Chemotherapy Flashcards
1
Q
Carmustine
A
Indication: cancer
- brain tumours
Class: alkyating agent
Action:
- methyl group forms covalent bond with cell constituents
- carbonium ion is the reactive intermediate
- many have 2 alkylating groups causing cross links
- DNA helix unable to unwind so defective DNA replication
Mechanisms of resistance:
- Decreased entry or increased exit of agent
- Inactivation of agent in cell
- Enhanced repair of DNA lesions produced by alkylation
Side effects:
- vomiting
- alopecia
- thrombophlebitis of veins/extravasation
- mucositis
- cardio toxicity - myopathy, arrythmias
- lung toxicity - pulmonary fibrosis
- haemotological - neutropenic sepsis, anaemia, thrombocytopenia
2
Q
Cisplatin/oxaliplatin
A
Indication: cancer
Class: platinum compound
Action:
- formation of platinated inter and intrastrand adducts
- intrasrand = G-G and G-A
- inhibition of DNA synthesis
Other: oxaliplatin can be used where cisplatin is ineffetive - DACH platinum adducts are bulky so more effective at inhibting DNA synthesis
Side effects:
- vomiting
- alopecia
- thrombophlebitis of veins/extravasation
- mucositis
- cardio toxicity - myopathy, arrythmias
- lung toxicity - pulmonary fibrosis
- haemotological - neutropenic sepsis, anaemia, thrombocytopenia
Specific:
- ototoxicity
- nephrotoxicity
3
Q
5-fluorouracil
A
Indication: cancer
Class: antimetabolite
Action:
- inhibits thymidylate synthase
- prevents synthesis of DNA from pyrimidine
Side effects:
- vomiting
- alopecia
- thrombophlebitis of veins/extravasation
- mucositis
- cardio toxicity - myopathy, arrythmias
- lung toxicity - pulmonary fibrosis
- haemotological - neutropenic sepsis, anaemia, thrombocytopenia
Specific: myelosupression
Interactions:
- capecitabine (oral 5FU) and warfarin
- capecitabine and st johns wort, grapefruit juice
4
Q
Methotrexate
A
Indication: cancer
Class: antimetabolite
Action:
- inhibits dihydrofolate reductase
- inhibits conversion of dihydrofolate to tetrahydrofolate
- inhibits production of purine
- inhibits DNA sythesis
Side effects:
- vomiting
- alopecia
- thrombophlebitis of veins/extravasation
- mucositis
- cardio toxicity - myopathy, arrythmias
- lung toxicity - pulmonary fibrosis
- haemotological - neutropenic sepsis, anaemia, thrombocytopenia
Specific: myelosuppression
Interaction: penicillin, NSAIDs
5
Q
vincristine/docetaxel
A
Indication: cancer
Class: spindle poisons
- vincristine = Vinca alkaloids
- docetaxel = taxoids
Action:
- vinca alkaloids = prevent spindle formation/polymerization
- taxoids = promote assembly, prevent disassembly
Side effects:
- vomiting
- alopecia
- thrombophlebitis of veins/extravasation
- mucositis
- cardio toxicity - myopathy, arrythmias
- lung toxicity - pulmonary fibrosis
- haemotological - neutropenic sepsis, anaemia, thrombocytopenia
Specific: peripheral neuropathy
Interaction: itraconazole (antifungal) = more neuropathy
