Chemo Flashcards
Platinum compounds example, mechanism of action
cisplatin, Inhibition of DNA replication
ototoxicity, nephrotoxicity
antimetabolites
5-Fluorouracil: Inhibit thymidylate synthase, x: warfarin, St Johns Wort, grapefruit juice
Methotrexate: Dihydrofolate reductase inhibitor, blocks purine production
myelosuppression caution with prescribing penicillin, NSAIDs
Vinca alkaloids, spindle poisons
Vincristine
Microtubule assembly inhibitor,
prevent spindle formation, peripheral neuropathy
caution with antifungals
Taxanes, spindle poisons
Paclitaxel
Microtubule depolymerisation inhibitor, – Stimulate polymerization
and prevent depolymerization
Mechanism of Resistance
- Decreased entry or increased exit of agent
- Inactivation of agent in cell
- Enhanced repair of DNA lesions produced by alkylation, Alkylating Agents
vomiting
direct action of chemotherapy drugs on
the central chemoreceptor trigger zone
acute/delayed/chronic
alopecia
vinca alkaloids, cyclophosphamide
thins at 2 - 3 weeks
Help sometimes with scalp cooling
Antiproliferative immunosuppressants:
Cyclophosphamide, hemorrhagic cystitis
Azathioprine, Mycophenolate mofetil
skin toxicity
• Local – Irritation and thrombophlebitis of veins – extravasation General • hyperkeratosis • hyperpigmentation • ulcerated pressure sores
mucositis
• Gastrointestinal tract epithelial damage
• May be profound and involve whole tract
• Most commonly worst in oropharynx
• Presents as
– sore mouth/throat – diarrhoea – G.I. bleed
cardio toxicity
Cardio-myopathy: high dose cyclophosphamide
Arrhythmias
– cyclophosphamide
lung toxicity
– pulmonary fibrosis – beware concurrent radiotherapy high dose oxygen can make it worse bleomycin cyclophosphamide
Haematological Toxicity
dose limiting Most frequent cause of death from toxicity
Different agents cause variable effects on
degree and lineages
– Neutrophils
– Platelets
– Erythrocytes
Neutropenic sepsis
neutropenia
Bleeding and bruising
more prone to infections
anaemia
