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ONCC Chemotherapy Immunotherapy Certificate Exam.
Typology: Exams
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3 major phases of cell division: - ANS-Interphase Mitotic phase Cytokinesis 3 steps of interphase: - ANS-First growth phase (G1) Synthesis phase (S phase) Second growth phase (G2) 4 phases of mitosis: - ANS-Prophase Metaphase Anaphase Telophase Innate immunity: - ANS-Non-specific response, either:
Define dose intensity - ANS-Amount of drug delivered over time How is relative dose intensity (RDI) calculated? - ANS-By comparing the dose that the patient ACTUALLY received to the planned dose of the standard regimen How do alkylating agents work? - ANS-By causing a break in the DNA helix strand, interfering with DNA replication and causing cell death 3 subcategories of alkylating agents: - ANS-1. Nitrogen mustards
What cardiac protectant medication can be administered prior to doxorubicin? - ANS- Dexrazoxane Significant side effects of doxorubicin are: - ANS-Cardiotoxicity N/V Mucositis Diarrhea Severe myelosuppression Hepatic impairment Secondary cancers Monitoring necessary with bleomycin: - ANS-Pulmonary toxicity Hypersensitivity reactions (esp. in lymphoma patients) Cutaneous reactions Lifetime dose tracking (pulmonary toxicity) Pulmonary fibrosis is possible when the lifetime dose of bleomycin exceeds: - ANS- 400 units What 6 patient characteristics make CINV more likely? - ANS-1. Younger than 50 years
Moderately emetogenic chemo (MEC) causes CINV in patients ___% to ___% of the time - ANS- 30 - 90 Patients on low-potential emetogenic chemo develop CINV ___% to ___% of the time - ANS- 10 - 30 Minimal-risk emetogenic chemo causes CINV less than ___% of the time - ANS- 10 Common IV HEC drugs include: - ANS-Carmustine Cisplatin Cyclophosphamide Dacarbazine Mechlorethamine Streptozosin Common IV MEC drugs include: - ANS-Carboplatin Cytarabine Daunorubicin Doxorubicin Epirubicin Idarubicin Ifosfamide Irinotecan Oxaliplatin Common low-potential IV emetogenic chemo drugs include: - ANS- 5 - FU Cytarabine Docetaxel Etoposide Gemcitabine Methotrexate Mitomycin C Mitoxantrone Paclitaxel Pemetrexed Common minimal-risk IV emetogenic chemo drugs include: - ANS-Bleomycin Bevacizumab Bortezomib Busulfan Cetuximab Fludarabine Trastuzumab Vinca alkaloids
Hx of neutropenia with previous chemotherapy Hx of chemotherapy or radiation treatment Hematologic malignancy Uncontrolled/advanced cancer Lung cancer Define neutropenic fever - ANS-Fever of 101 F or greater one time OR Fever of 100.4 F lasting one hour or longer ANC calculation - ANS-(% polys + % bands) x (WBC)/ Normal WBC count - ANS-4,500-10, Normal neutrophil count - ANS-54%-62% of WBC An ANC of less that _____ is considered a risk for infection - ANS-1, Define thrombocytopenia - ANS-Low platelet count Symptoms of thrombocytopenia - ANS-Petechiae or easily bruising Headaches Hypotension and tachycardia Prolonged bleeding (gums, menstruation) Define anemia - ANS-Deficiency of RBC or hemoglobin in the blood Symptoms of anemia - ANS-Dyspnea Fatigue Dizziness Headaches Acute diarrhea lasts: - ANS- 1 - 2 days and resolves on its own Persistent diarrhea lasts: - ANS- 2 - 4 weeks Chronic diarrhea lasts: - ANS-> 4 weeks Common constipation-causing agents: - ANS-Vinca alkaloids (vincristine and vinorelbine) Thalidomide Lenalidomide Bortezomib Define mucositis - ANS-Inflammation of the mucous membranes lining the digestive tract from mouth to anus
Define stomatitis - ANS-Inflammatory conditions of the mouth specifically AKA oral mucositis Define xerostomia - ANS-Dryness of the mouth caused by damage to or dysfunction of the salivary glands Common diarrhea-causing agents: - ANS-Irinotecan 5 - FU Paclitaxel Dactinomycin Capecitabine Hypersensitivity reaction (HSR) versus anaphylaxis - ANS-HSR- localized tissue injury; generalized Anaphylaxis- severe inflammatory response; systemic; caused by histamine release Immediate HSR can occur: - ANS-Within 5 minutes of start of infusion to 6 hours following infusion Delayed HSR can occur: - ANS-Days or weeks after immediate HSR window Risk factors for HSR and anaphylaxis: - ANS-Administration of a known HSR causing agent Hx of allergies Hx of hypersensitivity or anaphylaxis Premedications not ordered/administered First thing to do if a HSR occurs: - ANS-STOP THE INFUSION IMMEDIATELY Define cumulative dose - ANS-Total dose of an antineoplastic agent or radiation after repeated exposure to the treatment Define single dose - ANS-Recommended dose of one antineoplastic agent given at a single point in time Define course dose (AKA divided dose) - ANS-Recommended dose of one antineoplastic agent given over a defined period of time Define extravasation - ANS-Leak of a drug capable of causing tissue damage from the intended vessel into the surrounding tissue or unintended sites Agents classified as irritants can cause: - ANS-Inflammation Pain
3 aromatase inhibitors - ANS-Anastrozole Letrozole Exemestane Common side effects of aromatase inhibitors (AI): - ANS-Fatigue N/V* Weakness HA* Insomnia Dizziness Hot flashes* Weight gain* Higher cholesterol Increased sweating* Bone/joint pain* Selective ER downregulators (SERDs) MOA - ANS-Binding to and degrading ER Common SERD - ANS-Fulvestrant Selective ER modulators (SERMs) MOA - ANS-Blocking and downregulating ERs *Can function as ER agonists, antagonists, or mixed agonist-antagonists *Can activate or block estrogen Common SERMs - ANS-Tamoxifen Raloxifine Bazedoxifine Antiandrogens MOA - ANS-Keeps androgens from binding to androgen receptors found in prostate cancer cells (and in some other tissue cells) Androgen synthesis inhibitors MOA - ANS-Stop the adrenal glands from producing androgens Common androgen synthesis inhibitors - ANS-Ketoconazole Aminoglutethimide Abiraterone acetate CYP17 inhibitors MOA - ANS-Inhibit the key enzyme that catalyzes biosynthesis of androgens from all sources Common CYP17 inhibitors - ANS-Abiraterone Orteronel
Adrenolytic agents MOA - ANS-Suppress testicular and adrenal steroidogenesis, rapidly reducing testosterone levels Define receptor - ANS-Molecule inside/on surface of a cell that binds to a specific substance and causes a specific effect in that cell Define monomer - ANS-Molecule that can be bonded to other identical molecules to form a polymer Define ligand - ANS-Molecule that binds to a receptor to exert a biologic effect Define ligand bonding - ANS-Process by which ligand attaches to specific receptor site and activates receptor, activating the signaling pathway Define dimerization - ANS-2 monomers that are side-by-side on cell surface are paired and activated by a ligand, which causes a series of signals Define kinase - ANS-Enzyme that adds phosphates to other molecules, causing other molecules in the cell to become either active or inactive Define phosphorylation - ANS-Activation of a chemical process to initiate signaling Targeted therapies work by: - ANS-1. Blocking angiogenesis
mAbs ending in "-omab" source - ANS-Murine mouse Immune checkpoint inhibitors MOA - ANS-Prevent cancer cells from turning off T cells -- > allows T cells to infiltrate a tumor and stop it from growing Immune checkpoint inhibitors initially cause tumors to swell, making it appear as if the tumor is growing. This is called _____________ - ANS-Pseudoprogression 2 main types of cancer vaccines - ANS-Preventative/prophylactic Treatment/therapeutic Nonspecific immunotherapies MOA - ANS-Stimulating the immune system in a general way, hopefully leading to a better immune response against cancer cells Adoptive cell therapy MOA - ANS-T cells collected from patient T cells grown in laboratory This increases amount of T cells able to kill cancer cells or fight infections T cells given back to patient to help immune system Oncolytic virus therapy MOA - ANS-Naturally occurring or genetically engineered virus that can infect and kill a cancer call without harming normal cells Common side effects of immunotherapies - ANS-Fatigue Diarrhea Colitis Musculoskeletal pain Dermatitis Common treatment for immunotherapy side effects - ANS-Corticosteroids Results of immunotherapy agents most commonly occur between ____________ after starting therapy - ANS- 12 - 16 weeks Hierarchy of controls when controlling workplace hazards - ANS-Elimination Substitution Engineering controls Administrative controls PPE 4 different types of medication dosing: - ANS-1. Fixed doses
Weight-based doses
Body surface area (BSA) doses
Area under the curve (AUC) doses