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MD2002 > Cancer Chemotherapy > Flashcards

Cancer Chemotherapy Flashcards

1
Q

Give three examples of how cancer can arise.

A

Genetic predisposition
(Ionising) radiation
Chemical carcinogens

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2
Q

Name the three approaches a consultant will consider regarding cancer treatment.

A

Surgical excision
Radiotherapy
Chemotherapy

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3
Q

List the three major differences that exist in cancer cells by comparison to normal body cells.

A

Uncontrolled proliferation
Invasiveness
Metastasis

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4
Q

Name the four type of (traditional) chemotherapy agent.

A

Alkylating Agent
Antimetabolites
Cytotoxic Antibodies
Plant Derivatives

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5
Q

Outline the primary way in which alkylating agents work.

A

INTRASTRAND CROSS LINKING OF DNA

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6
Q

How does intrastrand cross linking of DNA prevent cancer cell division

A

The drug binds to two places on the cancer cell’s DNA, inhibiting cell division and cell proliferation

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7
Q

Where specifically on DNA does the drug bind to?

A

To the 7 nitrogen of guanine residues and alkylates them

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8
Q

What effect does alkylating the residues have and what does this lead to?

A

Makes them more acidic, leading to the formation of ENOL TAUTOMERS, allowing guanine to mis-pair with thymine residues during DNA synthesis, leading to DNA damage being recognised by apoptotic factors and apoptosis being initiated

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9
Q

What are the three major sub-groups of the alkylating agents?

A

Nitrogen Mustards
Nitrosoureas
Platinum Based Compounds

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10
Q

Name all the examples possible of the nitrogen mustards.

A 
CYCLOPHOSPHAMIDE
Chlorambucil
Uramustine
Ifostamide
Melphalan
Bendumustine
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11
Q

What is cyclophosphamide activated by and where is it activated?

A

P450 mixed function oxidases

The liver

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12
Q

What is special about phosphoramide?

A

It is cytotoxic

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13
Q

What is the function of mesna?

A

Counteracts the effects of acrolein (propana)

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14
Q

Outline how nitrosoureas are used and what property they possess that makes them so appropriate for this task.

A

Nitrosoureas are lipophilic so can cross the blood-brain barrier, making them viable for use against tumours of the brain and the meninges

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15
Q

Name all the examples possible of the nitrosoureas.

A 
LOMUSTINE
CARMUSTINE
Semustine
Ethylnitrosourea
Streptozocin
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16
Q

Outline how platinum based compounds act.

A

Cl- dissociates upon entry to cell allowing remaining reactive complex to react with water and interact with DNA causing intrastrand cross-linking between N7 & O6 of adjacent guanine molecules. This leads to local denaturation of DNA chain

17
Q

What is the structure of cisplatin?

A

Central platinum atom surrounded by 2 chlorine atoms and 2 ammonia groups

18
Q

List the three main groups of

A

Antifolates
Antipyramidines
Antipurines

19
Q

Give examples of antifolates.

A

METHOTREXATE

20
Q

Give examples of antipyramidines.

A

5-FU (fluorouracil)

GEMCITABINE

21
Q

Give examples of antipurines.

A

MERCAPTOPURINE
THIOGUANINE
FLUDARABINE

22
Q

Give an example of a platinum based compound.

A

CISPLATIN

23
Q

How do antifolates such as methotrexate act?

A

Blocks the metabolism of folic acid via inhibition of the DHFR enzyme (similar structure to folic acid)

24
Q

Describe the action of antipyramidines.

A

Interferes with DTMP (thymidylate synthesis) which is used in DNA synthesis during the S phase. Thymine is a DNA base of the nucleotide thymidylate so the blocking of the production of this inhibits DNA replication and thus cell proliferation

25
Q

Which compound, similar in structure to a nucleotide, does gemcitabine have a similar structure to?

A

Cytaradine

26
Q

What is the nucleotide that cytaradine is similar in structure to and how is it slightly different?

A

Cytosine - slightly different in that cytaradine has arabinose and not ribose attached

MD2002 (27 decks)

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