Chemo Drugs Flashcards
What are examples of alkylating agents?
Cyclophosphamide, chlorambucil, busulfan
What are examples of antimetabolites?
5-fluorouracil, methotrexate, fludarabine
What are examples of cytotoxic antibiotics?
Doxorubicin, bleomycin
What are examples of vinca alkaloids?
Vincristine, vinblastine
What are examples of taxanes?
Paclitaxel
What are examples of tyrosine kinase inhibitors?
Imatinib, nilotinib
What are examples of immunomodulators?
Thalidomide
What are some examples of endocrine modulators?
Tamoxifen, anastrozole, cyproterone
What are common side effects of cyclophosphamide?
Haemorrhagic cystitis - incidence reduced by MESNA (an organosulphate)
BM suppression
Alopecia
What are common side effects of doxorubicin?
Cardiomyopathy
BM suppression
What are common side effects of bleomycin?
Pulmonary fibrosis
What are common side effects of vincristine?
Peripheral neuropathy
What are common side effects of paclitaxel?
Hypersensitivity
Peripheral neuropathy
What are common side effects of 5-fluorouracil?
Mucositis
How would you mx N&V in a patient on chemo?
Regular anti-emetics: not PRN
Especially 5-HT3 antagonists, synthetic cannabinoid and glucocorticoids
How do 5HT3 antagonists work?
Block the 5HT3 area in the postrema (solitary tract nucleus and vagal afferents)
Work synergistically with other anti-emetics (steroids, NK-1)
When would you give 5HT3 antagonists?
Normally before chemo
What are common side effects of 5HT3 antagonists?
Constipation, headache and dizziness
What are examples of 5HT3 receptor antagonists?
Ondansetron, granisetron, palonosetron
How do neurokinin-1 antagonists work?
Block neurokinin-1, blocking effect of substance P.
When would you use an NK-1 antagonist?
Platinum containing regimes
How would you give NK-1 antagonists?
Part of a 3 day course with 5HT3 antagonists and corticosteroids.
What are common side effects of NK-1 antagonists?
Hiccups, constipation, dyspepsia
ALT raise may occur
What are some examples of NK-1 antagonists?
Aprepitant
What are some examples of synthetic cannabinoids?
Nabilone
How do synthetic cannabinoids work?
Mimics tetrahydrocannabinol (THC) Used in resistant chemotherapy unresponsive to other agents
How do glucocorticoids work to combat N&V?
Unclear. Work synergistically with other agents e.g. dexamethasone
Role in preventing delayed emesis (>24 hours after chemo)
What else are glucocorticoids used for in oncology?
Reduce cerebral oedema, cord compression
What is amifostine used for?
Reducing neutropenia and nephrotoxicity associated with cisplatin
Protects against xerostomia during head and neck radiotherapy
How does amifostine work?
Cytoprotective adjunct for DNA-binding chemotherapy
What is G-CSF used for?
Reduction of neutropenia associated with chemo
Should not be used routinely
What is a problem with prolonged use of G-CSF ?
Myeloid malignancy
What is Rasburicase used for?
Prevention and treatment of tumour lysis syndrome
How does Rasburicase work?
Recombinant enzyme which metabolises uric acid
What are side effects of Rasburicase?
Fever
Hypersensitivity reactions
How do you define neutropenic sepsis?
Neutrophil count less than 0.5x10^9 and temp >38 degrees
Or, signs and symptoms consistent with sepsis
How to ix neutropenic sepsis?
Urgent blood cultures
How do you treat neutropenic sepsis?
One hour for treatment!
Tazocin (piperacillin with tazobactam) + early oncology referral
