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Exam 2
Ranjan Lectures
65
Veterinary Medicine
Professional
09/30/2015

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Term
Definition: Cytotoxic Drug
Definition
-subsstances that are toxic to cells
Term
Definition: Hazardous Drug
Definition
-includes anti-neoplastic, antiviral, sex steroid hormones, and immuno suppressants
Term
What are the four important characteristics of hazardous drugs?
Definition
1) genotoxic
2) carcinogenic
3) tetrogenic
4) ability to cause serious organ or toxic manifestation in experimental animals
Term
Definition: Occupational Safety and Health Act (1970)
Definition
-federal law which governs workplace health and safety
-under this act, MIOSH makes recommendation to OSHA on required safety measures
-OSHA has the primary responsibility of enforcing safety measures at workplace
Term
What are the main routes of exposure to cytotoxic drugs?
Definition
-inhalation of dusts or aerosols, dermal absorption, and ingestion
Term
What are a couple recommended practices that can minimize exposure?
Definition
-establishment of a designated drug handling area
-use of biological safety cabinets
-procedures for safe disposal of contaminated waste
-decontamination procedures
Term
If BSCs are not available, what do you do?
Definition
-longer latex/nitrile gloves that cover the gown cuff, NIOSH-approved respiirator, and eye and face masks are recommended for use with HD's
Term
What are the advantages of a closed system?
Definition
-prevent leak and aerosol exposure to cytotoxic drugs
Term
What are the recommended types of biosafety cabinets?
Definition
-Class II, type B, or Class III BSC's (vent outside)
Term
What are the methods of decontamination?
Definition
-surface cleaning with water and detergent and thorough rinsing
-do not bleach as they do not inactivate all chemicals
Term
What are the potential toxic effects of cytotoxic drugs?
Definition
-genotoxic, carcinogenic, teratogenic/fertility impairment, serious organd or other toxic manifestations
Term
Definition: Chemotherapy
Definition
-the application of drugs to kill infectious organisms or foreign cells
Term
Definition: Immunotherapy
Definition
-treatment with use of specific antibodies to tumor molecules
Term
Definition: Cell Therapy
Definition
-introduction of new cells into body to treat disease
Term
Definition: Adjuvant therapy
Definition
-describe chemotherapy that accompanies surgery or radiation therapy
Term
Definition: Combination chemotherapy
Definition
-use of two or more drugs at specified dosage and intervals
Term
Definition: Holotherapy
Definition
-treatment drawn from all classes of therapeutic agents such as chemo, immuno, hormones, antibodies, gene therapy
Term
Definition: Cured
Definition
-when all the cancer cells have been killed
Term
Definition: Remission
Definition
-when all clinical evidence of cancer ha disappeared
Term
Definition: Palliative
Definition
-treatment to reduce pain, improve sense of well-being (when cure is unlikely)
Term
Definition: Cell cycle
Definition
-process of cell growth and division
Term
What are the phases of the cell cyle?
Definition
-INterphase, Metaphase, C phase
Term
What are the subdivisions of interphase?
Definition
-G1: cell growth phase
-S: DNA replication phase
-G2: phase of continued cell growth and preparation for division
Term
What is M-phase?
Definition
-process where DNA is moved to two ends of a cell
Term
What is C-phase?
Definition
-cytoplasm is divided to create two daughter cells
Term
What controls the transition between the phases of the cell cycle?
Definition
-Cyclin-Dependent Kinases (CDKs)
Term
How long doess it take for a normal cell cycle?
Definition
-20-24 hours
Term
True or False: Cancer cells respond to CDKs and thus can have controlled cell division.
Definition
-FALSE, do not not respond to CDKs and have uncontrolled cell division
Term
As tumor grows in size, the doubling time of cells (quickens/slows) and consequenlty the growth fraction (Decreases/increases).
Definition
-slows
-decreases
Term
What is the log kill hypothesis?
Definition
-states that a constant proportion of cells (normal and cancerous) are killed with each chemotherapy cycle
Term
True or False: Normal cells have a faster doubling time compared to tumor cells, and rebound quickly upon chemotherapy.
Definition
-TRUE
Term
What prevents the rapid renewal of cells and causes regression upon chemotherapy?
Definition
-slower growth fraction
Term
True or False:n Myelosuppression is generally oberved with chemotherapy.
Definition
-TRUE
Term
What is a possible side effects of chemotherapy drug toxicity?
Definition
-GI toxicity (diarrhea & vomiting) and hair thinning can also be seen
Term
What causes phelbitis and tissue necrosis?
Definition
-extravasation of chemotherapeutics at injection sites
Term
True or False: Drug resistance can occur at many levels.
Definition
-TRUE
Term
What is the purpose of Body Surface Area?
Definition
-a method to normalize drug dosage across species
-may not be accurate and small animals may receive mor drug
Term
What are Akylates? Example?
Definition
-alkylates in nitrogen atom of guanine in DNA causing inter and intra-strand cross links
-ex: cyclophosphamide, carmustine, melphalan, Dacarbazine
Term
What are some common Akylate side effects?
Definition
-myelosuppressin and GI toxicity
Term
Are Akylates cell cycle specific?
Definition
-no, not regarded as being cell cycle specific because of their abilit to kill non-proliferating cells
Term
Give an example of a nitrogen mustard. What are some possible side effects?
Definition
-ex: cyclophosphamide
-can cause sterile necrotizing hemorrhagic cystitis characterized by bloody urine, and transitional cell carcinoma in cats and dogs
Term
Give an example of a Platinum co-ordinated complex.
Definition
-cisplatin, carboplatin
Term
What is the indication for cisplatin?
Definition
-transition and squamous cell carcinoma, osteosarcoma
Term
When is cisplatin contraindicated? Why would it be limited i dogs?
Definition
-in cats because it causes fatal pulmonary toxicity
-nephrotoxicity is a dose limiting toxic effect in dogs
-should not be administered through an aluminum needle since aluminum reacts and inactivates the drug
Term
Most Antimetabolites are prodrugs that get converted (extracellularly/intracellularly) into their active forms.
Definition
-intracellularly
Term
Give an example of antimetabolites. What do they do?
Definition
-methotrexate, 5-Fluorouracil
-inhibits S-phase DNA synthesis (Cell cyycle specific)
Term
What are the possible side effects of antimetabolites?
Definition
-myelosuppression and GI toxicity
Term
How does methotrexate (MTX) work?
Definition
-binds to dihydrofolate reductase (DHFR) and affects purine and pyrimidine synthesis
Term
When is methotrexate contraindicated?
Definition
-in a patient with bone marrow depression
Term
What is the MOA of microtubule-targed agents?
Definition
-destroys mitotic spindle
Term
What are a few of members of microtubule-targed agents?
Definition
-vinca alkaloids (vincristine, vinblastine)
Term
Tell me about vincristin.
Definition
-a major drug in veterinary oncology, and effective against transmissible venereal tumor as a single agent
Term
What are the side effects of microtuble-targeted agents?
Definition
-severe tissue irritant, and neurotoxic
Term
What are a few examples of topoisomerase inhibitors antibiotics?
Definition
-doxorubicon, daunorubicin, bleomicin
Term
How do topoisomerase inhibitors work?
Definition
-broad spectrum anti-tumor activity and most widely used in small animal medicine
Term
Explain the mechanism of doxorubicon.
Definition
-stabilizes DNA-topoisomerase complex and prevents re-ligation of DNA strands
Term
What is another word for doxorubicon? Why is it called that?
Definition
-intercalating agents
-intercalates between adjacent base pair
Term
Give an example of an enzyme.
Definition
-asparaginase
Term
How does asparaginase work?
Definition
-asparaginase catalyses exogenous apsaragine required by cancer cells for DNA and protein synthesis
Term
In what cell cycle phase are enzymes most active? What are the used for?
Definition
-most active in G1-cell phase
-used in canine lymphomas but can cause hypersensitivity in dogs
Term
What is the MOA of tyrosine kinase inhibitors?
Definition
-selectively inhibit tyrosine kinase activity in cells
Term
What are a few examples of tyrosine kinase inhibitors?
Definition
-kinavet, toceranib
Term
What are tyrosine kinase inhibitors used for? Side effects?
Definition
-canine mast cell tumor
-severe GIT symptoms like diarrhea or bleeding
Term
What are the things to watch for with administration of tyrosine kinase inhibitors?
Definition
-protein levels in blood
Term
Discuss combination therapy.
Definition
-drug with different MOA achieving additive effect against tumors
-may reduce incidences of drug resistance
-toxicities of combined drugs should not overlap
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