Cancer Chemotherapy Flashcards
Types of cytotoxic drugs
Anti metabolites
Alkylating agents
Cytotoxic antibiotics aka intercalating agents
Mitotic inhibitors aka spindle poisons
Name two anti metabolites
Methotrexate
5 FU
Name some Alkylating agents
Platinum compounds eg cisplatin and carboplatin
Cyclophosphamide
Name some cytotoxic antibiotics aka intercalating agents
Anthracyclines eg doxo and dauno rubicin
Bleomycin
Mitotic inhibitors are plant derivatives affecting micro tubules
Name 2 examples and whether they inhibit polymerisation or depolymerisation
Taxanes allow formation then inhibit depolymerisation
Vinca alkaloids prevent polymerisation
MoA of anthracycline antibiotics (part of intercalating agents)
Inhibit topoisomerase II (a DNA gyrase that prevents DNA tangling)
Also intercalate DNA
MoA Bleomycin
Chelates w iron ions producing free radicals (DNA scisson)
Also binds to DNA directly
Alkylating agents only form bonds within cells. Why?
High Cl- concentration outside cells prevents dissociation of the “buffer” chloride attached to the active carbon.
Inside cells, Cl- levels are lower so the Cl- dissociates and the C+ can bind to nucleophilic groups on DNA bases
5 FU MoA
Interferes with thymidylate synthase (part of pyramidine synthesis)
Why is the Log kill ratio important?
Pulses of chemo every 2-3 weeks gives bone marrow cells time to recover while tumour cell numbers still decrease overall
Drug resistance in chemotherapy is a problem, what clinical strategies attempt to offset this?
High dose
Short term
Intermittent repeated therapy
W optimal drug combinations
Give 3 mechanisms of chemotherapy drug resistance
MDRP expression increased (acquired drug resistance)
Inactivation of agents within cells
Enhanced repair of DNA lesions
Name some common chemotherapy ADRs
ALOPECIA, Mucositis
(pulmonary fibrosis, cardio toxicity, renal failure)
NAUSEA/VOMITING, diarrhoea
Myelosuppression
Chemotherapy ADRs due to effect on tumour
Acute Renal Failure (tumour lysis-> hyperuricaemia etc)
GI perforation (at site of tumour eg GIT lymphoma)
DIC (treating AML)
Why is Nausea and Vomiting such an important ADR?
In built deterrent to patient compliance
What is the most frequent dose limiting ADR in chemotherapy?
Haematological toxicity
Most frequent chemotherapy cause of death
Name the chemotherapy drug most likely to cause cardio toxicity
Doxo and dauno rubicin (free radical production)
Name the chemotherapy drug most likely to cause pulmonary fibrosis
Bleomycin
Name the chemotherapy drug most likely to cause hearing loss and other neurotoxic effects
Cisplatin
Name the chemotherapy drug most likely to cause glove and stocking type peripheral neuropathy
Mitotic spindle inhibitors
Anti cancer drug broad classes
Cytotoxic drugs
Hormones
Monoclonal antibodies
Protein kinase inhibitors
