Cancer Chemotherapy

Question 1

Site of action for antimetabolites?

Answer 1

DNA synthesis

Question 2

Site of action for alkylating agents?

Answer 2

DNA

Question 3

Site of action for intercalating agents?

Answer 3

DNA transcription and duplication

Question 4

Site of action for spindle poisons?

Answer 4

Mitosis (metaphase)

Question 5

MoA of alkylating agents?

Answer 5

Impair replication by forming palatinates adducts

Question 6

Example of alkylating agent?

Answer 6

Eloxatin

Question 7

MoA of antimetabolites?

Answer 7

Inhibit folate cycle

Question 8

Example and specific MoA of antimetabolites?

Answer 8

S-Fluorouracil inhibits thymidylate synthase

Methotrexate inhibits dihydrofolate reductase

Question 9

MoA of spindle poisons?

Answer 9

Targets tubulin proteins in mitotic phase so that chromosomes can’t align and separate into daughter cells

Question 10

Examples and specific MoA of spindle poisons?

Answer 10

Vinca alkaloids inhibit polymerisation of tubulin

Taxanes bind irreversibly to tubulin and stabilise the molecule

Question 11

ADRs of spindle poisons?

Answer 11

Neurotoxicity: glove and stocking peripheral neruopathy

Question 12

MoA of glycopetide antibiotics?

Answer 12

Forms free radicals (when chelated with Fe2+) which attack phosphodiester DNA bonds -> DNA cutting

Question 13

Example of glycopeptide antibiotic?

Answer 13

Bleomycin

Question 14

ADR of glycopeptide antibiotics?

Answer 14

Pulmonary fibrosis

Question 15

MoA of anthracycline antibiotic?

Answer 15

Targets DNA synthesis in S phase
Intercalates between base pairs which interferes with transcription
Inhibits topoisomerase
Generates free radicals

Question 16

Example of anthracycline antibiotics?

Answer 16

Doxorubicin

Question 17

ADR of anthracycline antibiotic?

Answer 17

Cardiotoxic

Question 18

MoA of tamoxifen?

Answer 18

Selective oestrogen receptor modulator which acts as an antagonist of oestrogen in breast tissue
Metabolised in liver to active form (prodrug)
Cells remain in G0+G1

Question 19

ADRs of tamoxifen?

Answer 19

Only works if patient is ER positive

Question 20

ADRs of tamoxifen?

Answer 20

Hot flushes/sweats
Increase DVT/PE risk
Weight gain
Increase endometrial cancer risk

Question 21

ADRs of chemotherapy?

Answer 21

Fatigue
Hair loss
Altered taste
Mucositis
Altered bowel habits, nausea, vomiting
Thrombocytopenia (easy bruising/bleeding)
Neutropenia (increased infection risk)
AKI