chemo drugs

Question 1

describe a benign tumour

Answer 1

lacks invasive properties, unable to metastasize, can suppress vital organs

Question 2

describe a malignant tumour

Answer 2

causes loss of organ function, invasive, ability to metastasize

Question 3

describe the cell cycle

Answer 3

mitosis (M) –> growth phase (G1) –> cells no longer dividing (Go) –> DNA synthesis (S) –> further cell division in second growth phase (G2)

Question 4

what is a proto-oncogene?

Answer 4

a normal gene that has the potential to lead to cancer - it can mutate to become an oncogene.

Question 5

objectives of cancer therapy:

Answer 5

cure the patient and eliminate all cancer cells, prolong life by shrinking tumour and alleviating symptoms, palliative therapy to reduce pain and improve quality of life

Question 6

symptoms of cancer?

Answer 6

pain - due to compression of nerves, inhibition of organ function, detection of a solid mass (lump),

Question 7

what are the three ‘compartments’ that a cell occupies in a tumour?

Answer 7

1 - diving cells; susceptible to cytotoxic drugs
2 - resting cells (in Go phase of cell cycle) but capable of dividing
3- cells no longer dividing

Question 8

why can we not rely on the immune system to kill remaining cancer cells?

Answer 8

the immune system is unable to recognise tumour cells as foreign - because essentially they are normal cells that have undergone uncontrolled proliferation

Question 9

toxic effects of chemotherapy?

Answer 9

bone marrow suppression (reduced RBC and WBC), impaired wound healing, hair loss (due to hair follicles rapidly dividing), damage to GI epithelium, stunted growth, sterility, teratogenicity, bleeding/bruising (due to lack of platelets and clotting factors), nausea, vomiting, kidney damage

Question 10

targets for anti-cancer drugs?

Answer 10

hormonal regulation of tumour growth, defective cell cycle controls

Question 11

what are the main classes of anti-cancer drugs?

Answer 11

cytotoxic drugs, hormones, monoclonal antibiotics, protein kinase inhibitors

Question 12

examples of cytotoxic drugs?

Answer 12

alkylating agents, antimetabolites, antibiotics, plant derivatives

Question 13

examples of alkylating agents?

Answer 13

nitrogen mustards, nitrosaureas, platinum compounds

Question 14

function of alkylating agents?

Answer 14

target cells in the DNA synthesis phase to form covalent bonds with DNA and prevent uncoiling and inhibit replication

Question 15

side effects of prolonged use of alkylating agents?

Answer 15

sterility esp in men, increased risk on non-lymphocytic leukaemia

Question 16

examples of antimetabolites?

Answer 16

folate antagonists e.g. methotrexate, pyrimidine analogues e.g. fluorouracil, and purine analogies

Question 17

function of methotrexate?

Answer 17

inhibits dihydrofolate reductase, an essential enzyme for DNA synthesis.

Question 18

function of pyrimidine analogues?

Answer 18

inhibits DNA synthesis by competing with C and T bases of RNA and DNA.

Question 19

function of purine analogues?

Answer 19

compete with A and G bases to inhibit purine metabolism

Question 20

examples of cytotoxic antibiotics?

Answer 20

doxorubicin, bleomycin, dactinomycin, mitromycin

Question 21

side effects of doxorubicin?

Answer 21

can cause cardiac dysrhythmias and heart failure with high doses

Question 22

side effects of bleomycin?

Answer 22

myleosupression, pulmonary fibrosis (10% of patients) and mucocutaneous reactions (50% of patients)

Question 23

what are vinca alkaloids?

Answer 23

plant derivatives. e.g. vincristine, binblastine, vindesine

Question 24

when do vinca alkaloids work?

Answer 24

during the mitosis phase of the cell cycle

Question 25

function of hormones in cancer treatment?

Answer 25

they suppress hormones with opposing actions to inhibit tumour growth. they are used to treat cancers in hormone sensitive tissues such as the breast, ovaries and prostate

Question 26

examples of hormone treatment?

Answer 26

oestrogens (ethinylestradiol), progestogens, GnHR analogues, somatostatin analogues, hormone antagonists, glucocorticoids

Question 27

examples of glucocorticoids used in cancer treatment?

Answer 27

prednisolone and dexamethasone

Question 28

what produces monoclonal antibodies?

Answer 28

hybridoma cells

Question 29

examples of monoclonal antibodies?

Answer 29

rituximab, trastuzumab, oftasumumab, bevacizumab

Question 30

function of protein kinase inhibitors?

Answer 30

block cell signalling pathways in rapidly dividing cells.

Question 31

examples of protein kinase inhibitors?

Answer 31

imatinib, dasatinib, nilotinib

Question 32

how can the side effect ‘nausea and vomiting’ be controlled?

Answer 32

ondansetron / granisetron are serotonin antagonists that are effective against cytotoxic-induced vomiting

Question 33

which side effect can lorazepam treat?

Answer 33

anxiety. it is a benzodiazaepine drug.

Question 34

two types of stem cell transplant?

Answer 34

autologous - stem cells are harvested from patient and infused back after chemotherapy. allogenic - stem cells from a matched donor.

Question 35

function of lenograstim?

Answer 35

a drug that reduces cancer side effects; boosts stem cell production and speeds up the recovery of the immune system