent, repetitive dosing
2-allow for enough time for normal cells to recover but not enough time for cancer cells to recover
Term
alkylating chemo agents (2)
Definition
1-nitrogen mustards
2-nitrosoureas
Term
Antimetabolitic chemo agents (4)
Definition
1-folic acid analogs
2-pyrimidine analogs
3-purine analogs
4-hypomethylating agents
Term
Major Classifications of Cytotoxic Chemo Agents (5)
Definition
1-Alkylating agents
2-Antimetabolites
3-Platinum Compounds
4-Antitumor Antibiotics
5-Mitotic Inhibitors
Term
Antitumor chemo agents (2)
Definition
1-Anthracyclines
2-Non-anthracyclines
Term
Mitotic Inhibitor chemo agents (3)
Definition
1-Vinca alkaloids
2-Taxanes
3-Topoisomerase inhibitors
Term
Physiological vs pharmacological effects of glucocorticoid drugs
Definition
Physiological effect is achieved via low doses to maintain what the body cannot do on its own. Pharmacological effect is achieved via high doses to suppress the immune system and inflammation.
Term
Function of the adrenal cortex
Definition
Negative feedback loop that secretes hormones in response to ACTH stimulation
-ie. cortisol, aldosterone, adrogens
Term
Negative feedback loop of adrenal cortex (HPA axis)
Definition
Stressors in the body trigger hypothalamus to stimulate the anterior pituitary gland. Anterior pituitary releases ACTH that stimulates the adrenal cortex to release specific hormones. Once the stressor is turned off, the feedback loop stops.
Term
Effects of glucocorticoids on the body
Definition
1-Metabolism: inc sugars; inc fat breakdown; dec protein synthesis
2-CV: maintains HR, BP
3-GU: H2O and Na+ retention
Term
How are the molecular mechanisms of glucocorticoids different than other drugs?
Definition
1-receptors are on the inside of cells
2-Modulate the production of regulatory proteins directly rather than through signaling pathways
Term
Drug interactions with glucocorticoids
Definition
1-K+ loss--diuretics
2-NSAIDs
3-Insulin or other hypoglycemics
4-Vaccines
Term
Adverse effects of glucocorticoids
Definition
1-adrenal insufficiency; 2-infection; 3-fractures/osteoporosis; 4-glucose intolerance; 5-myopathy; 6-fluid and electrolyte imbalances; 7-growth retardation; 8-psychological disturbances; 9-cataracts/glaucoma; 10-peptic ulcer disease; 11-iatrogenic Cushing's syndrome
Term
Contraindications of Glucocorticoids
Definition
1-systemic fungal infections
2-Live virus vaccines
3-Pregnancy/breast-feeding
Term
Signs of Cushing's syndrome
Definition
1-moon face; 2-puffy eyelids; 3-edema in feet; 4-increased bruising; 5-dizziness; 6-bleeding; 7-menstrual irregularities
Term
Signs of Cushing's syndrome
Definition
1-moon face; 2-puffy eyelids; 3-edema in feet; 4-increased bruising; 5-dizziness; 6-bleeding; 7-menstrual irregularities
Term
Anti-inflammatory agents from most severe to least severe
Definition
1-glucocorticoids: prednisone IV/PO; fluticasone inhaler; fluticasone nasal
2-leukotriene modifiers: montelukast
Term
Short-acting beta 2 adrenergic agonist
Definition
bronchodilator--Albuterol
Term
long-acting beta 2 adrenergic agonist
Definition
two components:
1-bronchodilator (Albuterol)
2-anti-cholinergic (ipratropium) OR steroid (fluticasone)
Term
anti-cholinergic drugs
Definition
Ipratropium (Atrovent)
Term
Histamine H1 receptor
Definition
1-vasodilation
2-increased capillary permeability
3-bronchoconstriction
4-CNS effects
Term
Histamine H2 receptor
Definition
secretion of gastric acid
Term
Principle mediators in anaphylaxis
Definition
leukotrienes
Term
Drug of choice for anaphylaxis treatment
Definition
epinephrine
Term
MOA in Histamine H1 Antagonists
Definition
1-compete with histamine for receptor sites preventing histamine response
2-Smooth muscle constriction
3-Decrease nasopharyngeal, GI and bronchial secretions
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