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CHAPTER 21 Chemotherapy Drugs Quiz Yourself1. The physician must determine the type of cancer and the stage of the cancer beforebeginning treatment.2. Neoplasm: Anew growth of cells that may be malignant or benign.Stage: The extent of cancer progression.Adjuvant therapy: Chemotherapy (or radiation therapy) given to cancer patients afterthey have had surgery to remove a tumor. The purpose is to eradicate any remaining tumor cells.Remission: The period of time when cancerous cells stop actively reproducing.Analog: A drug that is created by slightly modifying the molecular structure of another substance.Mitosis: The process of cell division.Chemotherapy protocol: A combination of several chemotherapy drugs and othertypes of drugs that have been found to be successful in treating a particular type of cancer. A protocol maximizes the effectiveness of therapy through the actions of the various drugs, but minimizes the side effects that would occur with a large dose of a single drug.Leucovorin rescue: Administration of the drug leucovorin to counteract the toxiceffects of methotrexate chemotherapy.3. The word cancer is a Latin word meaning crab, because cancer metastasizes or spreadsoutward from the original site like the legs of a crab.4. Purine analog chemotherapy drugs and pyrimidine analog chemotherapy drugsare both examples of analogs or drugs that are created by slightly modifying themolecular structure of another substance (in this case purine or pyrimidine). Bothdrugs are used to treat different types of cancer and both keep DNA from beingproduced so the cancer cell cannot divide. They are different because purine analogchemotherapy drugs take the place of the purine base structure in the DNA,while pyrimidine analog drugs take the place of the pyrimidine base structure inthe DNA.5. The molecular structure of methotrexate is very similar to the structure of the B vitamin folic acid.6. During the 1940s, researchers who were reviewing medical records from World War Inoticed that Allied soldiers who were exposed to the chemical weapon nitrogenmustard gas had a decreased level of WBCs. It was thought that this adverseeffect could be used as a therapeutic effect in patients with leukemia whose WBCcounts were abnormally elevated. Nitrogen mustard (the drug mechlorethamine)and its derivative drugs are still used to treat leukemia today.7. Chemotherapy antibiotic drugs are not interchangeable with regular antibioticdrugs. Regular antibiotic drugs are used to treat infection act on the cell walls of bacteria. Human cells, which do not have a cell wall (they only have a cell membrane), are not affected by antibiotic drugs. However, unlike regular antibiotic drugs, chemotherapy antibiotic drugs do affect human cells (and cancer cells).8. The growth of breast cancer is influenced and promoted by female hormone levels.Hormonal chemotherapy drugs change the favorable hormonal environment bysupplying the opposite hormone, male hormone.9. Cisplatin was the first of the platinum chemotherapy drugs. It was discoveredwhen a researcher at Michigan State University was studying whether bacteriacould multiply in an electrical field. He placed platinum electrodes that would conduct electricity into a solution of bacteria.When the electrical field was turned on, the bacteria did not multiply, but they also did not multiply when the electrical field was turned off. He found that it was the platinum in the electrodes that was toxic to the bacteria. This ability to stop a cell from dividing was later applied to the treatment of cancer.10. Chemotherapy enzyme drugs are enzymes that break down the amino acid asparagine. Human cells can synthesize their own supply of asparagine, and so asparagine is not one of the eight essential amino acids that the body needs to produce protein. Leukemia cells, however, cannot synthesize their own asparagine. By breaking down asparagine, the cancer cell cannot use it to build protein and cannot divide.11. Raloxifene (Evista) and tamoxifen (Soltamox).12. Retinoid chemotherapy drugs are structurally related to vitamin A(retinoic acid).Normally vitamin A regulates cell differentiation and growth, particularly in theskin. Retinoid chemotherapy drugs bind to vitamin Areceptors on cancer cells andhelp them become more normal in their cell differentiation and growth.13. Interleukins are proteins that are secreted by white blood cells and act as a signalwhen they encounter bacteria or antigens to tell the immune system to produce morewhite blood cells to combat the infection or inflammation.14. Chemotherapy drugs cause nausea and vomiting because they affect the rapidlydividing cells in the mucous membrane of the GI tract, causing irritation. These drugsalso directly stimulate the vomiting center in the brain. In addition, some chemotherapy drugs cause the release of serotonin inthe small intestine, which stimulates the vomiting reflex.15. Doxorubicin is particularly toxic to the heart. Ifosfamide is particularly toxic to thebladder. Cisplatin is particularly toxic to the kidneys.16. a. Chemotherapy enzyme drugb. Retinoid chemotherapy drugc. Chemotherapy antibiotic drugd. Alkylating chemotherapy druge. Nitrogen mustard chemotherapy drugf. Platinum chemotherapy drugg. Nitrogen mustard chemotherapy drugh. Chemotherapy antibiotic drugi. Aromatase inhibitor hormonal chemotherapy drugj. Granulocyte colony-stimulating factor drugk. Purine analog chemotherapy drugl. Pyrimidine analog chemotherapy drugm. Monoclonal antibody drugn. Gonadotropin-releasing hormone chemotherapy drugo. Protein-tyrosine kinase inhibitor chemotherapy drugp. Topoisomerase inhibitor chemotherapy drugq. Epidermal growth factor receptor inhibitor chemotherapy drugr. Nitrosurea chemotherapy drugs. Folic acid blocker chemotherapy drugt. Estrogen hormonal chemotherapy drugu. Antiestrogen hormonal chemotherapy drugv. Podophyllotoxin chemotherapy drugw. Immunomodulator chemotherapy drugx. Topoisomerase inhibitor chemotherapy drugy. Monoclonal antibody drugz. Chemotherapy antibiotic drugaa. Vinca alkaloid chemotherapy drugClinical Applications Questions1. a. paclitaxelb. Taxolc. taxane chemotherapy drugsd. It allows the microtubules to form, but the microtubules do not function properly,and the cancer cell cannot divide.e. It is a liquid drug contained in a vial that must be withdrawn with a syringe. Theprinting says “Intravenous.”f. The original natural source was extract of the bark of the Pacific yew tree. Now,it is derived from the needles of European and Himalayan yews.g. [Only need to name three.] Daunorubicin and doxorubicin originally were extracted from a fungus-like bacterium found in soil near an ancient castle in Italy. Podophyllotoxin chemotherapy drugs were created from a toxin found in the fleshy root of the Mayapple. Vinca alkaloid chemotherapy drugs were extracted from the Madagascar rosy periwinkle plant. Platinum chemotherapy drugs contain the precious metal platinum.2. doxorubicin (Adriamycin)3. a. Epogenb. epoetin alfac. in units/mLd. It is used to stimulate red blood cell production to treat anemia caused by thecancer itself or by the treatment of chemotherapy drugs or radiation therapy.4. a. Zometab. zoledronic acidc. 4mg/5mLd. Intravenous infusione. It is used to decrease elevated calcium levels caused by cancer and bony metastases. ................
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